This post was last updated 9/27/23 under the section Notes on Cetrizine and Famotidine
“Dr. Darrel DeMello is a General Physician with over 30 years of experience. He has treated 26,000+ cases of acute COVID infection using Telemedicine and an Innovative Drug Therapy Program.
It’s his privilege to serve the global community by delivering quality medical attention through Telemedicine and providing sound medical advice and responsible diagnosis.”
If you would like to contact him, you can use his website, or you can contact him on WhatsApp (his preferred method is the clinic number through WhatsApp):
Doctor DeMello has helped me and many of my friends in the last few years since the beginnings of Covid. He has patiently guided me through his research and protocols via many phone conversations, he has reviewed some of the articles I wrote on my blog (including this one) when I asked him to verify my data, he has ordered medications shipped from a trusted local pharmacy as needed, he has literally saved my friends from going to the hospital and being put on ventilators, and I can honestly say he has brought some people I know back from the brink of death, with daily phone check-ups and instructions.
(He’s not smiling in his photo above, but I can tell you he’s a very cheerful man who will pull you right out of fear and gloom and talk to you with much humor when you speak on the phone. We have had many laughs together!)
Why Use Dr. DeMello’s Protocol?
Simple: I recommend Dr. DeMello’s protocol because I have seen it work! (But also, I have looked at the research that is the basis for his recommendations, and I will share some with you here – I hope to make it make sense to you.)
If you are interested in his protocol after reading the rest of this blog, I strongly suggest you contact him. You can contact him anytime and he will help you stock up on what you need to be prepared, or you can contact him when you are ill but I strongly suggest being prepared as the better alternative.
There are other protocols, yes. The best-known in my circle are from FLCCC and from Dr. Syed Haider in the USA. There are probably many more protocols used by various doctors treating Covid,
If you are uncomfortable following instructions long-distance from a doctor in India, then please visit these sites and find a doctor you are comfortable to work with:
Dr. Syed Haider:
A compilation of doctor lists:
I believe it is our responsibility when using telemedicine services to check any drugs suggested as treatment against any medications we are already taking for interactions. I suggest checking more than one site – the answers are not always identical.
What’s the protocol?
[I will provide lots of additional data in NOTES below]
- Colchicine 0.5 mg – 3 tablets per day for 15 days (2 tabs am + 1 tab pm, both after meals)
- Ivermectin 12 mg – 4 tablets per day for 2 days (2 tabs am + 2 tabs pm, both on empty stomach)
- Diclofenac 50 mg: – 2 tablets per day for 10 days (1 tab am + 1 tab pm, both after meals)
- Cetrizine 10 mg – 2 tablets per day for 5 to 10 days (1 tab am + 1 tab pm, both after meals)
- Famotidine 40 mg – 2 tablets per day for 10 days (1 tab before lunch + 1 tab before dinner)
Notes from Dr. DeMello:
“Ivermectin needs to be taken on an empty stomach at 7 am no coffee, tea or breakfast till 9 am and at 4 pm with nothing to eat or drink, except water, from 1 pm till 7 pm.”
Please emphasize good hydration with water and electrolytes, up to approximately a gallon or four liters per day. Good hydration will reduce fatigue.
I will go over how to obtain these medications later in this post.
Notes on Colchicine
Dr. DeMello has been prescribing colchicine for his patients since the very early days of the pandemic. He relies strongly on colchicine to minimize the inflammatory effects of the virus. Minimal inflammation means minimal hospitalizations, and he has a track record of great success keeping his patients out of the hospital.
Minimization of the inflammatory response is key in avoiding problems with clotting and micro clots which are known to occur after exposure to the virus and spike protein.
Dr. DeMello says:
There are two versions of colchicine.
USA version of 0.6 mg
International version: 0.5mg
It makes no difference whether one takes a 0.6mg tablet or a 0.5mg tablet.
Here is a scientific article (many technical words):
“Systemic inflammation results in activation of coagulation”
Here is an easy-to-read article about micro clots – but keep in mind that this seems less frequent with later variants:
“Once the clotting process begins, the body is no longer fighting against the virus but mostly against the clotting process instead, the study’s researchers said.”
I’ll share two references on colchicine. One is an easy-to-read article in the press.
The other is a scientific paper written by Dr. DeMello’s partner pharmacist explaining the various biological mechanisms that make colchicine effective.
“An ancient Greek drug derived from the saffron plant could improve the treatment of people with severe COVID-19 and reduce the COVID mortality rate by as much as 50%, according to a report published earlier this month in the European Journal of Internal Medicine by an Israeli researcher from the Hebrew University of Jerusalem and Hadassah Medical School.”
Click here for article.
Why Colchicine works in Covid19 and prevents thrombosis
Written for Dr Darrell DeMello, by Dr Alben Sigamani, MD Pharmacology, Head of Clinical
Research at a large Private Hospital Group.
“Thrombosis in vessels occur due to multiple factors, but of them inflammation is the most
common. Inflammation activates thrombosis through tissue factor – internal cascade of
coagulation. Tissue Factor when exposed to blood interacts with factor 7a to activate factor
Xa – the key activator of thrombin. Tumor necrosis factor is a key inflammatory marker and
this induces monocytes to produce this tissue factor inside the blood vessels. Once you
have activated monocytes producing plenty of tissue factor, you will see intravascular
thrombosis. Colchicine is a potent inhibitor of TNFalpha, thus prevents activation of the
Colchicine prevents tubulin formation inside neutrophil, which is needed for neutrophils to
migrate to a site of inflammation. In many inflammatory diseases, neutrophils are the
pivotal cells involved. Their participation in inflammation depends upon their ability to
migrate towards the damaged or stimulated tissues. Since neutrophil migration is affected
by microtubules, the interaction between colchicine and tubulin distorts this capability,
thereby suppressing the inflammatory process.
Endothelial cells play an important role in neutrophil transmigration towards the
inflammatory site, and since colchicine can alter the distribution of adhesion molecules on
these cells, it further inhibits the inflammation inside the vessels which triggers the tissue
factor and the entire internal cascade of coagulation.
Giving anti coagulants with colchicine not only blocks the Factor Xa activation but also the
inducer of Factor Xa and thus colchicine can prevent thrombosis if given as a prophylactic
and is protective in infected individuals as the virus induces TNFalpha which is also
subdued by colchicine.”
Notes on Ivermectin:
For those not familiar with ivermectin’s efficacy, I suggest you look at this page from FLCCC which has a great film about the history of ivermectin and lots of medical references. (At least, watch the film!)
Here is another film and compilation about ivermectin which shows the suppression of this efficacious drug and might put some of your confusions to rest:
Playing Devil’s Advocate:
Some of Dr. DeMello’s instructions might surprise you, either because you are more familiar with the FLCCC protocol, or because they have changed somewhat recently.
On the topic of empty stomach vs full stomach for ivermectin – FLCCC prefers full stomach [see quote below], Dr. DeMello prefers empty stomach, as that has worked well for him in thousands of patients.
I have brought this up in conversation with him a number of times, and finally Dr. D. threw up his hands and messaged me, “Empty stomach or full stomach, I don’t care how people take it, just TAKE IT!” (I love this answer!)
Here is an earlier post on this topic:
Here is a quote from the FLCCC page on early treatment:
First Line Therapies
“Ivermectin: 0.4 to 0.6 mg/kg – one dose daily for at least 5 days or until symptoms resolve.
If symptoms persist longer than 5 days, consult a healthcare provider. See Table 1 for help with calculating correct dose. Due to a possible interaction between quercetin and ivermectin, these drugs should be staggered throughout the day (see Table 2). For COVID treatment, ivermectin is best taken with a meal or just following a meal, for greater absorption.”
On the topic of dosage, Dr. DeMello’s dosage is 48 mg per day (12 mg x 4). I checked with him, this is not a typo.
Dr. D. had for a long time kept his dosage at 24 mg per day, so I questioned him about this new dosage.
“Not a typo. This seems to prevent a bad attack as viral replication appears to be faster and more insidious. Also people try to ignore or self medicate thinking it is flu. Then they come with a bad sore throat or fever not going away even after 5 days…Hit it hard right up front. We have so many variants, with all kinds of symptoms, it is not easy.”
“OK thanks! As you know, my personal preference has always been to go to 5 days (of ivermectin) – a compromise between your simpler way of dosing and FLCCC longer regimen. Do you think it accomplishes the same? Yours is 8 pills (12 mg each) in 2 days, mine would be 10 pills in 5 days (keeping with Dr. D.’s original dosage of 12 mg twice a day).
“Both should work. It depends upon how long the patient has been ill.”
“When do you think it becomes imperative to go to 4 tabs a day?”
“Usually if it is day 4-5-6 since symptoms started it is better to go to higher dose.”
Notes on Diclofenac:
The name “Diclofenac” is actually shorthand for a combination pill that Dr. DeMello obtains from his pharmacist and prescribes for his patients.
The ingredients of each tablet are:
Diclofenac Potassium 50mg
Paracetamol (same as Tylenol) 325 mg
Chlorzoxazone 250 mg
These three components work synergistically together. Chlorzoxazone is a muscle relaxant which helps with muscle pain.
This medication is extremely effective for pain relief (not an opioid) when experiencing body pains and muscle pains associated with Covid.
As far as I know, the only source for this medication is Dr. DeMello and his pharmacist. I have not found it anywhere else.
Notes on Cetrizine and Famotidine:
Cetrizine is the same as Zyrtec (OTC in the US) and Famotidine is the same as Pepcid (OTC in the US).
In the Us, Zyrtec comes in 10 mg strength, and Pepcid comes in either 10 mg or 20 mg strength. Notice that the protocol calls for 40 mg Pepcid per tablet. (Dr. DeMello has these tablets available as small pills of 40 mg).
Cetrizine and Famotidine are both anti-histamines: Cetrizine is H1 blocker, Pepcid is H2 blocker. If making brand substitutions, look for H1 blockers and H2 blockers (H1 and H2 being different kinds of histamines).
If you must substitute, here are the equivalents (please check for potential side effects and drug interactions):
Histamine 1 blockers – Hydroxyzine (Atarax) [see important note below], Doxepin (Silenor), Cyproheptadine (Periactin), Loratadine (Claritin), Fexofenadine (Allegra), Diphenhydramine (Benadryl), Ketotifen (Zaditen) and Cetirizine (Zyrtec, Reactine).
Histamine 2 blockers – Famotidine (Pepcid, Pepcid AC), Cimetidine (Tagamet, Tagamet HB) and Ranitidine (Zantac). Famotidine is chosen most often because it has fewer drug interactions than Tagamet.
Note on Atarax: This is actually a psychoactive medication, and I would not personally take it. I left it on this list in case someone prescribes it to you for purposes of blocking histamines, so that you can make an informed decision.
Is hydroxyzine a psychoactive drug?
Hydroxyzine has effective anxiolytic, hypnotic and sedative properties. It can induce feelings of relaxation and euphoria. On top of being versatile, this medication does not share any of the abuse, addiction or dependence potentials that come with other similar drugs.
Why are anti-histamines needed to treat Covid?
There is a lot of research behind this! Honestly, not being a medical professional, I’ve gotten lost in the weeds more than once trying to write this up. So, while knowing it’s not perfect or as simple as I would like it to be, I’ll share some of what I have and leave it to you to research more and clarify terms as needed.
First, let me acquaint you with MAST CELLS.
Here is an actual image of a mast cell. “Degranulation” occurs when the granules contained in the mast cell are released into the blood.
These granules are at the root of the name “mast cell” (nothing to do with sail boats).
How did mast cells get their name? The name was coined in 1878 by immunologist Paul Ehrlich.
He named “Mastzellen” in the belief that they had a nutritional function because of their granules. The German word “mast” denotes a “fattening” or “suckling” function.
What is a mediator? A chemical agent which takes an active part in the development of the inflammatory response.
Mast cells are key players in the inflammatory response as they can be activated to release a wide variety of inflammatory mediators, These mediators include histamine, neutral proteases, proteoglycans, and some cytokines, such as tumor necrosis factor-alpha (TNF-alpha). [TNF-alpha was mentioned in the pharmacist essay in the colchicine note in section above]
So, we all know you can have too much of a good thing. And you’ve probably heard of the dreaded “cytokine storm” that can occur with Covid illness. And now you see how cyctokines and histamines both originate in mast cells.
So there’s your connection to hyper-inflammation (to be avoided) and histamines.
Here is some research:
Dual-histamine receptor blockade with cetirizine – famotidine reduces pulmonary symptoms in COVID-19 patients
“This physician-sponsored cohort study of cetirizine and famotidine provides proof-of-concept of a safe and effective method to reduce the progression in symptom severity, presumably by minimizing the histamine-mediated cytokine storm.”
“A high dose of famotidine, commonly known as Pepcid, was found to have beneficial effects in adult patients with Covid-19, according to results of an outpatient clinical trial. “
Covid-19 Histamine theory: Why antihistamines should be incorporated as the basic component in Covid-19 management?
“Covid-19 Histamine theory explain clinical presentations of the disease as a result of Histamine activated pathways to a greater extent. It is basically activation of histamine pathways which lead to cytokine storm in Covid-19”
“Histamine pathways has been found to significantly be able to modulate immune response and inflammation hence cytokine storm, tissue response to inflammation, coagulation process including deep vein thrombosis through Histamine H1 receptor and can trigger acute symptoms due to its very rapid activity on vascular endothelium, bronchial and smooth muscles and so forth. All of these makes it one of the important cytokine for therapeutic target.”
A very good question was asked of Dr. DeMello on social media and his answer belongs in this post as an extension of his protocol.
Definition: What is MCAS ?
MCAS stands for Mast Cell Activation Syndrome. Let’s discuss below.
This article from WebMD does a good job of listing a large variety of triggers and symptoms related to MCAS. If you are having mysterious symptoms after Covid infection, it is a good place to look for answers.
“Mast cell activation syndrome is a condition that causes mast cells to release an inappropriate amount of chemicals into your body. This causes allergy symptoms and a wide range of other symptoms.”
This question was asked on social media:
“Is there any indication that taking the H1 and H2 blockers during Covid can prevent the later onset of MCAS that sometimes occurs after someone has had Covid?”
Dr. DeMello answered:
Taking H1 and H2 blockers during acute Covid infection is not enough. It is to reduce symptoms, not to treat the underlying root cause of inflammation.
One has to take a strong anti-inflammatory drug.
I use Colchicine from day 1 a patient presents to me, and will add Steroid/ Dexamethasone if O2 levels are lower than 95, irrespective of what day of disease the patient says he/she is.
Dr Sankara Chetty* adds Steroids from day 8 of Acute Covid19 infection.
Proper Treatment is treating the root cause of inflammation. Not just treating the symptoms.
If one uses my protocol in its entirety, one should not get any post Covid or Long COVID issues, including MCAS.“
*Dr. Shankara Chetty referenced above:
Success Story from Dr. DeMello Protocol
In January 2022, a friend posted this success story on social media,
[Please note, he mentions Clopidogrel (i.e. Plavix) in his story, but this is not currently on Dr. DeMello first line of treatment. Dr. DeMello might add it to the treatment in individual cases if indicated.]
“Back in August/Sept last year , when many of my friends were getting hit hard with the Delta variant it was evident that it was many times more severe than the prior waves of Covid. Particularly for men 50 years old +, even those with no other comorbidity. I had already been following the preventative protocols of the FLCCC and had Ivermectin and HCQ on hand in case of infection. But, sensing this would not be enough, I started to look for what else was out there as far as early treatment. Thanks to Mimi, she had sent me a video of a zoom interview of Dr. Darrell DeMello. In the interview, Dr. DeMello (who has to date treated 14,000 Covid patients, many via telemedicine) explained how he early on in 2020 had reversed engineered the cycle of the Covid disease as it affects the body. He discovered that Covid was not simply a viral respiratory disease as was being promoted by the mainstream medical monopoly, but in fact was much more. He found, after the initial viral load (within a week) the disease progresses into an inflammatory and blood clotting disease. The inflammation affects several parts of the body including the lungs which can lead to pneumonia. Concurrent with the inflammation, micro clotting occurs which has lead to strokes and much of the Covid fatalities. Covid is an inflammation and clotting disease. Most people are not aware of this and only assess their condition on how they feel from the first few days of the initial effects from the viral load. But, unbeknownst to them, the inflammation and clotting stage has started and begins to manifest around days 5-8. This is manifested with O2 percentages that drop below 95 (95-100 normal), difficulty breathing and chest pain. Without early treatment this progression can become very severe, and life threatening. After Dr. DeMello isolated these additional aspects of the disease, he researched and found the most effective, potent and safest drugs possible to prevent the inflammatory and clotting phases. For inflammation, he uses Colchicine, a powerful anti-inflammatory used safely for decades and Plavix (Clopidogrel) as the anti-coagulant, also been around for decades. He uses Ivermectin to kill the virus within 48 hrs. He also has a few other drugs that he recommends as part of his protocol, if they are needed. He’s treated 14,000 patients and less than 100 had to be admitted to the hospital. I reached out to Dr. DeMello in late September and he sent me his entire protocol to have on hand. Time is of the essence and treatment, to be the most effective, needs to start at first symptoms. Last month my entire family caught the Delta variant (or a delta descendant) of Covid. Having the meds on hand, we all started treatment immediately. Dr DeMello, available via WhatsApp, guided each of us through with the proper dosages and things to do to minimize the duration and severity. While it was a bit tougher for me, we all got through it relatively smoothly including my 85 year old step mom. The Omicron variant, generally considered mild still lands many vulnerable people in the hospital, is treated with the same meds but perhaps less dosages as determined by Dr. DeMello. I recommend to my friends, until there are local doctors who embrace this protocol and can prescribe and deliver it within 24 hrs, to reach out to Dr. DeMello and get his kit of drugs now (they are cheap) to have on hand and not wait as they take 5 days to be delivered. Here is a recent article mentioning Dr. DeMello and his protocol. His interviews are also available on YouTube. His # is +91 77180 79507. You can text or call him via WhatsApp.”
How to Obtain Medications on the Protocol
The best time to stock up on the meds you will need is BEFORE you get sick!
Dr. DeMello works with a trusted local pharmacist. It takes about a week to get the order filled by the pharmacy and into your hands in the US. If you did not prepare ahead, you’ll be scrambling for solutions.
All it takes is a message on WhatsApp to get you started (he will call you back).
Re: Ivermectin – that one causes a bit of difficulty with Customs, unless you are a US resident with a foreign passport. This occurs because Dr. DeMello is obligated as a physician to list all medications included in the package, For that reason, I strongly suggest you get ivermectin from other sources (unless you have that foreign passport).
Here are other ways to order it (none of these providers have difficulties with Customs in the US):
Re: Colchicine – it is available from most of the pharmacies in the link above. However, ordering from Dr. DeMello is fast and easy.
Re: Diclofenac – that one is only available from Dr. DeMello – and from what I’ve been told, people who have used it for pain (back pain, all over body pain from Covid) have said it was miraculously effective.
Re: Cetrizine and Famotidine – these are available over the counter in the US.
Re: Clopidogrel – mentioned in the success story above but not in current protocol – you might want to discuss with Dr. DeMello whether that is something you should have on hand. He can add it to his package.
You should have a thermometer and an oximeter in your home.
I personally think everyone should also have a nebulizer in their home, for help with congestion and possible breathing or oxygenation difficulties.
You can stay connected to Dr. DeMello by joining this Facebook group where you can ask questions and get updates on research and changes in protocols.
Dr. DeMello is one of the most generous people I know. He gives freely of his time with advice to all who ask – he really makes a personal connection with each person who asks for his help. He will stay up all night to check on a patient who has difficulties with oxygen, he will bolster someone’s confidence who might have fallen into despair or apathy as their infection takes hold. He is caring like a doctor should be.
If you order from from his pharmacy through Dr. DeMello, he will tell you the cost of the meds and have them sent out right away without waiting for confirmation of your payment. (Make sure you do pay him, as he has to pay his pharmacist).
If you are sick and consult with him (even if you have the meds on hand, you should call him to let him know what’s going on if you are sick, to make sure no changes to the protocol are advised) he will be attentive to your needs and check on you regularly.
The one thing he doesn’t do well is ask for payment for his consultation. So, please, if you have used his services, ask him how much you owe him, or he might never get paid.
Be well, do well, stay well!