Ivermectin: an award-winning drug with expected antiviral activity against COVID-19

Ivermectin is an FDA-approved broad-spectrum antiparasitic agent with demonstrated antiviral activity against a number of DNA and RNA viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite this promise, the antiviral activity of ivermectin has not been consistently proven in vivo. While ivermectin's activity against SARS-CoV-2 is currently under investigation in patients, insufficient emphasis has been placed on formulation challenges. Here, we discuss challenges surrounding the use of ivermectin in the context of coronavirus disease-19 (COVID-19) and how novel formulations employing micro- and nanotechnologies may address these concerns. [Display omitted] •Ivermectin is an FDA-approved antiparasitic agent, being currently investigated in COVID-19 patients•Ivermectin for COVID-19 is restrained by formulation challenges, whereas only oral dosage forms are available•The delivery of ivermectin by pulmonary route would provide high drug deposition in the airways and lungs•Expected efficacy by using aerosol micro- and nanocarriers containing ivermectin