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Stromectol Side Effects

Generic name: ivermectin

Medically reviewed by Drugs.com. Last updated on Dec 20, 2023.

Note: This document contains side effect information about ivermectin. Some dosage forms listed on this page may not apply to the brand name Stromectol.

Applies to ivermectin: oral tablet.

Serious side effects of Stromectol

Along with its needed effects, ivermectin (the active ingredient contained in Stromectol) 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 immediately if any of the following side effects occur while taking ivermectin:

More common

Less common

Rare

Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking ivermectin:

Symptoms of overdose

Other side effects of Stromectol

Some side effects of ivermectin 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:

Less common

For Healthcare Professionals

Applies to ivermectin: compounding powder, oral tablet.

General

Ivermectin (the active ingredient contained in Stromectol) is well tolerated compared to other microfilaricidal agents (i.e., thiabendazole, diethylcarbamazine). Adverse reactions (i.e., pruritus, fever, rash, myalgia, headache) occur commonly during the first 3 days after treatment and appear to be related to the extent of parasitic infection and systemic mobilization and killing of microfilariae. The majority of reactions can usually be treated with aspirin, acetaminophen and/or antihistamines. Adverse effects tend to occur with lesser frequency during periods of retreatment.[Ref]

Ocular

Ocular side effects have included eyelid edema, anterior uveitis, blurred vision, conjunctivitis, limbitis, punctate opacity, keratitis, abnormal sensation in the eyes, and chorioretinitis/choroiditis; however, these effects are also associated with the disease onchocerciasis. Loss of vision has occurred rarely but usually resolved without corticosteroid treatment. Conjunctival hemorrhage has been reported during postmarketing experience in patients treated for onchocerciasis.[Ref]

Other

Worsening of Mazzotti reactions, including arthralgia, synovitis, lymph node enlargement and tenderness, pruritus, skin involvement (including edema, papular and pustular or frank urticarial rash), and fever, has been reported during the first 4 days following treatment for onchocerciasis.

Nervous system

Nervous system side effects have included dizziness, headache, somnolence, vertigo, and tremor. Serious or fatal encephalopathy has been reported rarely in patients with onchocerciases, and heavily infected with Loa loa, either spontaneously or after treatment with ivermectin (the active ingredient contained in Stromectol) Seizures have been reported during postmarketing experience.[Ref]

Gastrointestinal

Gastrointestinal side effects have included anorexia, constipation, diarrhea, nausea, vomiting, and abdominal distention.[Ref]

Other

Other side effects have included asthenia, fatigue, abdominal pain, chest discomfort, facial edema, and peripheral edema.

Hematologic

Hematologic side effects have included decreased leukocyte count (3%), eosinophilia (3%), and increased hemoglobin (1%). Hematomatous swellings associated with prolonged prothrombin times have been reported, but the clinical significance is unknown. Leukopenia and anemia have been reported in at least one patient.[Ref]

Hepatic

Hepatic side effects have included elevated ALT and/or AST. Elevated liver enzymes, elevated bilirubin, and hepatitis have been reported during postmarketing experience.[Ref]

Cardiovascular

Cardiovascular side effects have included tachycardia and orthostatic hypotension. EKG changes, including prolonged PR interval, flattened T waves and peaked T waves, have been reported in single cases. Hypotension (primarily orthostatic hypotension) has been reported during postmarketing experience.[Ref]

Dermatologic

Dermatologic side effects have included pruritus, rash, and urticaria. Toxic epidermal necrolysis and Stevens-Johnson syndrome have been reported during postmarketing experience.

Respiratory

Respiratory side effects have included worsening bronchial asthma, laryngeal edema, and dyspnea.[Ref]

Musculoskeletal

Musculoskeletal side effects have included myalgia.

Renal

Renal side effects have included rare transient proteinuria.[Ref]

Frequently asked questions

References

1. Pacque M, Munoz B, Greene BM, Taylor HR. Community-based treatment of onchocerciasis with ivermectin: safety, efficacy, and acceptability of yearly treatment. J Infect Dis. 1991;163:381-5.

2. Kumaraswami V, Ottesen EA, Vijayasekaran V, Devi U, Swaminathan M, Aziz MA, Sarma GR, Prabhakar R, Tripathy SP. Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions [published erratum appears in JAMA 1988 Aug 5;260(5):640]. JAMA. 1988;259:3150-3.

3. Rothova A, van der Lelij A, Stilma JS, Wilson WR, Barbe RF. Side-effects of ivermectin in treatment of onchocerciasis. Lancet. 1989;1:1439-41.

4. Campbell WC. Ivermectin as an antiparasitic agent for use in humans. Annu Rev Microbiol. 1991;45:445-74.

5. De Sole G, Remme J, Awadzi K, Accorsi S, Alley ES, Ba O, Dadzie KY, Giese J, Karam M, Keita FM. Adverse reactions after large-scale treatment of onchocerciasis with ivermectin: combined results from eight community trials. Bull World Health Organ. 1989;67:707-19.

6. Goa KL, McTavish D, Clissold SP. Ivermectin. A review of its antifilarial activity, pharmacokinetic properties and clinical efficacy in onchocerciasis. Drugs. 1991;42:640-58.

7. Chijioke CP, Okonkwo PO. Adverse events following mass ivermectin therapy for onchocerciasis. Trans R Soc Trop Med Hyg. 1992;86:284-6.

8. Ette EI, Thomas WO, Achumba JI. Ivermectin: a long-acting microfilaricidal agent. DICP. 1990;24:426-33.

9. Product Information. Stromectol (ivermectin). Merck & Co., Inc. 2001;PROD.

10. Elmogy M, Fayed H, Marzok H, Rashad A. Oral ivermectin in the treatment of scabies. Int J Dermatol. 1999;38:926-8.

11. Homeida MM, Bagi IA, Ghalib HW, el Sheikh H, Ismail A, Yousif MA, Sulieman S, Ali HM, Bennett JL, Williams J. Prolongation of prothrombin time with ivermectin. Lancet. 1988;1:1346-7.

12. Richards FO Jr, McNeeley MB, Bryan RT, et al. Ivermectin and prothrombin time. Lancet. 1989;1:1139-40.

13. Pacque MC, Munoz B, White AT, Williams PN, Greene BM, Taylor HR. Ivermectin and prothrombin time. Lancet. 1989;1:1139-40.

14. Wijesundera MD, Sanmuganathan PS. Ivermectin therapy in chronic strongyloidiasis. Trans R Soc Trop Med Hyg. 1992;86:291.

15. delGiudice P, Bonnet H, Leotard AA, Marty P, GariToussaint M, LeFichoux Y. Ivermectin in elderly patients. Arch Dermatol. 1999;135:351-2.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.