Ivermectin
STROMECTOL
What it isGlutamate-gated chloride channel agonist in invertebrates; strongyloidiasis, onchocerciasis, scabies and rosacea.
Why this oneA single oral dose treats strongyloidiasis, and it is the oral option for crusted scabies.
What limits itSevere encephalopathy if Loa loa co-infection is present. It has no established role in viral illness.
FDA-approved for
- strongyloidiasis and onchocerciasis
- head lice and rosacea (topical)
Off-label
- crusted scabies with topical permethrin
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Strongyloidiasis | ≥15 kg | ~200 mcg/kg single oral dose | ||
| Onchocerciasis | ≥15 kg | ~150 mcg/kg single oral dose |
Renal Undefined
Hepatic Undefined
Onchocerciasis: retreatment at intervals as short as 3 months (mass programs commonly every 12 months).
Instructions
- Take on an empty stomach with water
- Give as a single oral dose
- Strongyloidiasis: perform follow-up stool exams to verify eradication
Cautions
- Onchocerciasis: Mazzotti-type reactions and ophthalmologic reactions in the first days post-treatment
Adverse reactions
- Strongyloidiasis: dizziness, pruritus, nausea, diarrhea, fatigue
- Onchocerciasis (Mazzotti): arthralgia/synovitis, lymph node enlargement/tenderness, pruritus, fever
- Transient transaminase elevation, leukopenia
Pregnancy Should not be used during pregnancy; safety not established (animal teratogenicity at maternotoxic doses).
Lactation Undefined
NO BOXED WARNINGS
Principal riskEncephalopathy if Loa loa co-infection is present
Cost, est. cash$10–$300/month
Generic entry2014
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Ivermectin ballicule
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