Ivermectin
Ascariasis, Elephantiasis ... show more
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DRUG STATUS
Approvals
US(FDA), UK(BNF)
Essential Medicine
YES
Teratogenicity
N/A
Pharmaceutical Class
Antiparasitic, Pediculicide
Ivermectin
Know More About This Medicine -
Click HereSummary
Ivermectin is used to treat infections caused by parasitic worms. It's effective against strongyloidiasis, an intestinal worm infection, and onchocerciasis, also known as river blindness. It can also be used to treat other roundworm infections, head lice, and scabies, a skin infection caused by a mite.
Ivermectin works by killing parasitic worms. In the case of strongyloidiasis, it kills the worms in your intestines. For onchocerciasis, it kills the developing worms but not the adult ones. After you swallow it, your liver breaks it down mostly and you eliminate most of it through your bowel movements over about 12 days.
Ivermectin doses can vary greatly depending on age. For adults, studies have used anywhere from 30 to 120 milligrams at once. Some studies used a much smaller single dose of 12 mg. It's usually taken orally, on an empty stomach with water.
Common side effects of Ivermectin include headache, muscle aches, tiredness, stomach pain, nausea, dizziness, and skin problems. Less common but potentially serious side effects include problems with the nervous system, dangerously low blood pressure, worsening asthma, severe skin reactions, seizures, and liver inflammation.
Avoid Ivermectin if you are allergic to it. It should not be used during pregnancy due to potential risks to the unborn baby. Patients with severe Loa loa infections or significant immune suppression should use it cautiously under medical supervision.
Indications and Purpose
What is Ivermectin used for?
Ivermectin is a medicine used to treat several infections caused by tiny worms called nematodes (roundworms). It effectively treats intestinal strongyloidiasis, an infection of the intestines. It also helps with onchocerciasis (river blindness), although it doesn't kill the adult worms. Ivermectin can also be used for other roundworm infections, head lice, and scabies (a skin infection caused by a mite). Essentially, it's a versatile drug against various parasitic infections.
How does Ivermectin work?
Ivermectin is a medicine that kills parasitic worms (anthelmintic). It works differently depending on the infection. For strongyloidosis (a worm infection in the gut), it kills the worms in the intestines. For onchocerciasis (river blindness), it kills developing worms, but not the adult ones. After you swallow it, the amount of ivermectin in your blood is directly related to the dose you take. Your liver breaks it down mostly, and you eliminate most of it through your bowel movements over about 12 days. It takes about 18 hours for half the medicine to leave your body (plasma half-life). Eating a fatty meal significantly increases how much of the medicine your body absorbs – about 2.5 times more. CYP3A4 refers to a specific liver enzyme involved in breaking down many medications.
Is Ivermectin effective?
Ivermectin is effective against certain parasitic worms. Studies show it can cure strongyloidiasis (a parasitic worm infection) in 64-100% of cases with a single dose. For onchocerciasis (river blindness), a single dose significantly reduces the number of parasitic larvae in the skin, although it doesn't kill the adult worms. Compared to other anti-parasitic drugs like albendazole and thiabendazole, ivermectin is better for strongyloidiasis and equally effective for some cases. Microfilariae are the larval stage of parasitic worms. mcg/kg refers to the dosage of the medicine – micrograms (mcg) per kilogram (kg) of body weight.
How does one know if Ivermectin is working?
Ivermectin's safety and effectiveness have been studied. Tests show it doesn't damage DNA (genotoxicity). While we lack enough data on children and the elderly, studies haven't shown different effects between age groups. The body processes ivermectin mainly through the liver enzyme CYP3A4 (a protein that breaks down drugs). Common side effects include tiredness, stomach pain, nausea, dizziness, and skin problems. Finally, confirming the elimination of a specific parasitic worm infection (strongyloidiasis) needs a stool test.
Directions for Use
What is the usual dose of Ivermectin?
Ivermectin doses vary greatly depending on age. For adults, studies have used anywhere from 30 to 120 milligrams (mg) at once. Some studies used a much smaller single dose of 12 mg. There's no established safe and effective dose for children under 22 pounds (15 kilograms kg). Milligrams (mg) and kilograms (kg) are units of weight. A milligram is a thousandth of a gram, and a kilogram is a thousand grams. Micrograms (mcg) are one millionth of a gram; so 165 mcg/kg means 165 micrograms of ivermectin per kilogram of body weight.
How do I take Ivermectin?
Ivermectin tablets should be taken on an empty stomach with water. This means you should take them at least one hour before or two hours after eating a meal. Following this instruction helps your body absorb the medication more effectively. Unless your doctor tells you otherwise, you can continue your regular diet. There are no dietary restrictions associated with ivermectin, aside from the timing of meals relative to taking the medication.
For how long do I take Ivermectin?
Treatment typically involves a single dose, but for onchocerciasis, repeat doses may be needed every 3, 6, or 12 months to manage infections. Follow-up stool tests or evaluations are often required to confirm eradication in strongyloidiasis.
How long does it take for Ivermectin to start working?
Ivermectin begins working within a few hours after ingestion. Improvement in symptoms or reduction in parasite counts is usually observed within days to weeks, depending on the infection.
How should I store Ivermectin?
Store at room temperature (below 30°C/86°F), away from moisture and heat. Keep the medicine in its original container and out of reach of children.
Warnings and Precautions
Who should avoid taking Ivermectin?
Avoid Ivermectin if you are allergic to it or its components. Patients with severe Loa loa infections or significant immune suppression should use it cautiously under medical supervision.
Can I take Ivermectin with other prescription drugs?
Ivermectin may interact with blood thinners like warfarin (elevating INR levels) and medications affecting liver enzymes (e.g., CYP3A4 inhibitors). Inform your doctor of all prescription drugs to prevent complications.
Can I take Ivermectin with vitamins or supplements?
There are no major known interactions with vitamins or supplements, but always inform your doctor about all products you are taking to avoid unforeseen interactions.
Can Ivermectin be taken safely while pregnant?
Ivermectin should not be used during pregnancy. We don't know if it's safe for pregnant women and their babies because there haven't been enough good studies. While it doesn't seem to directly harm the unborn baby (fetotoxic means harmful to the fetus), we can't be completely sure. Tests on animals showed birth defects (teratogenicity) at high doses that also harmed the mother. Because of these uncertainties, it's best to avoid ivermectin while pregnant.
Can Ivermectin be taken safely while breastfeeding?
Ivermectin is found in small amounts in breast milk. If a breastfeeding mother needs to take ivermectin, she should discuss the risks and benefits with her doctor. The doctor will help her decide if the medicine's benefits for her outweigh any potential risks to her baby. Essentially, the decision depends on whether the mother's need for ivermectin is more important than the possible effects on the baby.
Is Ivermectin safe for the elderly?
Ivermectin's safety for older adults isn't completely known. Doctors should be careful when prescribing it to seniors. This is because older people may have weaker livers (hepatic), kidneys (renal), or hearts (cardiac). They might also have other health problems (concomitant diseases) or be taking other medications (drug therapies) that could interact badly with ivermectin. Therefore, using ivermectin in elderly patients requires extra caution and close monitoring.
Is it safe to exercise while taking Ivermectin?
Exercise is generally safe, but avoid intense physical activity if you experience dizziness or fatigue. Listen to your body and adjust your routine as needed during treatment.
Is it safe to drink alcohol while taking Ivermectin?
Alcohol is best avoided as it may worsen side effects like dizziness or nausea. Consult your doctor for personalized advice about alcohol use.
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