FLCCC I-PREVENT COVID Prevention Protocol 2022

Do any treatments reduce the risk of infection after you've been exposed to someone with COVID-19?

Recent data suggest that therapies like ivermectin, melatonin, naso-oropharyngeal hygiene, quercetin, and Vitamin C may play an important role in helping prevent COVID-19.

The I-PREVENT protocol consists of inexpensive, safe, and widely available medications. Use these therapeutics in conjunction with an overall strategy that includes common sense public health actions like washing your hands, avoiding crowded gatherings, getting adequate ventilation, and other measures.

FLCCC I-Prevent I-CARE

I-PREVENT can be used for both chronic (ongoing) prevention as well as to avoid getting sick after you may have been exposed to the virus. Chronic prevention is especially recommended for healthcare workers, and for high-risk individuals such as those over 60 years old with comorbidities, people who are morbidly obese, and residents of long-term care facilities. Follow the post-exposure prevention instructions if a household member is COVID-positive or if you have had prolonged exposure to the virus or a COVID-positive patient but you have not developed symptoms.

At the onset of any flu-like symptoms, please refer to the I-CARE Early COVID Treatment Protocol.

For additional information on COVID prevention, the rationale behind these medications, and other optional treatments, see A Guide to the Prevention of COVID-19.

The I-Prevent protocol has been updated several times and below is their latest version (version 1.3: June 29, 2022).

I-PREVENT Protocol

The I-PREVENT protocol must be part of an overall strategy that includes common sense public health actions such as good hand hygiene, avoiding crowded public gatherings, adequate ventilation and other measures. The following protocol can be used for both chronic and post-exposure prevention. Chronic prevention is especially recommended for healthcare workers, those over 60 years old with comorbidities, people who are morbidly obese, and residents of long-term care facilities. Follow post-exposure prevention if a household member is COVID-positive or if you have had prolonged exposure to COVID but have not developed symptoms. At the onset of any flu-like symptoms, please refer to the I-CARE Early Treatment Protocol.

CHRONIC PREVENTION (In order of priority; not all required)
  • Ivermectin: 0.2 mg/kg – start treatment with one dose, take second dose 48 hours later, then 1 dose every 7 days (weekly). Those at high risk of contracting COVID-19 can consider dosing twice a week. 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. For COVID treatment, ivermectin is best taken with a meal or just following a meal, for greater absorption. 
  • Zinc: 30-40 mg daily. Zinc supplements come in various forms (e.g., zinc sulfate, zinc citrate and zinc gluconate). 
  • Melatonin: Begin with 1 mg and increase as tolerated to 6 mg before bedtime (causes drowsiness). Slow- or extended-release formulations preferred. 
  • Mouthwash: three times a day. Gargle three times a day (do not swallow) with an antiseptic-antimicrobial mouthwash containing chlorhexidine, cetylpyridinium chloride (e.g., Scope™, Act™, Crest™) or povidone-iodine (e.g. Betadine® Antiseptic Sore Throat Gargle™).
  • Steam inhalation: once a day. Inhaled steam supplemented with antimicrobial essential oils (e.g., Vicks VapoRub™ inhalations) has been demonstrated to have virucidal activity. Antimicrobial essential oils include lavender, thyme, peppermint, cinnamon, eucalyptus and sage. 
  • Vitamin D: dosing varies (see tables below). Vitamin D supplementation is likely a highly effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, (i.e., the elderly, obese, people of color, and those living in northern latitudes). The greatest COVID protection benefit from Vitamin D supplementation will occur in individuals deficient in Vitamin D. Those individuals should take Vitamin D prophylactically on a longer-term basis. When a person with Vitamin D deficiency develops COVID-19, risks increase for developing complications, and Vitamin D supplementation subsequent to infection will have less of a response. Dosing recommendations for Vitamin D supplementation vary widely. The optimal target is over 50 ng/ml; at this level the risk of dying from COVID-19 is extremely reduced. It may take many months or years to achieve optimal levels in patients who are extremely Vitamin D deficient. It is therefore important that the optimal regimen for Vitamin D supplementation for the prophylaxis of COVID-19 is provided promptly, based on baseline Vitamin D levels (see Table 2). If baseline levels are unknown, the needed dose can be calculated from body weight or BMI (see Table 3).
  • 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. 
  • Nigella sativa (black cumin): 80 mg/kg daily and Honey 1 g/kg daily. Note: thymoquinone (the active ingredient of Nigella sativa) decreases the absorption of cyclosporine and phenytoin. Patients taking these drugs should therefore avoid taking Nigella sativa. 
  • Vitamin C: 500-1000 mg twice a day. 
  • Quercetin (or a mixed flavonoid supplement): 250-500 mg daily. 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.
  • Probiotics. Low levels of Bifidobacterium may predispose a person to COVID-19 and increase disease severity. Likewise, COVID-19 depletes the microbiome of Bifidobacterium, which may then increase the severity and duration of symptoms. Kefir (a fermented milk drink) is high in Bifidobacterium and other probiotics that have demonstrated health benefits. Suggested probiotic supplements include Megasporebiotic (Microbiome labs), TrueBifidoPro (US Enzymes) and yourgutplus+.

Table 1. How to calculate ivermectin dose for chronic prevention
Table 1. How to calculate ivermectin dose for chronic prevention

Table 2. How to replenish Vitamin D levels based on baseline levels
Table 2. How to replenish Vitamin D levels based on baseline levels

Table 3. How to calculate Vitamin D dose when baseline not available
Table 3. How to calculate Vitamin D dose when baseline not available


POST-EXPOSURE PREVENTION

If symptoms develop, treat promptly with I-CARE protocol. If symptoms do not develop, resume chronic prevention after one week.
  • Ivermectin: 0.4 mg/kg immediately, then repeat second dose in 48 hours. See Table 1 for help calculating dose. 
  • Hydroxychloroquine (HCQ): 200 mg twice a day for 5 days. 
  • Zinc: 75-100 mg daily. 
  • Melatonin: 6 mg daily, at bedtime. 
  • Mouthwash: three times a day. 
  • Nasal spray with 1% povidone-iodine: two to three times a day. Sprays such as Immune Mist™, CoFixRx™ or IoNovo™ administered 2-3 times per day are recommended in post-exposure prophylaxis and in the early phase of COVID-19 infection. Due to low level systemic absorption, povidone-iodine nasal spray should not be used for longer than 5-7 days in pregnant women. IoNovo™ contains iodine in an amount equivalent to the daily dietary requirement and hence is safe to ingest. 
  • Curcumin (turmeric): 500 mg twice a day for 1 week. Nigella sativa: 80 mg/kg daily for 1 week. 
  • Vitamin C: 1000 mg twice daily for 1 week. 
  • Quercetin: 500 mg twice daily for 1 week. 
  • Probiotics. 
  • B complex vitamins.

Notes:
  • High risk Individuals: > 60 years with co-morbidities (hypertension, diabetes, chronic lung disease, chronic kidney disease), obesity, long term care facilities, etc.
  • Post COVID-19 exposure: To use if a household member is COVID-19 positive, or you have prolonged exposure to a COVID-19 positive patient without wearing a mask.
  • Precautionary Note: Ivermectin has a number of potentially serious drug-drug interactions. Please check for potential drug interaction at Ivermectin Drug Interactions - Drugs.com. The most important drug interactions occur with cyclosporin, tacrolimus, anti-retroviral drugs, and certain anti-fungal drugs. 
  • Precautionary Note: Hydroxychloroquine - Animal studies have revealed evidence of teratogenic effects (fetal harm; embryonic deaths and malformations of anophthalmia and microphthalmia) have been observed in the offspring of pregnant rats who were administered large doses of chloroquine. This drug crosses the placenta - Drugs.com.
  • Due to the possible drug interaction between quercetin and ivermectin (may increase ivermectin levels), these drugs should not be taken simultaneously (i.e. should be staggered morning and night). 
  • Ivermectin is also lipophilic and therefore, bioavailability is maximised on a full stomach; or best to be taken with meal.
  • Vitamin D3 RDA (Recommended Daily Allowance) is 800–1000 IU/day. The safe upper-dose daily limit is likely < 4000 IU/day. Vitamin D deficiency has been associated with an increased risk of acquiring COVID-19 and from dying from the disease. Vitamin D supplementation may therefore prove to be an effective and cheap intervention to lessen the impact of this disease, particularly in vulnerable populations, i.e. the elderly and obese.
  • When Is the Best Time to Take Vitamin D? Morning or Night? It is possible that increasing vitamin D levels during the day may act, in part, as a signal that suppresses melatonin generation (source). Therefore, it's better to take vitamin D (with meal) during the day and melatonin to be taken just before bedtime.
  • It is likely that vitamin C and quercetin have synergistic prophylactic benefit. Quercetin should be used with caution in patients with hypothyroidism and TSH levels should be monitored.
  • Please consult with a qualified doctor and only use human ivermectin. Ivermectin for animals contain excipients (binding and storage compounds such as polyethylene glycol (PEG)) that are known to cause liver failure in high doses. 
  • There have been reports of visual problems associated with ivermectin. However, the effect is minor and transient.
Related: 

Disclaimers: Please do not consider these protocols as personal medical advice, but as a recommendation for use by professional providers. Consult with your doctor, share the information on this website and discuss with her/him. 

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