Treatment protocols

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I-CARE

Early Covid Treatment

A Guide to Early Treatment of COVID-19

Early treatment is critical and the most important factor in managing this disease. COVID-19 is a clinical diagnosis; a confirmed antigen or PCR test is not required. Treatment should be initiated immediately after the onset of flu-like symptoms. The multiple therapies and drugs in this protocol have different mechanisms of action and work synergistically during various phases of the disease.

About this Protocol

The information in this document is our recommended approach to COVID-19 based on the best (and most recent) literature. It is provided as guidance to healthcare providers worldwide on the early treatment of COVID-19. Patients should always consult with their provider before starting any medical treatment.

New medications may be added and/or changes made to doses of existing medications as further evidence emerges. Please be sure you are using the latest version of this protocol.

A note about anesthesia and surgery:

Please notify your anesthesia team if you are using the following medications and/or nutraceuticals as they can increase the risk of Serotonin Syndrome — a life-threatening condition — when opioids are administered:

  • Methylene blue
  • Curcumin
  • Nigella Sativa
  • Selective Serotonin Reuptake Inhibitors (SSRIs)

For more information on nutritional therapeutics and how they can help with COVID-19, visit our guide to Nutritional Therapeutics.

For more information on vitamins and nutraceuticals during pregnancy, visit our guide to Vitamins and Nutraceuticals During Pregnancy.

First Line Therapies

(In order of priority; not all required.)

  • Ivermectin: 0.4 to 0.6 mg/kg – one dose daily for at least 5 days or until symptoms resolve.
    If symptoms persist longer than 5 days, consult a healthcare provider. See Table 1 for help with calculating correct dose. Due to a possible interaction between quercetin and ivermectin, these drugs should be staggered throughout the day (see Table 2). For COVID treatment, ivermectin is best taken with a meal or just following a meal, for greater absorption.

  • Hydroxychloroquine (HCQ): 200 mg twice a day for 5 to 10 days.
    Best taken with zinc. HCQ may be taken in place of, or together with, ivermectin. While ivermectin should be avoided in pregnancy, the FDA considers HCQ safe in pregnancy. Given the pathway used by the Omicron variant to gain cell entry, HCQ may be the preferred drug for this variant.

  • Mouthwash: 3 times a day.
    Gargle three times a day (do not swallow) with an antiseptic-antimicrobial mouthwash containing chlorhexidine, cetylpyridinium chloride; a combination of eucalyptus, menthol, and thymol; or 1% povidone-iodine. Some mouthwashes may contribute to temporary tooth staining in certain individuals. Discontinue use and try a different product if this problem arises.

  • Nasal spray with 1% povidone-iodine: 2-3 times a day.
    Do not use for more than 5 days in pregnancy. If 1% product is not available, dilute the more widely available 10% solution (see box) and apply 4-5 drops to each nostril every 4 hours.

    • Pour 1 ½ tablespoons (25 ml) of 10% povidone-iodine solution into a 250 ml nasal irrigation bottle.
    • Fill bottle to top with distilled, sterile, or previously boiled water.
    • To use: tilt head back, apply 4-5 drops to each nostril. Keep head tilted for a few minutes, then let drain.

  • Quercetin (or a mixed flavonoid supplement): 250-500 mg twice a day.
    Due to a possible interaction between quercetin and ivermectin, these drugs should not be taken simultaneously (i.e., should be staggered at different times of day.) As supplemental quercetin has poor solubility and low oral absorption, lecithin-based and nanoparticle formulations are preferred.

  • Nigella sativa: If using seeds, take 80 mg/kg once a day (or 400 to 500 mg of encapsulated oil twice a day).

  • Melatonin: 5-10 mg before bedtime (causes drowsiness).
    Slow- or extended-release formulations preferred.

  • Curcumin (turmeric): 500 mg twice a day.
    Curcumin has low solubility in water and is poorly absorbed by the body; consequently, it is traditionally taken with full fat milk and black pepper, which enhance its absorption.

  • Zinc: 75-100 mg daily.
    Take with HCQ. Zinc supplements come in various forms (e.g., zinc sulfate, zinc citrate and zinc gluconate).