reading both the original tweet the FDA and the advisory it links to it the FDAâ(TM)s message sounds appropriate.
The tweet is directed at lay-people and is informal and very short, but it does not say anything technically incorrect.
The advisory [1] clarifies some of the questions/complaints that some of the posters have raised:
> the FDA has received multiple reports of patients who have required medical attention, including hospitalization, after self-medicating with ivermectin intended for livestock.
Thus pointing to the main issue endangering patients is the diversion of medicine for livestock (or fish in one case I think) to human use.
The advisory also states explicitly that ivermectin is packaged and dosed for human use and that if you (the patient) is prescribed ivermectin, then you should fill the prescription at a legitimate pharmacy (for humans) and take it exactly as directed by your doctor.
Of note, ivermectin can be a useful medicine in humans. The most dramatic example I can think of is that it is used in preventing river blindness [2] which caused by parasitic infection and which can be a major cause of blindness in some places.
Of course ivermectin has side-effects, some serious. Also, like many medicines it can be a poison in excessive doses.
Regarding the conspiracy theories:
All doctors I know (and the FDA too) would have loved for it to be an effective treatment for covid-19. Multiple trials were done at with money, effort and patientâ(TM)s health put on the line. I believe the FDA even gave emergency authorizations for these trials. [can someone check this]
Unfortunately, it turned out that ivermectin didnâ(TM)t work to improve patients health in any of the well designed trials.
Doctors can use medicines âoeoff labelâ . But the ethics and practice of such off-label use varies widely based upon the context. It is a complicated issue.
This article by Furey and Wilkins in the AMA Journal of Ethics [3] had a nice summary statement:
> Off-label prescribing is a common and legal practice in medicine. This practice is justified when scientific evidence suggests the efficacy and safety of a medication for an indication for which it does not have FDA approval and when the practice is supported by expert consensus or practice guidelines. Through shared decision making, patients and families are equal partners in clinical decision-making processes, which can help a physician carefully weigh risks and benefits of a given treatment according to the patientâ(TM)s unique circumstances.
References:
[1] fda advisory that the tweet links to : https://www.fda.gov/consumers/consumer-updates/why-you-should-not-use-ivermectin-treat-or-prevent-covid-19
[2] river blindness (onchocerciasis) https://www.cdc.gov/parasites/onchocerciasis/treatment.html
[3] Furey and Wilkins. 2016. Prescribing âoeOff-Labelâ: What Should a Physician Disclose? AMA Journal of Ethics https://journalofethics.ama-assn.org/article/prescribing-label-what-should-physician-disclose/2016-06#:~:text=Off%2Dlabel%20prescribing%20is%20a,expert%20consensus%20or%20practice%20guidelines.