ivermectin (Oral route)

Pronunciation

eye-ver-MEK-tin

Commonly used brand name(s)

In the U.S.

  • Stromectol

Available Dosage Forms:

  • Tablet

Therapeutic Class: Anthelmintic

Chemical Class: Avermectin

Uses For ivermectin

Ivermectin is used in the treatment of certain worm infections. It is used to treat river blindness (onchocerciasis) and a certain type of diarrhea (strongyloidiasis). It may also be used for some other kinds of worm infections.

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Ivermectin appears to work by paralyzing and then killing the offspring of adult worms. It may also slow down the rate at which adult worms reproduce. This results in fewer worms in the skin, blood, and eyes.

Ivermectin is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, ivermectin is used in certain patients with the following medical condition:

  • Bancroft's filariasis
  • Scabies

Before Using ivermectin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ivermectin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ivermectin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on ivermectin have been done only in adults and in children weighing 15 kilograms (kg) (33 pounds) and over, and there is no specific information comparing use of ivermectin in children weighing less than 15 kg with use in other age groups.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of ivermectin in the elderly with use in other age groups.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking ivermectin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ivermectin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of ivermectin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bronchial asthma—Ivermectin may make this problem worse.

Proper Use of ivermectin

Ivermectin is best taken as a single dose with a full glass (8 ounces) of water on an empty stomach (1 hour before breakfast), unless otherwise directed by your doctor.

To help clear up your infection, take ivermectin exactly as directed. Your doctor may want you to take another dose every 3 to 12 months.

Your doctor may also prescribe a corticosteroid (a cortisone-like medicine) for certain patients with river blindness, especially those with severe symptoms. This is to help reduce the inflammation caused by the death of the worms. If your doctor prescribes these two medicines together, it is important to take the corticosteroid along with ivermectin. Take them exactly as directed by your doctor. Do not miss any doses.

Dosing

The dose of ivermectin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ivermectin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For river blindness:
      • Adults and teenagers—Dose is based on body weight and must be determined by your doctor. The usual dose is 150 micrograms (mcg) per kilogram (kg) (68 mcg per pound) of body weight as a single dose. The treatment may be repeated every three to twelve months.
      • Children—Dose is based on body weight and must be determined by your doctor. For children weighing 15 kg (33 pounds) or more, the usual dose is 150 mcg per kg (68 mcg per pound) of body weight as a single dose. If necessary, the treatment may be repeated every three to twelve months. For children weighing less than 15 kg, use and dose must be determined by your doctor.
    • For strongyloidiasis:
      • Adults and teenagers—Dose is based on body weight and must be determined by your doctor. The usual dose is 200 micrograms (mcg) per kilogram (kg) (91 mcg per pound) of body weight as a single dose. Additional doses usually are not needed.
      • Children—Dose is based on body weight and must be determined by your doctor. For children weighing 15 kg (33 pounds) or more, the usual dose is 200 mcg per kg (91 mcg per pound) of body weight as a single dose. For children weighing less than 15 kg, use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using ivermectin

It is important that your doctor check your progress at regular visits. This is to help make sure that the infection is cleared up completely. In addition, if you have river blindness (onchocerciasis), your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor). If you have a certain type of diarrhea (strongyloidiasis), your doctor may want to examine three stool samples. This should be done over the 3-month period following treatment.

If your symptoms become worse, check with your doctor.

ivermectin may cause some people to become lightheaded. Make sure you know how you react to ivermectin before you drive, use machines, or do anything else that could be dangerous if you are lightheaded. If these reactions occur, check with your doctor.

Before you have any medical tests, tell the medical doctor in charge that you are taking ivermectin. The results of some tests (blood or liver tests) may be affected by ivermectin.

ivermectin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Less common—for the treatment of river blindness (onchocerciasis) only
  • Eye or eyelid irritation, pain, redness, or swelling

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common—for the treatment of river blindness (onchocerciasis) only
  • Fever, itching or skin rash
  • joint or muscle pain
  • painful and tender glands in neck, armpits, or groin
  • rapid heartbeat
Less common—for the treatment of river blindness (onchocerciasis) only
  • Headache
  • swelling of the face, hands, arms, feet, or legs
Less common—for the treatment of strongyloidiasis only
  • Diarrhea
  • dizziness
  • skin rash or itching
Rare—for the treatment of river blindness (onchocerciasis) only
  • Lightheadedness when getting up from a lying or sitting position
Rare—for the treatment of strongyloidiasis only
  • Loss of appetite
  • shaking or trembling
  • sleepiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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