Ivermectin and BBB Warning - LEXISCAN !!!

I noticed this info in a few places and thought it might be important for us afibbers.

Cardiac stress test drug allows IVM to cross BBB.

Ivermectin Blood Brain Barrier WARNING!
If you are taking ivermectin and getting a cardiac stress test that uses the drug Lexiscan (regadenoson) you are at serious risk (up to death) as Lexiscan inhibits P-glycoprotein pumps.
Adenosine, dipyridamole (Persantine), and dobutamine are widely available pharmacologic agents for cardiac stress testing and should be requested instead.
I am looking up additional information and will add to this post.
Add # 1 - [www.ncbi.nlm.nih.gov]
Add # 2 - Lexiscan is unique in that it is sometimes used intentionally to allow drugs to cross the BBB.
[research.cornell.edu]

[scontent-dfw5-1.xx.fbcdn.net]

Thanks for posting this, NLAMA. I have been a bit worried about this issue - taking ivermectin with a PGP inhibitor (P-glycoprotein inhibitor), which could theoretically enable ivermectin to cross BBB, where it would be very neurotoxic. It works as an anti-parastic by being a neurotoxin on the parasites. We are protected from that effect by BBB. Apparently PGP is essential for maintaining BBB integrity/non-permeability.

According to wikipedia, a variety of drugs are PGP inhibitors, including various heart meds and also widely used SSRI sertraline:

"Some common pharmacological inhibitors of P-glycoprotein include: amiodarone, clarithromycin, ciclosporin, colchicine, diltiazem, erythromycin, felodipine, ketoconazole,[32] lansoprazole, omeprazole and other proton-pump inhibitors, nifedipine, paroxetine, reserpine,[33] saquinavir,[32] sertraline, quinidine, tamoxifen, verapamil,[34] and duloxetine."

[en.wikipedia.org]

In my own case, I am on a cancer drug for leukemia (venetoclax) that is a PGP inhibitor. I can stop it for a few days with no problem/no risk (and that's commonly done if a person is having problems with the drug). So I am wondering how to interface this with my ivermectin usage, which I have not started taking but wanted to for prophylaxis.

I also wonder about the reality of the BBB risk because 3.7 billion doses of ivermectin have been distributed worldwide in last 30 years. Plus the drug has won Nobel prize and is considered extremely safe. Yet with so many other drugs inhibiting PGP... you would think there would be a lot of neurotoxic fatalities from ivermectin if this were serious risk.

I don't know what to think. But will probably halt my venetoclax for a day on each side of any ivermectin dosing.

Kim - there are lists of meds that can be of concern + you have all of CYP3A4 concerns. But for sure avoid Lexiscan it's the most direct way to become a border collie with IVM.

You might consider fluvoxamine - it's better than IVM according to the trials to date.

The data on ivermectin's effectiveness for Covid treatment/prevention is overwhelming now. Not nearly so much data on fluvoxamine.

I do have a call into pharmacy at BC Cancer Agency about drug interaction between venetoclax & ivermectin. But with so many drugs being PGP inhibitors, and so many people worldwide using ivermectin, I don't think IVM would have the great 3-decade-long safety profile and reputation it does if all these many people on PGP-inhibiting drugs were also dying from ivermectin.

But still looking into this!

I have also now put the question to 5 doctors on the Ivermectin MD Team (on MeWe).

Just heard back from pharmacist at BC Cancer Agency (Vancouver) who assured me there is no adverse interaction between ivermectin and my cancer drug venetoclax. But really what that means is no "documented" interaction. Still, I feel reasonably reassured that I'm okay with this.

I have just tweeted at all the ivermectin doctors on twitter I could find. So we shall see if any of them weighs in on this issue of ivermectin levels in brain potentially reaching neurotoxicity if taken with med that inhibits P-glycoprotein, as quite a few common meds do.

From an article: “In conclusion, P-glycoprotein is an integral component of the human blood brain barrier and plays a central role in limiting drug uptake into the brain. Altered expression or function of p-glycoprotein could conceivably allow elevation of brain concentrations of ivermectin and produce severe neurotoxicity. This might arise through a genetic polymorphism in p-glycoprotein or co-administration of ivermectin with a drug or foodstuff that might inhibit this efflux transporter.”

[www.ncbi.nlm.nih.gov]



Edited 1 time(s). Last edit at 02/18/2021 06:10PM by PoetKim.

Just finished my first day of ivermectin - for Covid prophylaxis, not treatment (as I am not sick). And lived to tell the tale! haha! Whew! glad that's out of the way.



Edited 1 time(s). Last edit at 02/22/2021 10:37AM by PoetKim.

Quote
PoetKim
Jut finished my first day of ivermectin - for Covid prophylaxis, not treatment (as I am not sick). And live to tell the tale! haha! Whew! glad that's out of the way.

Good for you! As for side effects, I had none until second dose on day 3. However, they are quite mild and easy to deal with. My entire family and in laws have done multiple doses the last couple of weeks with no issues. Ready to travel now!

Quote
hwkmn05
Good for you! As for side effects, I had none until second dose on day 3. However, they are quite mild and easy to deal with. My entire family and in laws have done multiple doses the last couple of weeks with no issues. Ready to travel now!

Thank for the heads up about the second dose on Day 3. I will be prepared for that tomorrow. Great that your whole family onboard.