Ivermectin

Indications
Oral
Onchocerciasis
Adult: ≥15 kg: 150 mcg/kg as a single dose; retreatment may be given every 6-12 mth until adult worms die.
Child: >5 yr and ≥15kg: 150 mcg/kg as a single dose every 6-12 mth until adult worms die.
Oral
Strongyloidiasis
Adult: 200 mcg/kg as a single dose for 1-2 days.
Child: >15 kg: 200 mcg/kg as a single dose for 1-2 days.
Oral
Filariasis
Adult: Dosing regimen depends on the causative agent. Mansonella streptocerca 150 mcg/kg as a single dose; Mansonella ozzardi 200 mcg/kg as a single dose.
Child: ≥15 kg: Dosing regimen depends on the causative agent. Mansonella streptocerca 150 mcg/kg as a single dose; Mansonella ozzardi 200 mcg/kg as a single dose.
Oral
Ascariasis
Adult: Ascaris lumbricoides 150-200 mcg/kg as a single dose.
Child: ≥15 kg: Ascaris lumbricoides 150-200 mcg/kg as a single dose.
Oral
Gnathostomiasis
Adult: Gnathostoma spinigerum: 200 mcg/kg once daily for 2 days.
Child:
≥15 kg: Gnathostoma spinigerum: 200 mcg/kg once daily for 2 days.
Oral
Scabies

Adult: Sarcoptes scabiei
200 mcg/kg as a single dose, repeat dose in 2 wk.
Child: ≥15 kg: Sarcoptes scabiei 200 mcg/kg as a single dose, repeat dose in 2 wk.
Contraindications
Hypersensitivity. Pregnancy and lactation. Childn <15 kg body weight.
Warnings / Precautions
Concurrent Loa loa infection, impaired blood-brain barrier function due to infection.
Adverse Reactions
Diarrhoea, nausea, vomiting, dizziness, pruritus, urticaria, rash, arthralgia, fever, myalgia, asthenia, postural hypotension, tachycardia, oedema, lymphadenopathy, sore throat, cough, headache, somnolence, transient eosinophilia, raised liver enzyme values.
Drug Interactions
Bioavailability may be increased by alcohol, levamisole.
See Below for More ivermectin Drug Interactions
Food Interactions
Orange juice slightly reduces bioavailability of ivermectin.
Mechanism of Actions
Ivermectin selectively binds and with high affinity to glutamate-gated chloride ion channels, which occur in invertebrate nerve and muscle cells leading to an increase in the permeability of cell membranes to chloride ions with hyperpolarization of the nerve or muscle cell and, ultimately, death of the parasite.
Absorption: Absorbed from the GI tract (oral); peak plasma concentrations after 4 hr.
Distribution: Enters breast milk (<2%). Protein-binding: About 93%.
Excretion: Via faeces (as metabolites), via urine (<1%). Plasma elimination half-life: 12 hr.
Administration
Should be taken on an empty stomach. (Take on an empty stomach.)
ATC Classification
P02CF01 - ivermectin ; Belongs to the class of avermectine agents. Used as antinematodal.
Available As
  • Ivermectin 1.5 mg
  • Ivermectin 12 mg
  • Ivermectin 3 mg
  • Ivermectin 5 mg
  • Ivermectin 6 mg
  • Ivermectin 9 mg
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