I am concerned about recommending people take 12 mg of ivermectin daily for 3 weeks (along with hydroxychloroquine). Was I over-influenced by having that interchange with [Name Withheld] about “his protocol” to believe that giving both compounds would effect a viral cleanout? Was this a lesson to me about being more thorough, knowing as I investigated the literature about appropriate doses of ivermectin I would see the pharmacokinetic data, revealing the inability of oral administration to reach antiviral concentrations? What is most important for me to know?

This was not an object lesson for you or a wake-up call. We would not have risked your doing something potentially explosive by ignoring an opportunity to weigh in were you misguided in the first place. You, indeed, asked us about the appropriateness of using ivermectin and was reassured that would be useful. So you did not simply swallow Jason's projection of possibility and run with it, but were indeed cautious and careful in your usual high-standard fashion, to go incrementally and be sure at each step you are moving in the right direction. So you get a high mark from us for how this all came about. You were simply unaware of the science suggesting a possible liability and even negating, potentially, the wisdom of proceeding. There are certainly other situations where drugs have high protein binding but yet do work. The issue is one of getting ivermectin to do something it is not known to do best, that is, as an antiviral. The testing so far has underrepresented its potential. But the major reason to proceed with the suggestion of combining both ivermectin and hydroxychloroquine is that it will be of benefit. So you are on shaky ground but it is not your doing nor your limitations, it is the uncertainty of the science here that is the problem.