Why Ivermectin Plus Fluvoxamine?

SARS-CoV-2 AND IVERMECTIN

CORONAVIRUS

Coronavirus (CoV) belong to a larger family Coronaviridae, within the order of Nidovirales. Several human pathogenic strains (HCoV) cause mainly respiratory disease, some cause a mild cold and others lead to severe infection. Fatal infections are caused mostly by SARS-CoV and MERS-CoV, having 10% and 39% mortality, respectively. COVID-19 causes immediate illness and "Long-Haul Syndrome" that leaves patients chronically ill for months and months.

The SARS-CoV outbreak in 2002-2003 caused over 8,000 infections and 800 deaths; the 2012 Middle East respiratory syndrome (MERS) outbreak had about 2,500 cases and over 800 deaths; the World Health Organization daily report shows the current Coronavirus Disease 2019 (COVID-19) pandemic has over 15 million confirmed cases and over 600,000 deaths to date, as of July 26, 2020. Officially, the severe respiratory illness caused by the late December 2019 novel coronavirus is named Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2).

There is no effective treatment for COVID-19. A big effort to develop a vaccine requires significant time and safety testing, and not everyone will or can take a vaccination. All vaccine trials omitted patients with anaphylaxis or severe allergies from the testing. If you are allergic to many medications, have had anaphylaxis or used an EpiPen for a swollen airway in the past, the vaccine may not be for you. 

There must be other options for the general population, as well as at-risk first responders. For this reason, and to keep you out of the hospital, the Front Line COVID-19 Critical Care Alliance (www.FLCCC.net)  developed the I-MASK+ Protocol that uses Ivermectin and now fluvoxamine to diminish the threat of COVID deaths. Fluvoxamine has been added to prevent severe illness and avoid Long-Haul Syndrome.

Do you already know that you want to go on ivermectin + fluvoxamine? 

YOUR FIRST STEP: Get medical equipment to send us your vital signs: 

1. Thermometer

2. Blood pressure cuff

3. Pulse Oximeter

4. Weight scale

Why are these so important? Because every doctor, once getting these numbers from you, evaluates the rest of your appointment based on this. It helps determine how sick you are, most especially whether you can be treated at home or if instead, you need to be seen in person and/or go to the hospital.

Note that Dr. Margaret Aranda is one of several doctors in the US who writes prescriptions for ivermectin. Per the new FLCCC Recommendations on the I-MASK+ Protocol, she prescribes ivermectin + fluvoxamine for optimal protection of mild illness or a positive COVID-19 test. Take ivermectin for prevention, and save fluvoxamine in case you get mild COVID-19 symptoms or newly test positive for COVID-19.

Before your appointment, you first need to take your own set of vital signs at home. This includes your weight, temperature, blood pressure, heart rate, and oxygen saturation. To do this, you can purchase medical equipment from a drug store, Amazon, or order a TELE-KIT® from us. And because we know you need your TELE-KIT® ASAP, we will get your shipment out to you within 24 business hours of the day your order is placed.

Ivermectin. The Front Line COVID-19 Critical Care Alliance (FLCCC) developed ivermectin protocols for both the prevention and treatment of COVID-19. On April 28, 2021, Dr. Pierre Kory announced during the FLCCC Weekly Update Wednesday evenings at 6 pm (PST) new updates.

April 28, 2021 I-MASK+ PROTOCOL UPDATE:

PREVENTION PROTOCOL: IVERMECTIN

1. Food. Take ivermectin with a fatty meal; increases absorption 2-3 times.
2. High risk. One dose Day 1 and 3, then once per week. This is an increase from once every 2 weeks.
3. Post-COVID-19 Exposure for Household Member. Living with a household member that is COVID-19 positive? Take one dose on Day 1 and 3, as soon as possible. 
4. Take Supplements:

• Vitamin D3 1,000–3,000 IU/day (We suggest it is better absorbed with Vitamin K2)
• Vitamin C 500–1,000 mg twice a day 
• Quercetin 250 mg/day (Our modification is that you may substitute for 3-5 cups green tea, no sugar please). This is a new addition. 
• Zinc 30–40 mg/day 
• Melatonin 6 mg before bedtime (causes drowsiness)

PREVENTION PROTOCOL: FLUVOXAMINE

Fluvoxamine is not on the Prevention Protocol, and we defer to the FLCCC on this. See below for the Early Outpatient Treatment Protocol; connect to get fluvoxamine ASAP case of 1) mild COVID-19 symptoms or 2) newly turning positive on a COVID-19 test. 

For these reasons, we like to prescribe 20 doses of ivermectin: enough for low-risk patients mostly at home to take every 2 weeks; the supply then lasts almost 40 weeks. Therefore, your doctor's appointment is like getting two appointments in one: ivermectin for prevention now, and ivermectin enough to take for 5 days in a row.

EARLY OUTPATIENT TREATMENT PROTOCOL

1. Ivermectin. Up to double the dose (0.2-0.4 mg/kg or 0.09 - 0.18 mg/lb) as needed for high-risk exposure, as is living in California or New York, South Africa, India, or the UK. This is why you need a pulse oximeter at home: so your oxygen levels can severity of illness can be best assessed. 
2. Ivermectin frequency. Increase the frequency to 1 time per week for the following:

              A. Aggressive-variant areas. California, New York, South Africa, and more.

              B. Late treatment. On or after Day 5 of sickness, 

              C. Pulmonary phase. This is a later stage associated with the cytokine storm.

              D. Comorbidities. Diabetes, COPD, chronic illness, organ dysfunction.

              E. Risk factors. High-exposure contact: first responders, teachers, travel.

Take Supplements:

• Vitamin D3 4,000 IU/day (We suggest it is better absorbed with Vitamin K2)
• Vitamin C 500–1,000 mg twice a day 
• Quercetin 250 mg twice a day.This is now a double-dose.
• Zinc 100 mg/day 
• Aspirin 325 mg/day unless contraindicated
• Pulse oximeter. Use it to monitor oxygen saturation.

NEW MEDICATIONS ADDED

1. Fluvoxamine. Add fluvoxamine, 50 mg tablets twice a day for 7-14 days.   

     If the patient is already on an SSRI like Prozac, do not add another one.

2. Add Chlorhexidine/benzydamine mouthwash gargle 

3. Add Betadine nasal spray 2-3 x/day.

4. Essential oil inhaler. Use a steamed, essential oil inhaler 3 times a day, such as vapo-rub to protect the nasopharynx, which has high viral concentrations. 

If you have a story of how ivermectin has worked on yourself, a patient, or a loved one, use #ivermectinworks. If you have adverse events from any drug that harms you, report it to the FDA Adverse Event Reporting System (FAERS). You may also contact the FLCCC for any side effects of ivermectin, fluvoxetine, or any drug.

Iverectin is not experimental or unsafe. It has been used on literally billions of people for 46 years. It is FDA approved for onchocerciasis and strongyloidiasis as an anti-parasitic drug. It is anti-viral, anti-inflammatory, and both clinicians and researchers have discovered how to use it for COVID-19  as an adjunct in breast cancer therapy. 

TOP 10 FACTS ON IVERMECTIN

1. Worldwide, it has been used safely since 1975
2. It won the Nobel Prize in 2015 and eradicated parasitic infections in several countries
3. It is on the WHO’s 2019 List of Essential Medicines
4. It has been given safely 3.7 billion times around the world
5. There is growing published medical evidence showing ivermectin’s highly potent capability to inhibit SARS-CoV-2 replication and suppress inflammation
6. The I-MASK+ protocol was created by the FCCCA, a group of critical care doctors caring for patients with COVID in the ICUs. They are tired of watching patients suffocate on ventilators and want you to stay out of the hospital. The I-MATH+ protocol uses ivermectin for hospitalized patients. 
7. As of January 14, 2021, the NIH no longer advises against the use of ivermectin for COVID-19. Now, they are "neither for nor against" it's use, an upgrade
8. Specifically, the NIH now says regarding Ivermectin that "there are insufficient data to recommend either for or against" using it against COVID-19; they await further studies
9. Ivermectin is a clear therapeutic option for patients
10. It is felt by FLCCC that placebo-based controlled trial studies are unethical because every patient should be given ivermectin and no one should die without it

Ivermectin is also known by many trade names throughout the world, such as Stromectol. It is an anti-parasitic medication in the class of antihelmintics. Generic ivermectin is known as ivermectol, manufactured by Ochoa Laboratories Ltd.  Ivecop is manufactured by Invida, and Scavista is manufactured by Zuvista (Zuventus Health Care Ltd).  Edenbridge pharmaceuticals also manufactures generic ivermectin.

Ivermectin comes in three strengths: 3 mg, 6 mg and even 12 mg tablets.

Since all pharmacies are back-ordered with ivermectin (the manufacturers are not), it is difficult to find a pharmacy that has it. Some pharmacies can compound it, creating capsules by hand out of ivermectin powder that is for human, not veterinary, use.

The cost of ivermectin has skyrocketed in many countries, due to its increased use. Be aware that there are reportedly "fake" ivermectin sellers, as well. Be sure to get your ivermectin from a credible source. 

You have your vital signs, are pre-registered, and now it is time to email us! 

After invading a cell, the SARS-CoV-2 virus emits cargo or particles. These particles are actually an enzyme molecule that goes into the human nucleus by a protein complex and instructs it not to defend itself. The surrounding cells then are indefensible. 

Thus, SARS-CoV-2 invades the nucleus, bypasses the body’s immune system and allows SARS-CoV-2 to run rampant through all cells.

The SARS-CoV-2 particles are brought into the nucleus by our bodies’ protein complex, and they enter the nucleus together. 

While ivermectin has a very safe profile, common side effects of ivermectin include dizziness, headache, muscle pain, kidney and liver issues. Testicular dysfunction and infertility have been described. Those with allergies, asthma or liver disease should use special care. If ivermectin kills internal parasites, dying microbes release toxins; some gastrointestinal complaints include nausea, soft stool, diarrhea and abdominal pain. 

Multiple soft stools are a common side effect. Many experience increased gas or flatulence at the onset of treatment; this usually disappears after the first weeks. Interestingly, the SARS-CoV-2 virus resides not only in the nasalpharynx and lungs, but also the gut. Long after lung and mouth/nasal problems resolve, it is still detectable in the stool. Those with irritable bowel syndrome, IBD, have particular concerns on how to manage their biological therapies.

Drowsiness: Some have reported drowsiness and take their dose at bedtime. Rarely, adverse side effects include seizure and hypotension, seen at super high doses not used on the I-MASK+ Protocol. 

Do not operate machinery, drive or do any activity that requires alertness until you are sure you can safely do so. Limit alcohol consumption, especially if you have liver dysfunction. Note that ivermectin passes through breast milk and in third world countries, has been used to treat both mom and baby for decades.

Pain: Anecdotal reports state some patients have less pain from such conditions as spondylolysis and arthritis, as well as knee pain; both increased and decreased cervical lymph nodes have been reported. 

“River blindness:” or onchocerciasis, reactions may include eye swelling, pain or redness; fever; joint pain; rash or itching; tender or swollen lymph nodes and vision changes. These patients may also experience the most abdominal pain as the parasite particles and toxins are eliminated through the stool.

Liver: Some take ivermectin with selenium and/or vitamin E to protect against hepatic and renal toxicity. Low selenium levels are associated with higher COVID-19 mortality, as selenium redistributes both Vitamin D and dexamethasone from liver storage to the immune system. If you are low on Vitamin D, you should also consider taking a selinium supplement. Not everyone absorbs all Vitamin Ds, so be sure to read that section. 

Selenium: Talk to your doctor about selenium supplementation, which may be preferred for those with low Vitamin D and/or liver dysfunction.

REFERENCES:

American Gastroenterological Association (AGA). Management of patients with IBD during the COVID-19 pandemic. https://aga-cms-assets.s3.amazonaws.com/20204915614---Coronavirus%20IBD%20CPU%20digital%20graphics_Flowchart_FINAL.pdf. Accessed May 27, 2020.

Rubin DT, Feuerstein JD, Wang AY, et al. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: expert commentary. Gastroenterology. Published online April 10, 2020. https://www.gastrojournal.org/article/S0016-5085(20)30482-0/pdf. Accessed May 27, 2020. 

Coronavirus and IBD reporting database. COVIDIBD website. https://covidibd.org/. Last updated May 26, 2020. Accessed May 27, 2020.

Ivermectin works in many different ways to protect against COVID-19. 

In parasitic worms, ivermectin paralyzes worm muscles, causing loss of breathing. It kills both endoparasites and ectoparasites, making it in the class of an endectocide. The mechanism of action is on glutamate channels. In worms, ivermectin acts on these gated channels, acting in both nerves and muscles to cause uncontrolled chloride ions to flood into the cells, causing paralysis and death.

In one mechanism against SARS-CoV-2, ivermectin is not antiparasitic. It prevents the spiked protein complex from carrying SARS-CoV-2 particles into the nucleus. If the virus cannot cross into the nucleus, it cannot instruct the immune system to remain dormant. 

Oppositely, ivermectin allows the nucleus to ramp up its defenses and fight SARS-CoV-2. The nucleus defends itself, producing interferons that instruct other cells to be alert against SARS-CoV-2 invaders. This mounts a good immune response and antibody production, similarly to what vaccines do, i.e. cause antibodies to form.

After exposure, it can take from 2-14 days to get sick. Some have reported sickness after 28 days, and the mean average time is 5.1 days. Variability is related to one’s immune system. 

This is key to understanding the dosing regimen for ivermectin. If it is dosed on Day #1, SARS-CoV-2 may be inactivated. However, in some people the virus does not start replicating until Day #3 or Day #14, which is why the second and third doses are spread apart. 

Additionally, the half-life of ivermectin is 18 hours, so splitting the dose in two not only decreases side effects but also brings the opportunity to work against the virus for a long time and in different phases of the virus' life cycle. 

Here is a link of a review of emerging evidence demonstrating the efficacy of ivermectin in both the prophylaxis and treatment of COVID-19. Properties of ivermectin are listed here and include the following:

· Ivermectin inhibits the replication of many viruses, including SARS-CoV-2 and the flu.

· It is anti-inflammatory and therefore may decrease pain.

· It decreases viral load and protects against organ damage in animals.

· When taken either pre- or post-exposure, ivermectin prevents COVID-19 transmission.

· It hastens recovery, decreases hospitalization and mortality in patients with COVID-19.

· Ivermectin leads to far fewer COVID fatalities in regions where it has been widely used.

* It works against any variant, unlike vaccinations that do not necessarily do so.

The total number of studies done on ivermectin for COVID-19 include 27 controlled trials in 6,612 patients placed in well-matched control groups. There are 16 trials with over 2,500 patients in prospective, randomized, controlled studies. 11 of the 27 trials are published in peer-reviewed journals. An estimated 3,900 more patients have been in trials that are in press.

A meta-analysis by an independent research consortium calculated the chances that ivermectin is ineffective in COVID-19 to be 1 in 67 million. The FLCCC Alliance, based on evidence totality, supports an “A-1” recommendation in the NIH rating scheme, showing strong level, high-quality evidence in both the prophylaxis and treatment of all phases of COVID-19. Finally, multiple, population-wide ivermectin distribution program data show a significant reduction in cases and mortality rates.

There are two protocols for outpatients: 

1) Prophylaxis or Prevention: for when you are not yet sick, and 

2) Early Treatment for when you are sick or turn COVID+. This includes a mild cold with loss of smell or taste.

I-MASK+ PROPHYLAXIS:  May repeat one dose every 1-2 weeks

Ivermectin 

High-risk individual prophylaxis: 0.15 - 0.2 mg/kg per dose; one dose  today, 2nd dose in 48 hours, then one dose every 1-2 weeks (this  recommendation is constantly updated); for co-morbidities and the elderly. The half-life of ivermectin is 18 hours, which is why one day is skipped. 

For 70 kg weight, one dose may be split into 6 mg twice a day. We highly recommend splitting the dose in two per day (i.e., every 12 hours) it is taken, because it lasts for 18 hours and by adding 12 hours to that, the dose is extended out to 30 hours to stop SARS-CoV-2, the COVID-19 virus, from multiplying itself.

After COVID-19 exposure prophylaxis: 0.2 mg/kg per dose; one dose today, then 2nd dose in 48 hours; use if a household member is COVID-19  positive, or for prolonged exposure. For 70 kg weight, one dose may be split into 6 mg twice a day.

I-MASK+ PROPHYLAXIS

Ivermectin: One tablet on Days #1 and #3, then one tablet every week

Melatonin 6 mg before bedtime for sleepiness 

Ascorbic acid (Vitamin C) 1000 mg twice per day

Vitamin D3 + K2 1000 – 3000 IU per day Vitamin D3

Quercetin 250 mg per day (also drink green tea)

Zinc 50 mg per day

I-MASK+ EARLY OUTPATIENT TREATMENT: May repeat one dose every 1-2 weeks

This is the most common dosing for those who are sick with suspected COVID-19.

Ivermectin 0.30-0.40 mg/kg dose (up to double that previously used); one dose daily for 5 days.

Ivermectin: One regular dose to a double-dose for 5 days, then 1-2 times per week. That means if you wake up on Day #2 and feel well, you still have to take another dose. That also means that if you wake up on Day #6 and are still sick, you should not take another dose because it is not working - consider adding fluvoxamine, doxycycline antibiotic, inhaled steroid and/or prescription-strength supplements.

Melatonin 10 mg before bedtime

Ascorbic acid (Vitamin C) 2000 mg, 2-3 times per day

Vitamin D3 + K2 4000 IU per day 

Quercetin 250 mg per day or may drink macha green tea (ECGC) or Brazilian tea, 3-5 cups per day

Zinc 100 mg per day

Aspirin 325 mg per day, unless contraindicated

Pulse oximeter: Watch for a downward trend. Note that 94% saturation should be regarded as ominous and you should go to the hospital or call 911 for breathing difficulties

Home monitoring with pulse oximetry is recommended for COVID-symptomatic patients. Be aware that low oxygen levels can otherwise be impossible to detect, as the patient may have no hypoxic symptoms, i.e., may feel just fine when something grave is happening to the lungs.

Home pulse oximeters have limitations and it is preferred to use a validated device that is FDA approved. Take multiple readings throughout the day, watching for downward trends that require 911 or hospitalization. Most believe that a baseline less than 94%, or a saturation of 94% upon walking is a reason to hospitalize. 

Warm a cold extremity and take off nail polish prior to using. Use the middle or index finger; avoid toes or the ear lobe. Only believe values that also give a strong light with each pulse, i.e., a strong pulse signal. Take a reading for 30-60 seconds, and use the most common number. 

Supplements are regulated by the Food and Drug Administration (FDA) as a food. The Dietary Supplement Health and Education Act of 1994 allows that dietary supplement manufacturers do not need FDA approval; instead, the manufacturer is responsible to ensure their products are safe. 

The FDA cannot test every product to ensure it does not contain potentially harmful additives or fillers, including cancer-causing ones. In the case of Vitamin D, beware that even if you are taking a vitamin D supplement, there may not actually even be any absorbable Vitamin D in it, and your blood level may still show an abnormally low level. 

Additionally, Vitamin D needs help to be absorbed by the body. We recommend our patients use a proprietary blend made exclusively for physician-grade purposes. Get Vitamin D3 plus Vitamin K2, which helps increase absorption. If after 3 months of a good product your blood level does not go up, you may need a higher dose or absorbability, i.e., an injectable or topical route. To optimize absorption, take Vitamin D, a fat-soluble vitamin, after eating high-fat food or after a meal. In general, many doctors recommend taking 800 IU of Vitamin D3 per day.

Gut absorption is a factor in Vitamin D3 supplementation, because it is absorbed in the small intestine, just after passing the stomach. Things that influence absorption include stomach juices and pH, secretions from the pancreas and gallbladder, liver bile, and small intestine integrity. The following diagnoses can limit Vitamin D3 absorption: celiac disease, Crohn’s disease, cystic fibrosis, chronic pancreatitis, liver dysfunction, kidney disease, and gastroparesis. In end-stage kidney disease, Vitamin D levels are undetectable. 

DISCLAIMER:

The I-MASK+ Prophylaxis & Early Outpatient Treatment Protocol for COVID-19 and the MATH+ Hospital Treatment Protocol for COVID-19 are only for informational and educational purposes, and is not medical advice. Never disregard professional medical advice due to something you read on the internet. This is not intended to be a substitute for professional medical advice, diagnosis, or treatment in regards to any specific patient. Treatment for an individual patient should always rely on the judgement, opinion, and advice of your personal physician or other qualified health provider. Always seek their specific advice with your questions about your health or medical condition. 

NOTE: Dr. Aranda may receive a small commission on Metagenics supplements purchased from this website.

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Arévalo AP, Pagotto R, Pórfido J, et al. Ivermectin reduces coronavirus infection in vivo: a mouse experimental model. bioRxiv. 2020; Preprint. 

Callan N, Hanes D and Bradley R. Early evidence of efficacy for orally administered SPM-enriched marine lipid fraction on quality of life and pain in a sample of adults with chronic pain. J Transla Med 18:401. Oct 21, 2020.

Caly L, Druce JD, Catton MG, Jans DA and Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Research 178, 104787, June 2020.

Campbell WC, Fisher MH. Stapley EO, Albers-Shönberg G, Jacob TA. Ivermectin: a potent new antiparasitic agent. Science. 1983 Aug 26; 221(4613): 823-828. 

Chamie-Quintero, J and H, J and Scheim, D. Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments (January 12, 2021). SSRN Jan 21, 2021. 

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Aranda MD Enterprises wants to keep you in the family. After you have suffered from a post-viral syndrome like COVID-19, lower back pain, adrenal or other hormone issues, we can help.

Dr. Margaret Aranda is a Keck-USC and Stanford-trained anesthesiologist with subspecialty training in critical care. Her PhD is in forensic science; her thesis was on women's health. After doing operating room and intensive care at the University of Pennsylvania, she was Assistant Professor in three departments: Anesthesiology and Critical Care, Surgery and Traumatology, and Radiology. As Interim Chief of Anesthesiology at the University of Pennsylvania's Philadelphia VA Medical Center during 911, she optimized veteran's health care outcomes and spearheaded several patient protocols. As an Attending Physician at the David Geffen UCLA School of Medicine, she again served our Veterans as Director of the Surgical Intensive Care Unit at the West Los Angeles VA Medical Center.

Dr. Aranda has been practicing medicine for over fifteen years. Her services include pain management in a caring manner for patients with a type of chronic pain that is never going to change, age management, weight control, hair loss, and regenerative medicine. She now helps patients avoid hospitalization and death due to COVID-19, by prescribing ivermectin through the I-MASK+ Protocols for Prevention and Outpatient Treatment. Her seventh book, Guidebook to Low Back Pain: Diagnosis and Treatment, centers on the management of failed back syndrome and describes her current protocol that both patients and physicians can understand.

Now a traumatic brain injury survivor after a tragic accident with her daughter, Dr. Aranda understands pain and disability. She has personal insight into rejuvenating you back to a your best possible  health. Her most recent publication is The Rebel Patient™ book. 

Dr. Margaret Aranda is a member of the following Societies:

Invisible Disabilities™ Association (IDA), Vice Chair

American Medical Association, Member

American Society of Anesthesiologists, Member

California Society of Anesthesiologists, Member

Tucked away in the mountains of southern California, Dr. Aranda is a devoted mother of two who stays active writing, cooking, and training Buddha, her relaxed German Shepherd.