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Ivermectin + metformin is a combination of two small-molecule drugs, each with distinct mechanisms of action and primary indications. Ivermectin is an antiparasitic agent that acts by binding to glutamate-gated chloride channels in the nerve and muscle cells of parasites, leading to paralysis and death of the parasite. Metformin is a biguanide derivative widely used as a first-line treatment for type 2 diabetes; it lowers blood glucose primarily by inhibiting hepatic gluconeogenesis and improving insulin sensitivity. This combination has been studied in clinical trials for repurposing against COVID-19, but did not show significant benefit in preventing severe outcomes such as hypoxemia, emergency department visits, hospitalization, or death compared to placebo[2][4][5][6]. Preclinical research also suggests potential synergistic antitumor effects when used together[8].
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