Multicenter double-blind RCT with 100 hospitalized patients in Bulgaria showing faster viral clearance, greater clinical improvement, and improved biomarkers with treatment. Limited data has been reported currently. No serious adverse events were observed.

Authors administered ivermectin on an empty stomach. Ivermectin is a lipophilic drug with low aqueous solubility and is better absorbed when given with food, especially high-fat meals. Administration with a high-fat meal can significantly increase plasma and tissue concentrations (~2.5x plasma concentration in Guzzo) and reduce time to onset of action. Standard practice for systemic use of ivermectin is administration with food (for intestinal parasitic infections, systemic distribution may not be required). Specifying fasted administration may avoid or delay the attainment of therapeutic concentrations and raises concerns about possible investigator bias.

This is the 21st of 54 COVID-19 RCTs for ivermectin, which collectively show efficacy with p=0.000000027.

This is the 43rd of 106 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001.