FLCCC Covid19 Management, The I-MASK+ Protocol
The following Covid19 management protocols were developed by Paul Marik, MD, Professor of Medicine and Chief of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School, and others, as members of the Front Line COVID-19 Critical Care Alliance (FLCCC).
A key point is to start supplements and Ivermectin asap, at the first sign of Covid19 infection.
NOTE: Ivermectin is not FDA approved for treating Covid19 and is used “off label” for this indication.
Symptomatic patients at home (for the duration of acute symptoms)
- Ivermectin 0.4-0.6 mg/kg daily, x5 days
- Vitamin C 500 mg and Quercetin 250–500 mg 2x/day
- Zinc 75–100 mg/day (elemental zinc)
- Melatonin 10 mg at night (the optimal dose is unknown)
- Vitamin D3 2000–4000 IU/day.
Body weight conversion for ivermectin dose (using 0.4mg/kg at upper weight) in prevention and treatment of COVID-19
70–90 lb = 32–40 kg = 16mg
91–110 lb = 41–50 kg = 20mg
111–130 lb = 51–59 kg = 24 mg
131–150 lb = 60–68 kg = 27mg
151–170 lb = 69–77 kg = 30 mg
171–190 lb = 78–86 kg = 34 mg
191–210 lb = 87–95 kg = 38 mg
211–230 lb = 96–104 kg = 42 mg
231–250 lb = 105–113 kg = 45 mg
251–270 lb = 114–122 kg = 48 mg
271–290 lb = 123–131 kg = 52 mg
291–310 lb = 132–140 kg = 56 mg
• Aspirin 81–325 mg/day (unless contraindicated). ASA has antiinflammatory, antithrombotic, and
antiviral effects. Platelet activation may play a major role in propagating the prothrombotic state associated with COVID-19.
• B complex vitamins
• Optional: Famotidine 40 mg BID (reduce dose in patients with renal dysfunction) [82-88].
• Optional: Omega-3 fatty acid – 4 gram/day EPA/DHA. Omega-3 fatty acids have anti-inflammatory properties and play an important role in the resolution of inflammation. In addition, omega-3 fatty acids may have antiviral properties.
• In symptomatic patients, monitoring with home pulse oximetry is recommended (due to asymptomatic hypoxia). The limitations of home pulse oximeters should be recognized, and validated devices are preferred. Multiple readings should be taken over the course of the day, and a downward trend should be regarded as ominous. Baseline or ambulatory desaturation < 94% should prompt hospital admission.
• Not recommended: Hydroxychloroquine (HCQ). The use of HCQ is extremely controversial. The best scientific evidence to date suggests that HCQ has no proven benefit for post exposure prophylaxis, for the early symptomatic phase and in hospitalized patients. [102-120] Considering the unique pharmacokinetics of HCQ, it is unlikely that HCQ would be of benefit in patients with COVID-19 infection (it takes 5–10 days to achieve adequate plasma and lung concentrations).[112,121-123] Finally, it should be recognized that those studies which are widely promoted to support the use of HCQ are severely methodologically flawed.[124-127]
• Not recommended: Systemic or inhaled corticosteroids (budesonide). In the early symptomatic (viral replicative phase), corticosteroids may increase viral replication and disease severity. An OpenSAFELY analysis in patients with COVID-19 demonstrated a higher risk of death in COPD and asthmatic patients using high dose ICS.  The role of ICS in the pulmonary phase is unclear as patients require systemic corticosteroids to dampen the cytokine storm, with ICS having little systemic effects.