FRONT LINE COVID-19 CRITICAL CARE ALLIANCE

PREVENTION & TREATMENT PROTOCOLS FOR COVID-19

A Guide to the Prevention of COVID-19, Influenza and Respiratory Syncytial Virus (RSV) About this protocol
The information in this docu-
As rates of infection with influenza and RSV rose in fall/winter 2022, FLCCC adapted the I-PREVENT protocol ment is our recommended
to include prevention against these viruses. The interventions recommended are likely to reduce the risk and approach to preventing
severity of infection with COVID-19, influenza, and RSV infections as well as the common cold. It should be COVID-19, flu or RSV based
noted that the medications included in the I-PREVENT protocol are inexpensive, safe, and widely available. on the best (and most
This protocol includes a section for pre-exposure (long-term) as well as a post-exposure (acute, short-term) recent) literature.
It is provided as guidance to
At the onset of flu-like symptoms please refer to the I-CARE: Early COVID Treatment or I-CARE: RSV and Flu healthcare providers world-
Treatment Protocols. wide. Patients should always
consult with their provider
before starting any medical
PRE-EXPOSURE PREVENTION treatment.

(recommended for healthcare workers, and for high-risk individuals such as those over 60 years old and those with New medications may be
added and/or changes made
comorbidities.)
to doses of existing medica-
Antiseptic antimicrobial mouthwash; gargle twice daily (do not swallow) tions as further evidence
emerges. Please check our
Choose mouthwashes containing chlorhexidine, povidone-iodine, cetylpyridinium chloride, or the combination of
website at flccc.net to be
eucalyptus, menthol, and thymol.
sure you are using the latest
Vitamin D; dosing varies; optimal target is greater than 50 ng/ml version of this protocol.
Table 1 presents a safe and practical treatment schedule for raising serum concentrations in non-urgent situations. The For more information on
dosing schedule illustrated in Table 2 should be used when recent serum concentration levels are unavailable. nutritional therapeutics and
how they can help with
Vitamin C: 500 mg twice daily COVID-19, visit geni.us/
The effects of Vitamin C on the course of upper respiratory tract infections have long been recognized. COVID_nutrition
Zinc; 20-50 mg daily For additional information
Commercial zinc supplements are commonly formulated as zinc oxide or salts with acetate, gluconate, and sulfate. on prophylaxis, the rationale
behind these medications,
Melatonin; 1-6 mg nightly (slow/extended release) and references, see ‘A Guide
Begin with 1 mg and increase as tolerated to 6 mg at night. Causes drowsiness. Some patients are intolerant to melatonin, to the Prevention of
having very disturbing and vivid dreams; in these patients, it may be best to start with a 0.3 mg slow-release tablet and COVID-19, Influenza, and
increase slowly, as tolerated. Respiratory Syncytial Virus
(RSV) Infection’.
Elderberry syrup, supplements or gummies; follow manufacturer’s dosing recommendations
Take during periods of high transmission of COVID-19, influenza, and RSV. A triple combination containing elderberry, Disclaimer
Vitamin C, and zinc may be a convenient approach. Patients with autoimmune disease should take for 2 weeks or less and
monitor their symptoms closely. This protocol is meant
solely for educational pur-
Resveratrol/Quercetin/Pterostilbene Combination Flavonoid supplement; 400-500 mg daily poses regarding potential-
ly beneficial prevention
The safety of these phytochemicals has not been determined in pregnancy and they should therefore be avoided. Due approaches for COVID-19.
to the possible drug interaction between quercetin and ivermectin, these drugs should not be taken simultaneously (i.e.,
should be staggered morning and night). Never disregard profes-
sional medical advice
Ivermectin because of something you
In the current situation of abundant natural immunity along with the recent circulation of less severe and more highly have read on our website
transmissible variants, chronic weekly or bi-weekly ivermectin prophylaxis is no longer applicable to most people. and releases. This is not
intended to be a substi-
• Bi-weekly ivermectin at 0.2mg/kg; can be considered in those with significant comorbidity and lack of natural tute for professional medi-
immunity or immunosuppressive states or those with long COVID or post-vaccine syndrome who are not already on cal advice, diagnosis, or
ivermectin as treatment treatment regarding any
patient.
• Daily ivermectin just prior to and during periods of high possible exposure such as travel, weddings, conferences, etc.
Treatment for an individu-
• Immediate initiation of daily ivermectin at treatment doses (0.4mg/kg) upon first symptoms of a viral syndrome  al patient is determined by
many factors and thus
should rely on the judg-
ment of your physician or
qualified healthcare pro-
vider.
→ continue on page 2

For updates and more information on our treatment protocols please see: flccc.net
www.
I-PREVENT COVID, Flu and RSV Protection Protocol · Version 1 · November 30, 2022 · Page 1/3
 FRONT LINE COVID-19 CRITICAL CARE ALLIANCE
PREVENTION & TREATMENT PROTOCOLS FOR COVID-19

Always seek their advice

(continued from page 1 with any questions you
may have regarding your
Table 1. Guidance on Upfront Loading Dose Regimens to Replenish Vitamin D medical condition or
Stores in the Body health.
When serum Vitamin D levels are available, the doses provided in this table can be used for the longer-term maintenance
of serum 25(OH)D concentration above 50 ng/mL (125 nmol/L). The table provides the initial bolus dose, weekly dose, Please note our full dis-
frequency, and duration of administration of oral Vitamin D in non-emergency situations, in a non-obese, 70 kg adult. claimer at: www.flccc.net/
disclaimer

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updates geni.us/FLCCC_
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Support FLCCC
The FLCCC Alliance is a
501c3 non-profit organiza-
Source: Nutrients’—Special Issue: “Vitamin D—Calcifediol and COVID” [92] tion. We are 100% donor
* A suitable daily or weekly maintenance dose to be started after completing the loading-dose schedule. The dose should be adjusted for funded. Your donations
those who are overweight (higher) or underweight (lower). directly support FLCCC
Alliance research, educa-
** To convert ng/mL to nmol/L, multiply the amount in ng by 2.5; One µg = 40 IU. $ Mentioned replacement doses can be taken as single, tion, translation, advocacy
cumulative doses, two to three times a week spread out over a few weeks. and outreach efforts.
$$ From day one of week two onwards. Please visit FLCCC.net/
donate
# Estimated total Vitamin D dose needed to replenish the body stores (i.e., the deficit) is provided in the last column.

Table 2. Vitamin D Dosing in the Absence of a Baseline Vitamin D Level

Longer-term maintenance schedules of oral Vitamin D based on body weight to maintain the levels above 50 ng/mL (125
nmol/L) when the serum 25(OH)D concentrations are unknown.

Source: Nutrients’—Special Issue: “Vitamin D—Calcifediol and COVID” [92]

* Example of a daily or once-a-week dose range for adults with specific body types (based on BMI for white Caucasians and body weight
for other ethnic groups). Appropriate dose reductions are necessary for children.

# For those with chronic comorbid conditions, such as hypertension, diabetes, asthma, COPD, CKD, depression, and osteoporosis, and to
reduce all-cause mortality, higher doses of Vitamin D are needed. For them, one can use the doses that are recommended for persons with
obesity (BMI, 30–39: the third row).

$ Those with multiple sclerosis, cancer, migraine headaches, and psoriasis, and those routinely taking medications such as anti-epileptic
and anti-retroviral agents that significantly increase the catabolism of Vitamin D should consider taking age-appropriate doses recom-
mended for those with morbid obesity (BMI ≥ 40; the higher end of the daily doses in the fourth row).

→ continue on page 3

For updates and more information on our treatment protocols please see: flccc.net
www.
I-PREVENT COVID, Flu and RSV Protection Protocol · Version 1 · November 30, 2022 · Page 2/3
 FRONT LINE COVID-19 CRITICAL CARE ALLIANCE
PREVENTION & TREATMENT PROTOCOLS FOR COVID-19

POST-EXPOSURE PREVENTION (continued from page 2

(recommended if a household member is COVID-positive or if you have had prolonged exposure to COVID
but have not developed symptoms.)
Naso-Oropharyngeal hygiene (Nasal Spray and Mouthwash); 2-3 times daily
The combination of nasal antiseptic sprays and oropharyngeal mouthwashes is strongly suggested. Choose a nasal spray
with 1% povidone-iodine (for example Immune Mist™, CofixRX™ or Ionovo™) and a mouthwash containing chlorhexidine,
povidone-iodine, cetylpyridinium chloride (e.g., Scope™, Crest™ or Act™), or the combination of eucalyptus, menthol, and
thymol (Listerine™).

Elderberry; four times daily as per manufacturer’s directions for 1 week (gummy, supplement, or syrup)
Vitamin C: 500-1000 mg four times daily for 1 week
Elemental Zinc; 50-90 mg daily for 1 week
Melatonin; 2-5 mg at night (slow/extended release)

Resveratrol/Combination Flavonoid supplement; 500 mg twice daily

A flavonoid combination containing resveratrol, quercetin and pterostilbene is recommended.
Optional with documented exposure to COVID-19 (positive test)
Ivermectin: 0.4 mg/kg immediately, then repeat second dose in 24 hours; and Hydroxychloroquine (HCQ): 200 mg twice
a day for 5 days. OR
Nitazoxanide 500-600 mg twice daily for 5 days 

Table 1. How to calculate ivermectin dose

Note that ivermectin is available in different strengths (e.g., 3, 6 or 12 mg) and administration forms (tablets, capsules,
drops, etc.). Note that tablets can be halved for more accurate dosing, while capsules cannot.

How much do I weigh? What dose does the protocol say?

In pounds In kilos 0.2 mg/kg 0.3 mg/kg 0.4 mg/kg 0.6 mg/kg
70–90 32–41 6-8 mg 10-12 mg 13-16 mg 19-25 mg
91–110 41–50 8-10 mg 12-15 mg 17-20 mg 25-30 mg
111–130 50–59 10-12 mg 15-18 mg 20-24 mg 30-35 mg
131–150 60–68 12-14 mg 18-20 mg 24-27 mg 36-41 mg
151–170 69–77 14-15 mg 21-23 mg 27-31 mg 41-46 mg
171–190 78–86 16-17 mg 23-26 mg 31-35 mg 47-52 mg
191–210 87–95 17-19 mg 26-29 mg 35-38 mg 52-57 mg
211–230 96–105 19-21 mg 29-31 mg 38-42 mg 58-63 mg
231–250 105–114 21-23 mg 32-34 mg 42-45 mg 63-68 mg
251–270 114–123 23-25 mg 34-37 mg 46-49 mg 68-74 mg
271–290 123–132 25-26 mg 37-40 mg 49-53 mg 74-79 mg
291–310 132–141 26-28 mg 40-42 mg 53-56 mg 79-85 mg

For updates and more information on our treatment protocols please see: flccc.net
www.
I-PREVENT COVID, Flu and RSV Protection Protocol · Version 1 · November 30, 2022 · Page 3/3