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ivermectin

P02CF01

Forms & Strengths

Oral Tablet: 3 mg
Topical Cream: 1%
Topical Lotion: 0.5%
Topical Solution: 0.08%

Adult Dosing

Strongyloidiasis: 200 mcg/kg PO single dose
Onchocerciasis: 150 mcg/kg PO single dose, repeat at 3-12 months
Rosacea (Topical): Apply 1% cream to affected areas once daily
Head Lice (Topical): 0.5% lotion applied to dry hair and scalp, rinse after 10 minutes

Pediatric Dosing

Strongyloidiasis (Children >= 15 kg): 200 mcg/kg PO single dose
Onchocerciasis (Children >= 15 kg and >= 90 cm): 150 mcg/kg PO single dose
Head Lice (Children >= 6 months): 0.5% lotion applied topically as single treatment

Indications

Intestinal strongyloidiasis
Onchocerciasis (river blindness)
Inflammatory lesions of rosacea (topical)
Head lice infestation (topical)

Mechanism of Action

Binds selectively and with high affinity to glutamate-gated chloride channels in invertebrate nerve and muscle cells
Increases cell membrane permeability to chloride ions, resulting in hyperpolarization
Causes paralysis and death of the parasite

Contraindications

Hypersensitivity to ivermectin or any component of the formulation
Oral administration in children weighing less than 15 kg (safety not established)
Oral administration in patients with Loa loa co-infection and high microfilarial load (risk of severe encephalopathy)

Adverse Reactions

Dizziness
Pruritus
Nausea
Diarrhea
Orthostatic hypotension
Mazzotti reaction in onchocerciasis treatment (fever, pruritus, rash, arthralgia, lymphadenopathy)

Drug Interactions

Warfarin: May increase anticoagulant effect, monitor INR closely
Strong CYP3A4 inhibitors (e.g., ketoconazole): May increase ivermectin plasma concentrations
P-glycoprotein inhibitors: May increase systemic exposure of oral ivermectin
CNS depressants: May enhance sedative effects

Curated Content: Needs Vetting Before Put to Clinical Use