Stromectol Side Effects
Generic Name: ivermectin
Note: This page contains side effects data for the generic drug ivermectin. It is possible that some of the dosage forms included below may not apply to the brand name Stromectol.
In Summary
Common side effects of Stromectol include: fever, pruritus, and skin rash. See below for a comprehensive list of adverse effects.
For the Consumer
Applies to ivermectin: oral tablet
As well as its needed effects, ivermectin (the active ingredient contained in Stromectol) may cause unwanted side effects that require medical attention.
Severity: Moderate
If any of the following side effects occur while taking ivermectin, check with your doctor or nurse as soon as possible:
Less common—for the treatment of river blindness (onchocerciasis) only- Eye or eyelid irritation, pain, redness, or swelling
Minor Side Effects
Some ivermectin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned 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
- Headache
- swelling of the face, hands, arms, feet, or legs
- Diarrhea
- dizziness
- skin rash or itching
- Lightheadedness when getting up from a lying or sitting position
- Loss of appetite
- shaking or trembling
- sleepiness
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]
References
1. Goa KL, McTavish D, Clissold SP "Ivermectin. A review of its antifilarial activity, pharmacokinetic properties and clinical efficacy in onchocerciasis." Drugs 42 (1991): 640-58
2. 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 163 (1991): 381-5
3. 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 67 (1989): 707-19
4. 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 259 (1988): 3150-3
5. Campbell WC "Ivermectin as an antiparasitic agent for use in humans." Annu Rev Microbiol 45 (1991): 445-74
6. Rothova A, van der Lelij A, Stilma JS, Wilson WR, Barbe RF "Side-effects of ivermectin in treatment of onchocerciasis." Lancet 1 (1989): 1439-41
7. "Product Information. Stromectol (ivermectin)." Merck & Co, Inc, West Point, PA.
8. Ette EI, Thomas WO, Achumba JI "Ivermectin: a long-acting microfilaricidal agent." DICP 24 (1990): 426-33
9. Chijioke CP, Okonkwo PO "Adverse events following mass ivermectin therapy for onchocerciasis." Trans R Soc Trop Med Hyg 86 (1992): 284-6
10. Elmogy M, Fayed H, Marzok H, Rashad A "Oral ivermectin in the treatment of scabies." Int J Dermatol 38 (1999): 926-8
11. Pacque MC, Munoz B, White AT, Williams PN, Greene BM, Taylor HR "Ivermectin and prothrombin time." Lancet 1 (1989): 1139-40
12. 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 1 (1988): 1346-7
13. Richards FO Jr, McNeeley MB, Bryan RT, et al. "Ivermectin and prothrombin time." Lancet 1 (1989): 1139-40
14. Wijesundera MD, Sanmuganathan PS "Ivermectin therapy in chronic strongyloidiasis." Trans R Soc Trop Med Hyg 86 (1992): 291
15. delGiudice P, Bonnet H, Leotard AA, Marty P, GariToussaint M, LeFichoux Y "Ivermectin in elderly patients." Arch Dermatol 135 (1999): 351-2
It is possible that some side effects of Stromectol may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.
More about Stromectol (ivermectin)
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