ivermectin (Stromectol)

Ivermectin is an anti-parasitic medication. Ivermectin works by binding to invertebrate muscle and nerve cells of parasites, causing paralysis and death of parasites. Ivermectin is active against the non-adult form of Onchocerca volvulus. Ivermectin is also active against the intestinal activity of Strongyloides stercoralis. The FDA approved ivermectin in November 1996.

What brand names are available for ivermectin?

• Stromectol

Is ivermectin available as a generic drug?

Yes

Do I need a prescription for ivermectin?

Yes

• Ivermectin is used for intestinal infection caused by Strongyloides stercoralis.
• Ivermectin is also used for infections caused by a non-adult form of Onchocerca volvulus.
• Off-label use includes treatments for head lice, blepharitis, and filariasis.

Common side effects of ivermectin are:

• abdominal pain,
• asthenia,
• hypotension,
• mild EKG changes,
• peripheral & facial edema,
• transient tachycardia,
• headache,
• itching,
• rash,
• dizziness,
• insomnia,
• somnolence,
• vertigo,
• pruritus,
• hyperthermia,
• constipation,
• urticaria,
• eosinophilia,
• leukopenia,
• ALT/AST increased,
• Limbitis,
• myalgia,
• tremor,
• blurred vision,
• mild conjunctivitis,
• punctate opacity,
• Mazzotti reaction (with onchocerciasis)
• nausea, and
• vomiting.

Other side effects include:

• low blood pressure,
• edema,
• lymphadenopathy,
• ocular damage,
• pruritus rash,
• hepatitis,
• conjunctival hemorrhage (with onchocerciasis)
• facial swelling, and
• increased heart.

Dosing is complicated and varies for each disease.

• Dosing begins with 15 kg weight and varies with weight ranges up to 80 or 85 kg depending on the disease process and based on about 200 mcg ivermectin per kg body weight.

Intestinal strongyloidiasis:

• If weighing more than 85 kg take 200 mcg/kg of ivermectin by mouth as a single dose. If evidence of larvae is still presented during 3 months following therapy, re-treat with a single dose.

Onchocerciasis:

• If weighing more than 85 kg take 150 mcg/kg of ivermectin by mouth as a single dose. Consider retreatment between 3 to 12 months.

Safe and effective use of ivermectin is not established for patients weighing less than 15 kg.

Ivermectin should be used with caution with warfarin (Coumadin) because ivermectin can increase risks of bleeding and bruising when co-administered with warfarin.

There are no adequate studies done on ivermectin to determine safe and effective use in pregnant women. Ivermectin should be avoided in pregnant mothers to avoid any risk to the unborn.

Ivermectin enters breast milk in trace amounts. Therefore, it should be avoided in nursing mothers to prevent any adverse effects to the newborn.

What preparations of ivermectin are available?

Tablets: 3 mg

How should I keep ivermectin stored?

Store ivermectin tablets at temperatures below 30 C (86 F).