Pulmonary Route of Targeted Ivermectin Delivery to SARS-CoV-2 in Lungs of COVID-19 Patients Based on Nanotechnology Approach

Although it is evidenced to exhibit virucidal activity against SARS-CoV-2, ivermectin has not been recommended for COVID-19 therapy due to the negative result in clinical trials. It is predicted that oral administration of the conventional formulation is unsuccessful in achieving the minimum inhibitory concentration in the alveolar lining fluid of COVID-19 patients. The development of lung-targeting drug delivery systems needs to be performed. Several studies to develop the inhalation delivery of ivermectin have been published. This review aims to examine the potential of delivery carriers and technology to administer ivermectin via the pulmonary route to reach the minimum inhibitory concentration against SARS-CoV-2 revealed in in vitro studies. Nebulizer technology of solution, nanoemulsion, or nanomicellar formulation, as well as Dry Powder Inhaler of engineered particle powder, freeze-dried product of nanostructured lipid carriers or solid lipid nanocarriers, has the potential to deliver ivermectin, achieving alveoli in sufficient concentration equal to about 5 μM of in vitro result. This review can be a point of view in conducting research to develop ivermectin target-oriented drug delivery systems.