For administering ivermectin and hydroxychloroquine, we have seen a recommendation to give the ivermectin on an empty stomach 1 hour prior to a meal, but to give hydroxychloroquine along with a meal. Ivermectin with a fatty meal can reportedly reach higher blood levels and might be less well tolerated in terms of GI complaints, but that might be advantageous and worth trying if tolerated. What is the best dosing regimen when using these together as joint antiviral and anticancer agents?

We see that most people could tolerate having higher blood levels of ivermectin as a consequence of taking it with meals and that would simplify coadministration of these two agents along with a meal. The strategy would be that if side effects happen acutely, to then try giving the ivermectin separately while fasting so that the administration of both could continue. For those who want to be more conservative, the agents could be given as described in your question, with the ivermectin an hour before a meal and then the hydroxychloroquine along with the meal. While this would still deliver the two close enough together to be effective, the reason we would support the more aggressive higher blood level of ivermectin by co-administering them with a meal would be simply to gain the advantage of a higher concentration of drug adding to effectiveness, potentially. That might not always be meaningful, but could in some cases.