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Ivermectin (systemic): Drug information

Ivermectin (systemic): Drug information
(For additional information see "Ivermectin (systemic): Patient drug information" and see "Ivermectin (systemic): Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Stromectol
Pharmacologic Category
  • Anthelmintic
Dosing: Adult
Ascariasis

Ascariasis (alternative agent) (off-label use):

Note: For patients with complications (eg, intestinal obstruction, acute cholangitis), initiate therapy after resolution of acute symptoms (Ref).

Oral: 150 to 200 mcg/kg as a single dose (Ref).

Demodex folliculitis

Demodex folliculitis (off-label use): Oral: 200 mcg/kg once weekly for 2 doses (Ref).

Gnathostomiasis, cutaneous

Gnathostomiasis, cutaneous (off-label use):

Note: Not recommended for CNS disease due to inflammatory response from dying larvae (Ref).

Oral: 200 mcg/kg once daily for 2 days (Ref).

Hookworm-related cutaneous larva migrans

Hookworm-related cutaneous larva migrans (off-label use): Oral: 200 mcg/kg once daily for 1 or 2 days (Ref).

Lice, refractory

Lice, refractory (off-label use):

Note: Reserve for patients with an insufficient response to topical therapy (Ref). Optimal dose, dosing interval, and frequency are uncertain (Ref).

Pediculus capitis: Oral: 200 mcg/kg once weekly for 2 doses (Ref); some experts suggest 400 mcg/kg once weekly for 2 doses (Ref).

Pediculosis pubis: Oral: 200 mcg/kg once weekly for 2 doses (Ref); some experts suggest 250 mcg/kg once, with a repeat dose in 7 to 14 days (Ref).

Mansonella infection

Mansonella infection (off-label use):

Note: For individuals from Loa loa–endemic areas, rule out co-infection prior to ivermectin administration to avoid life-threatening encephalopathy (Ref).

Mansonella ozzardi: Oral: 150 mcg/kg as a single dose (Ref).

Mansonella streptocerca infection (alternative agent): Oral: 150 mcg/kg as a single dose (Ref).

Onchocerciasis

Onchocerciasis:

Note: For individuals from Loa loa–endemic areas, rule out co-infection prior to ivermectin administration to avoid life-threatening encephalopathy (Ref).

Oral: 150 mcg/kg once; repeat dose every 3 to 6 months until asymptomatic (Ref). For patients outside endemic areas or in areas with low transmission, doxycycline therapy is initiated 1 week after the initial ivermectin dose (Ref).

Scabies

Scabies (off-label use):

Note: For cohabitants or other individuals who have had prolonged skin-to-skin contact within the previous 6 weeks, simultaneous treatment is recommended (Ref).

Classic scabies, treatment: Oral: 200 mcg/kg once; repeat dose in 7 to 14 days (Ref).

Crusted scabies, treatment: Oral: 200 mcg/kg once daily in combination with permethrin for 3, 5, or 7 nonconsecutive days depending on infection severity (eg, for 3 days: give on days 1, 2, and 8; for 5 days: give on days 1, 2, 8, 9, and 15; for 7 days: give on days 1, 2, 8, 9, 15, 22, and 29) (Ref).

Strongyloidiasis

Strongyloidiasis:

Note: For individuals from Loa loa–endemic areas, rule out co-infection prior to ivermectin administration to avoid life-threatening encephalopathy (Ref).

Uncomplicated infection:

Patients who are immunocompetent: Oral: 200 mcg/kg once daily for 1 or 2 days (Ref).

Patients who are immunocompromised: Oral: 200 mcg/kg once daily for 2 days; repeat dosing regimen in 2 weeks (Ref).

Severe, disseminated infection: Oral: 200 mcg/kg once daily until symptoms have resolved and stool and/or sputum examination is negative for ≥2 weeks (Ref). Some experts suggest switching to an alternative approach for patients who are immunocompromised or critically ill with persistently positive (eg, ≥3 days) stool examination (Ref). For patients with persistent immunosuppression after clinical improvement, some experts use suppressive ivermectin 200 mcg/kg once monthly for ≥6 months (Ref).

Trichuriasis

Trichuriasis (whipworm) (alternative agent) (off-label use): Oral: 600 mcg/kg once daily for 3 days in combination with albendazole (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: No dosage adjustment necessary for any degree of kidney dysfunction (<1% excreted in the urine) (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be significantly dialyzed (highly protein bound; large Vd): No supplemental dose or dosage adjustment necessary (Ref).

Peritoneal dialysis: Unlikely to be significantly dialyzed (highly protein bound; large Vd): No dosage adjustment necessary (Ref).

CRRT: No dosage adjustment necessary (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): No dosage adjustment necessary (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in manufacturer’s labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Ivermectin (systemic): Pediatric drug information")

Dosage guidance:

Safety: For individuals from Loa loa-endemic areas, rule out coinfection prior to ivermectin administration to avoid life-threatening encephalopathy (Ref).

Dosing: Description of ivermectin use in infants and children weighing <15 kg is limited due to theoretical risk for CNS adverse events, however it has been used in this population for a variety of indications with no reports of serious adverse events (Ref). Following the indication-specific dosing information are weight-band dosing tables to assist with calculation and rounding of doses.

Ascariasis; roundworm

Ascariasis (Ascaris lumbricoides); roundworm (alternative agent): Limited data available: Children ≥15 kg and Adolescents: Oral: 150 to 200 mcg/kg/dose as a single dose (Ref).

Gnathostomiasis, cutaneous

Gnathostomiasis, cutaneous: Limited data available: Children ≥15 kg and Adolescents: Oral: 200 mcg/kg/dose once daily for 2 days (Ref).

Hookworm-related cutaneous larva migrans

Hookworm-related cutaneous larva migrans: Limited data available: Children ≥15 kg and Adolescents: Oral: 200 mcg/kg as a single dose (Ref).

Lice

Lice (alternative agent): Limited data available: Note: Ivermectin is not ovicidal; therefore, repeat doses are necessary to eradicate infestation:

Head lice: Children ≥15 kg and Adolescents: Oral: 200 to 400 mcg/kg/dose for 2 doses administered 9 to 10 days apart. Dosing at the higher end of the range (ie, 400 mcg/kg/dose) may result in fewer treatment failures (Ref).

Pubic lice: Children ≥15 kg and Adolescents: Oral: 250 mcg/kg/dose for 2 doses administered 7 to 14 days apart (Ref).

Mansonella infection

Mansonella infection:

Mansonella ozzardi: Limited data available: Children ≥15 kg and Adolescents: Oral: 150 mcg/kg as a single dose (Ref).

Mansonella streptocerca : Limited data available: Children ≥15 kg and Adolescents: Oral: 150 mcg/kg as a single dose (Ref).

Onchocerciasis; river blindness

Onchocerciasis (Onchocerca volvulus); river blindness:

Children ≥15 kg and Adolescents: Oral: 150 mcg/kg/dose every 3 to 6 months until asymptomatic (Ref). Ivermectin is only effective against microfilariae; if treatment of macrofilariae is desired, doxycycline may be initiated 1 week after ivermectin treatment (Ref).

Scabies

Scabies: Limited data available: Children ≥15 kg and Adolescents: Oral: 200 mcg/kg/dose for 2 doses administered at 7 to 14 days apart (Ref).

Strongyloidiasis

Strongyloidiasis:

Children ≥15 kg and Adolescents: Oral: 200 mcg/kg/dose once daily for 1 to 2 days. Patients with hyperinfection and disseminated disease may need prolonged or repeated treatment (eg, daily treatment until stool and/or sputum exams are negative for 2 weeks) (Ref).

Trichuriasis; whipworm

Trichuriasis ( Trichuris trichiura); whipworm: Limited data available: Children ≥15 kg and Adolescents: Oral: 200 mcg/kg/dose once daily for 3 days (Ref).

Weight-band dosing: Weight-band dosing tables are provided to assist with calculation and rounding of doses; refer to indication-specific dosing for details.

Weight-Band Dosing to Provide ~150 mcg/kg

Patient Weight

Single Oral Dose

15 to 25 kg

3 mg

26 to 44 kg

6 mg

45 to 64 kg

9 mg

65 to 84 kg

12 mg

Weight-Band Dosing to Provide ~200 mcg/kg

Patient Weight

Single Oral Dose

15 to 24 kg

3 mg

25 to 35 kg

6 mg

36 to 50 kg

9 mg

51 to 65 kg

12 mg

66 to 79 kg

15 mg

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling.

Adverse Reactions (Significant): Considerations
CNS effects

CNS effects including neurotoxicity (eg, ataxia, confusion, disorientation, encephalopathy, impaired consciousness [including coma], stupor, tremor) and central nervous system depression with subsequent breathing difficulties, have rarely been reported in humans, but are well known to occur in animals (Ref). Theoretical risk for CNS effects in infants and young children due to immature blood-brain barrier has been extrapolated from animal data and has minimized use in patients <15 kg. Existing data in younger pediatric patients are limited, with recent evaluations describing ivermectin use in patients <15 kg for a variety of indications with no reports of serious adverse events (Ref).

Mechanism: CNS effects occur when ivermectin crosses the blood-brain barrier into the spinal cord, midbrain or cerebrum and blocks important neuronal transmission that involves glutamate or gamma-amino butyric acid (Ref). In infants and young children, it has been proposed that ivermectin may cross the immature blood-brain barrier, resulting in CNS toxicity (Ref). In patients with a well-developed blood-brain barrier, the neurological adverse effects of ivermectin are thought to occur when the ATP-binding cassette subfamily B member 1 (ABCB1) transporter (also known as P-glycoprotein) is altered and fails to prevent the uptake of ivermectin into the brain (Ref).

Onset: Rapid; typically occurs within hours of dosing, although has also been described as late as 7 days after administration (Ref).

Risk factors:

• Immature blood-brain barrier (Ref)

• Body weight <15 kg as a surrogate marker for an immature blood-brain barrier (Ref)

• Mutation in ABCB1 (P-glycoprotein) transporter (Ref)

Hypersensitivity reactions (delayed)

A variety of delayed hypersensitivity reactions, ranging from skin rash to severe cutaneous adverse reactions (SCAR), including Stevens-Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms have been reported with ivermectin use (Ref).

Mechanism: Non–dose-related; immunologic. Delayed hypersensitivity reactions, including rashes (often maculopapular) and SCARs are T-cell-mediated (Ref).

Onset: Delayed hypersensitivity reactions: Varied. SCARs usually occur within 1 to 8 weeks after initiation (Ref), although cases associated with ivermectin have been reported within 3 days after receiving a single dose (Ref).

Immunologic post-treatment reaction (Mazzoti reaction)

Ivermectin may cause an immunologic post-treatment reaction, also known as a Mazzoti reaction, which is associated with pruritus, skin rash, fever, fatigue, lymphadenopathy, arthralgia, tachycardia, hypotension (including orthostatic hypotension), edema, and abdominal pain (Ref). Most cases have been reported in association with the treatment of onchocerciasis, but cases have also been reported in association with the treatment of other infections (eg, scabies) (Ref). Symptoms are mostly mild and usually resolve in 4 days; however, cases of coma and death have been reported, although these deaths are often attributed to Loa loa-associated encephalopathy (Ref). Serious Mazzoti reactions are estimated to occur in 19% to 81% of patients exposed to ivermectin for the treatment of filarial parasites, which is disproportionality more than other antinematodal drugs (Ref).

Mechanism: Non–dose-related; immunologic. Ivermectin exerts a strong microfilaricidal effect on filariae, leading to a destruction of microfilariae. In patients with high densities of microfilariae in the skin or blood, this may induce complex inflammatory reactions resulting in local tissue damage and degradation of host structures (Ref).

Onset: Varied; within 1 to 7 days of therapy initiation (Ref).

Risk factors:

• High densities of microfilariae (ie, the larval stages of the filarial parasites) (Ref)

• Treatment of filarial parasites (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

≥10%: Miscellaneous: Mazzotti reaction (associated with onchocerciasis: pruritus: 28%; fever: 23%; skin edema, papular rash, pustular rash, and urticaria: ≤23%; arthralgia and synovitis: ≤9%; lymphadenitis [axillary node: 4% to 11%, cervical node: 1% to 5%, inguinal node: 13% to 14%, other lymph node: 2% to 3%])

1% to 10%:

Cardiovascular: Orthostatic hypotension (1%), peripheral edema (3%), tachycardia (4%)

Dermatologic: Pruritus (associated with strongyloidiasis: 3%)

Gastrointestinal: Diarrhea (2%), nausea (2%)

Hematologic & oncologic: Decreased white blood cell count (3%), eosinophilia (3%), increased hemoglobin (1%)

Hepatic: Increased serum alanine aminotransferase (2%), increased serum aspartate aminotransferase (2%)

Hypersensitivity: Facial edema (1%)

Nervous system: Dizziness (3%)

Ophthalmic: Inflammation of limbus of eyes (4% to 6%), punctate cataract (1% to 2%)

<1%:

Dermatologic: Skin rash, urticaria (associated with strongyloidiasis)

Gastrointestinal: Abdominal pain, anorexia, constipation, vomiting

Hematologic & oncologic: Anemia, leukopenia

Nervous system: Asthenia, drowsiness, fatigue, headache, tremor, vertigo

Neuromuscular & skeletal: Myalgia

Ophthalmic: Vision loss

Frequency not defined:

Cardiovascular: Chest discomfort

Gastrointestinal: Abdominal distention

Postmarketing:

Cardiovascular: Hypotension

Dermatologic: Stevens-Johnson syndrome (Oshikoya 2020), toxic epidermal necrolysis (Oshikoya 2020)

Hepatic: Hepatitis (Veit 2006), increased liver enzymes, increased serum bilirubin

Hypersensitivity: Drug reaction with eosinophilia and systemic symptoms (Kerneuzet 2018)

Nervous system: Central nervous system depression (Chandler 2018), neurotoxicity (including ataxia, confusion, disorientation, encephalopathy, impaired consciousness [including coma], stupor) (Baudou 2020; Chandler 2018), seizure (Chandler 2018)

Ophthalmic: Abnormal sensation in eyes, anterior uveitis, chorioretinitis (including choroiditis), conjunctival hemorrhage, conjunctivitis, diplopia (Campillo 2021), eyelid edema, keratitis

Respiratory: Exacerbation of asthma

Contraindications

Hypersensitivity to ivermectin or any component of the formulation

Warnings/Precautions

Special populations:

• Immunocompromised patients: Repeated treatment may be required in immunocompromised patients (eg, HIV); control of extraintestinal strongyloidiasis may necessitate suppressive (once monthly) therapy.

Other warnings/precautions:

• Appropriate use: Onchocerca volvulus: Ivermectin has no activity against adult O. volvulus parasites. L. loa: Ivermectin is not active against adult worms.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Stromectol: 3 mg

Generic: 3 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Ivermectin Oral)

3 mg (per each): $4.97

Tablets (Stromectol Oral)

3 mg (per each): $5.58

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: Administer on an empty stomach with water (manufacturer’s labeling). Some experts recommend administering with food to increase absorption (Ref).

Administration: Pediatric

Oral: The manufacturer recommends administration on an empty stomach with water. However, some experts recommend administering with food to increase absorption; administration with a high-fat meal as compared to fasted increased bioavailability ~2.5 times in healthy volunteers (Ref).

Use: Labeled Indications

Onchocerciasis: Treatment of onchocerciasis due to the immature form of Onchocerca volvulus.

Limitations of use: Ivermectin has no activity against adult Onchocerca volvulus parasites. The adult parasites reside in subcutaneous nodules, which are infrequently palpable. Surgical excision may be considered since removal of these nodules will eliminate the microfilariae-producing adult parasites.

Strongyloidiasis: Treatment of intestinal (eg, nondisseminated) strongyloidiasis due to Strongyloides stercoralis.

Use: Off-Label: Adult

Ascariasis; Demodex folliculitis; Gnathostomiasis, cutaneous; Hookworm-related cutaneous larva migrans; Lice, refractory; Mansonella infection; Scabies; Trichuriasis

Medication Safety Issues
Pediatric patients: High-risk medication:

KIDs List: Ivermectin (systemic), when used in infants <1 year of age, is identified on the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) list and should be avoided due to risk of encephalopathy (weak recommendation; low quality of evidence) (PPA [Meyers 2020]).

Metabolism/Transport Effects

Substrate of CYP3A4 (minor), P-glycoprotein/ABCB1 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Bacillus clausii: Antibiotics may diminish the therapeutic effect of Bacillus clausii. Management: Bacillus clausii should be taken in between antibiotic doses during concomitant therapy. Risk D: Consider therapy modification

BCG (Intravesical): Antibiotics may diminish the therapeutic effect of BCG (Intravesical). Risk X: Avoid combination

BCG Vaccine (Immunization): Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Risk C: Monitor therapy

Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid combination

Fecal Microbiota (Live) (Oral): May diminish the therapeutic effect of Antibiotics. Risk X: Avoid combination

Fecal Microbiota (Live) (Rectal): Antibiotics may diminish the therapeutic effect of Fecal Microbiota (Live) (Rectal). Risk X: Avoid combination

Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies): Antibiotics may diminish the therapeutic effect of Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies). Risk C: Monitor therapy

Lactobacillus and Estriol: Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol. Risk C: Monitor therapy

Sodium Picosulfate: Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider therapy modification

Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider therapy modification

Vitamin K Antagonists (eg, warfarin): Ivermectin (Systemic) may enhance the anticoagulant effect of Vitamin K Antagonists. Risk C: Monitor therapy

Food Interactions

Bioavailability appears to be increased with food, but the extent of the interaction is uncertain. When administered following a high-fat meal, bioavailability has been shown to increase 1.18- to 2.57-fold with a wide range of doses studied (6 to 30 mg) (Duthaler 2020; Guzzo 2002; Miyajima 2016). Management: The manufacturer recommends to administer on an empty stomach, although some experts recommend administering with food to increase absorption (CDC [Workowski 2021]; Currie 2010).

Reproductive Considerations

Evaluate pregnancy status prior to use in patients who may become pregnant; patients arriving as refugees from specific countries should not be given ivermectin for the presumptive treatment of intestinal parasites without a reliable history of their last menstrual period (CDC 2019a).

Pregnancy Considerations

Outcome information following maternal use of ivermectin during pregnancy is primarily limited to inadvertent exposure during mass treatment programs (Chippaux 1993; Gyapong 2003; Ndyomugyenyi 2008; Nicolas 2020; Pacqué 1990; Westlake 2020).

The decision to use ivermectin during pregnancy should consider the specific indication (eg, onchocerciasis or Strongyloides infection) and the risk of disease progression in the absence of treatment (CDC 2021; CDC 2022) Although use in pregnancy is likely low risk, other agents are currently recommended for the treatment of pediculosis pubis or scabies in pregnant patients (CDC [Workowski 2021]).

Breastfeeding Considerations

Ivermectin is present in breast milk.

Peak ivermectin breast milk concentrations generally occurred between 4 hours (n=2) and 6 hours (n=2) after a single maternal dose; although the peak breast milk concentration occurred at 12 hours in one patient (Ogbuokiri 1994; Rodari 2020).

The decision to use ivermectin in a patient who is breastfeeding should consider the specific indication (eg, onchocerciasis or Strongyloides infection) and the risk of disease progression in the absence of treatment (CDC 2021; CDC 2022). Although use is likely low risk, other agents are currently recommended for the treatment of pediculosis pubis or scabies in patients who are breastfeeding (CDC [Workowski 2021]). Breastfeeding patients arriving as refugees from specific countries should not be given ivermectin for the presumptive treatment of intestinal parasites during their first week postpartum (CDC 2019a).

Monitoring Parameters

Skin and eye microfilarial counts, periodic ophthalmologic exams; follow up stool examinations; signs and symptoms of neurotoxicity.

Mechanism of Action

Ivermectin is a semisynthetic anthelminthic agent; it binds selectively and with strong affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to increased permeability of cell membranes to chloride ions then hyperpolarization of the nerve or muscle cell, and death of the parasite.

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Well absorbed in the fasting state (Baraka 1996; Edwards 1988; Okonkwo 1993); may be increased with a high-fat meal (Duthaler 2020; Guzzo 2002; Miyajima 2013).

Distribution: Vd:

Children 2 to 5 years: Median range: 7.46 to 8.26 L/kg (Schulz 2019).

Children 6 to 12 years: Median range: 8.58 to 10.4 L/kg (Schulz 2019).

Adults: 3.1 to 3.5 L/kg in healthy volunteers; mean 9.9 L/kg (range: 6.9 to 15.3 L/kg) in patients with onchocerciasis; high concentration in the liver and adipose tissue; does not readily cross the blood-brain barrier (Gonzalez Canga 2008; Okonkwo 1993).

Protein binding: ~93% primarily to albumin (Gonzalez Canga 2008).

Metabolism: Hepatic via CYP3A4 (major), CYP2D6 (minor), and CYP2E1 (minor).

Half-life elimination:

Children 2 to 5 years: Median range: 16.3 to 17.3 hours (Schulz 2019).

Children 6 to 12 years: Median range: 18.1 to 19.1 hours (Schulz 2019).

Adults: 18 hours.

Time to peak, serum: ~4 hours.

Excretion: Feces; urine (<1%).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Imectin;
  • (AR) Argentina: Iver p | Ivercass | Ivertal | Securo | Vermectin;
  • (AT) Austria: Scabioral;
  • (AU) Australia: Stromectol;
  • (BD) Bangladesh: Ivactin;
  • (BG) Bulgaria: Huvemec;
  • (BR) Brazil: Ivermec | Ivermectina | Iverneo | Leverctin | Plurimec | Revectina | Uciose | Vermectil;
  • (CL) Chile: Kaonol;
  • (CN) China: Hai zheng mai ke ding;
  • (DE) Germany: Driponin | Iveraxiro | Ivermectin Padia | Scabioral;
  • (DO) Dominican Republic: Ivermectina | Ivermectina calox | Ivermectina mamey | Ivexterm;
  • (EE) Estonia: Stromectol;
  • (EG) Egypt: Ivactin | Iverzine | Razimectin;
  • (ES) Spain: Ivergalen;
  • (FI) Finland: Scatol;
  • (FR) France: Ivermectine arrow | Ivermectine biogaran | Ivermectine cristers | Ivermectine eg | Ivermectine mylan | Ivermectine pierre fabre | Ivermectine sandoz | Ivermectine zentiva | Iverscal | Stromectol;
  • (GB) United Kingdom: Stromectol;
  • (GR) Greece: Scaball;
  • (HK) Hong Kong: Stromectol;
  • (IN) India: Afdiver | Covidmectin | Covimac | Ivecop | Iver sol | Ivercid | Ivermectol | Iverpil | Iverzen | Ivor | Mectin | Scavista | Vermact | Vermectin;
  • (IT) Italy: Stromectol;
  • (JP) Japan: Stromectol;
  • (KE) Kenya: Ivermectol;
  • (KR) Korea, Republic of: Iverin;
  • (LB) Lebanon: Ivactin | Iver p | Ivermectine | Ivermectine biogaran;
  • (LT) Lithuania: Scabioral | Stromectol;
  • (LV) Latvia: Stromectol;
  • (MX) Mexico: Ivexterm | Stromectol | Veridex;
  • (MY) Malaysia: Ivermectol;
  • (NL) Netherlands: Ivermectine xiromed | Stromectol;
  • (NO) Norway: Driponin | Scatol | Stromectol | Stromectol specific;
  • (NZ) New Zealand: Stromectol;
  • (PE) Peru: Kaonol;
  • (PK) Pakistan: Everlite | Felvot | Iveratan | Iverest | Ivermite | Iverterm | Mectis | Norm | Suint;
  • (PR) Puerto Rico: Stromectol;
  • (PT) Portugal: Mectizan | Stromectol;
  • (PY) Paraguay: Ivermectina dutriec | Ivermectina guayaki | Kaonol | Vivermet | Yvermil;
  • (SE) Sweden: Scatol;
  • (SG) Singapore: Stromectol;
  • (SI) Slovenia: Stromectol;
  • (SL) Sierra Leone: Mectizan;
  • (TW) Taiwan: Stromectol;
  • (UY) Uruguay: Iver 6 | Ivermectina | Ivermectina Athena | Sanifer;
  • (VE) Venezuela, Bolivarian Republic of: Ivergot | Ivermectina | Iverwell
  1. Addiss DG, Beach MJ, Streit TG, et al, "Randomised Placebo-Controlled Comparison of Ivermectin and Albendazole Alone and in Combination for Wuchereria bancrofti Microfilaraemia In Haitian Children," Lancet, 1997, 350(9076):480–4. [PubMed 9274584]
  2. American Academy of Pediatrics (AAP). Devore CD, Schutze GE; The Council on School Health and Commitee on Infectious Diseases. Head Lice. Pediatrics. 2015; 135:e1355-e1365.
  3. American Academy of Pediatrics (AAP). In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics; 2021.
  4. Aroke D, Tchouakam DN, Awungia AT, Mapoh SY, Ngassa SN, Kadia BM. Ivermectin induced Steven-Johnsons syndrome: case report. BMC Res Notes. 2017;10(1):179. doi:10.1186/s13104-017-2500-5 [PubMed 28482929]
  5. Baraka OZ, Mahmoud BM, Marschke CK, Geary TG, Homeida MM, Williams JF. Ivermectin distribution in the plasma and tissues of patients infected with Onchocerca volvulus. Eur J Clin Pharmacol. 1996;50(5):407-410. doi:10.1007/s002280050131 [PubMed 8839664]
  6. Baudou E, Lespine A, Durrieu G, et al. Serious ivermectin toxicity and human ABCB1 nonsense mutations. N Engl J Med. 2020;383(8):787-789. doi:10.1056/NEJMc1917344 [PubMed 32813957]
  7. Belizario VY, Amarillo ME, de Leon WU, de los Reyes AE, Bugayong MG, Macatangay BJ. A comparison of the efficacy of single doses of albendazole, ivermectin, and diethylcarbamazine alone or in combinations against Ascaris and Trichuris spp. Bull World Health Organ. 2003;81(1):35-42. [PubMed 12640474]
  8. Bellón T. Mechanisms of severe cutaneous adverse reactions: Recent advances. Drug Saf. 2019;42(8):973-992. doi:10.1007/s40264-019-00825-2 [PubMed 31020549]
  9. Boussinesq M, Gardon J, Gardon-Wendel N, Kamgno J, Ngoumou P, Chippaux JP. Three probable cases of Loa loa encephalopathy following ivermectin treatment for onchocerciasis. Am J Trop Med Hyg. 1998;58(4):461-469. doi:10.4269/ajtmh.1998.58.461 [PubMed 9574793]
  10. Brockow K, Przybilla B, Aberer W, et al. Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists (AeDA), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Contact Dermatitis Research Group (DKG), the Swiss Society for Allergy and Immunology (SGAI), the Austrian Society for Allergology and Immunology (ÖGAI), the German Academy of Allergology and Environmental Medicine (DAAU), the German Center for Documentation of Severe Skin Reactions and the German Federal Institute for Drugs and Medical Products (BfArM). Allergo J Int. 2015;24(3):94-105. doi:10.1007/s40629-015-0052-6 [PubMed 26120552]
  11. Brooks PA, Grace RF. Ivermectin is better than benzyl benzoate for childhood scabies in developing countries. J Paediatr Child Health. 2002;38(4):401-414. doi:10.1046/j.1440-1754.2002.00015.x [PubMed 12174005]
  12. Burkhart CG, Burkhart CN. Oral Ivermectin for Phthirus pubis. J Am Acad Dermatol. 2004;51(6):1037; author reply 1037-1038. doi:10.1016/j.jaad.2004.04.041 [PubMed 15583618]
  13. Burkhart CN, Burkhart CG. Before using ivermectin therapy for scabies. Pediatr Dermatol. 1999;16(6):478-479; discussion 480. doi:10.1046/j.1525-1470.1999.00124.x [PubMed 10632951]
  14. Campillo JT, Boussinesq M, Bertout S, Faillie JL, Chesnais CB. Serious adverse reactions associated with ivermectin: A systematic pharmacovigilance study in sub-Saharan Africa and in the rest of the World. PLoS Negl Trop Dis. 2021;15(4):e0009354. doi:10.1371/journal.pntd.0009354 [PubMed 33878105]
  15. Carme B, Ebikili B, Mbitsi A, Copin N. [Therapeutic trial with ivermectin in loiasis with medium and high microfilaremia]. [Article in French]. Am J Trop Med Hyg. 1988;39(5):480-483. [PubMed 2043000]
  16. Centers for Disease Control and Prevention (CDC). Guidelines for overseas presumptive treatment of strongyloidiasis, schistosomiasis, and soil-transmitted helminth infections for refugees resettling to the United States. https://www.cdc.gov/immigrantrefugeehealth/guidelines/overseas/intestinal-parasites-overseas.html. Updated February 2019a. Accessed November 9, 2020.
  17. Centers for Disease Control and Prevention (CDC). Parasites - Onchocerciasis (also known as River Blindness). https://www.cdc.gov/parasites/onchocerciasis/health_professionals/index.html. Updated November 10, 2021. Accessed July 25, 2022.
  18. Centers for Disease Control and Prevention (CDC). Parasites - Strongyloides. https://www.cdc.gov/parasites/strongyloides/health_professionals/index.html. Updated July 7, 2022. Accessed July 13, 2022.
  19. Centers for Disease Control and Prevention (CDC). Parasites - Strongyloides. https://www.cdc.gov/parasites/strongyloides/health_professionals/index.html. Updated June 16, 2023. Accessed July 19, 2023.
  20. Centers for Disease Control and Prevention (CDC). Parasites - zoonotic hookworm. https://www.cdc.gov/parasites/zoonotichookworm/health_professionals/index.html. Updated May 26, 2020. Accessed July 19, 2023.
  21. Centers for Disease Control and Prevention (CDC). Scabies. http://www.cdc.gov/parasites/scabies/health_professionals/meds.html. Updated October 2019b. Accessed April 15, 2022.
  22. Chandler RE. Serious neurological adverse events after ivermectin-do they occur beyond the indication of onchocerciasis? Am J Trop Med Hyg. 2018;98(2):382-388. doi:10.4269/ajtmh.17-0042 [PubMed 29210346]
  23. Chippaux JP, Gardon-Wendel N, Gardon J, Ernould JC. Absence of any adverse effect of inadvertent ivermectin treatment during pregnancy. Trans R Soc Trop Med Hyg. 1993;87(3):318. doi:10.1016/0035-9203(93)90146-h [PubMed 8236406]
  24. Chosidow O, Giraudeau B, Cottrell J, et al. Oral ivermectin versus malathion lotion for difficult-to-treat head lice. N Engl J Med, 2010;362(10):896-905. doi:10.1056/NEJMoa0905471 [PubMed 20220184]
  25. Currie BJ, McCarthy JS. Permethrin and ivermectin for scabies. N Engl J Med. 2010;362(8):717-725. doi:10.1056/NEJMct0910329 [PubMed 20181973]
  26. de Almeida Basano S, de Souza Almeida Aranha Camargo J, Fontes G, et al. Phase III clinical trial to evaluate ivermectin in the reduction of Mansonella ozzardi infection in the Brazilian Amazon. Am J Trop Med Hyg. 2018;98(3):786-790. doi:10.4269/ajtmh.17-0698 [PubMed 29313486]
  27. de Almeida Basano S, Fontes G, Medeiros JF, et al. Sustained clearance of Mansonella ozzardi infection after treatment with ivermectin in the Brazilian Amazon. Am J Trop Med Hyg. 2014;90(6):1170-1175. doi:10.4269/ajtmh.13-0410 [PubMed 24710613]
  28. de Silva N, Guyatt H, and Bundy D, “Anthelmintics. A Comparative Review of Their Clinical Pharmacology,” Drugs, 1997, 53(5):769-88. [PubMed 9129865]
  29. Devore CD, Schutze GE, Council on School Health and Committee on Infectious Diseases, American Academy of Pediatrics. Head lice. Pediatrics. 2015;135(5):e1355-1365. [PubMed 25917986]
  30. Drugs for Parasitic Infections. In: The Medical Letter. 2013;11(143):e1-e31.
  31. Duthaler U, Leisegang R, Karlsson MO, Krähenbühl S, Hammann F. The effect of food on the pharmacokinetics of oral ivermectin. J Antimicrob Chemother. 2020;75(2):438-440. doi:10.1093/jac/dkz466 [PubMed 31691813]
  32. Edwards G. Ivermectin: does P-glycoprotein play a role in neurotoxicity? Filaria J. 2003;2 Suppl 1(Suppl 1):S8. doi:10.1186/1475-2883-2-S1-S8 [PubMed 14975065]
  33. Edwards G, Dingsdale A, Helsby N, Orme ML, Breckenridge AM. The relative systemic availability of ivermectin after administration as capsule, tablet, and oral solution. Eur J Clin Pharmacol. 1988;35(6):681-684. doi:10.1007/BF00637608 [PubMed 3234475]
  34. Eismann R, Bramsiepe I, Danz B, Wohlrab J, Marsch WC, Fiedler E. Abscessing nodular demodicosis--therapy with ivermectin and permethrin. J Eur Acad Dermatol Venereol. 2010;24(1):79-81. [PubMed 19453783]
  35. Elston DM. Demodex mites: facts and controversies. Clin Dermatol. 2010;28(5):502-504. doi:10.1016/j.clindermatol.2010.03.006 [PubMed 20797509]
  36. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  37. Fischer P, Bamuhiiga J, and Büttner DW. Treatment of human Mansonella streptocerca infection with ivermectin. Trop Med Int Health,1997;2(2):191-199. doi:10.1046/j.1365-3156.1997.d01-233.x [PubMed 9472305]
  38. Fischer P, Tukesiga E, Büttner DW. Long-term suppression of Mansonella streptocerca microfilariae after treatment with ivermectin. J Infect Dis. 1999;180(4):1403-1405. doi:10.1086/315014 [PubMed 10479183]
  39. Foucault C, Ranque S, Badiaga S, Rovery C, Raoult D, Brouqui P. Oral ivermectin in the treatment of body lice. J Infect Dis. 2006;193(3):474-476. [PubMed 16388498]
  40. Frankowski BL and Bocchini JA Jr, “Head Lice,” Pediatrics, 2010, 126(2):392-403. [PubMed 20660553]
  41. Gardon J, Boussinesq M, Kamgno J, Gardon-Wendel N, Demanga-Ngangue, Duke BO. Effects of standard and high doses of ivermectin on adult worms of Onchocerca volvulus: a randomised controlled trial. Lancet. 2002;360(9328):203-210. doi:10.1016/S0140-6736(02)09456-4 [PubMed 12133654]
  42. Gardon J, Gardon-Wendel N, Demanga-Ngangue, Kamgno J, Chippaux JP, Boussinesq M. Serious reactions after mass treatment of onchocerciasis with ivermectin in an area endemic for Loa loa infection. Lancet. 1997;350(9070):18-22. doi:10.1016/S0140-6736(96)11094-1 [PubMed 9217715]
  43. Goldstein AO, Goldstein BG. Pediculosis capitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022a.
  44. Goldstein AO, Goldstein BG. Pediculosis pubis and pediculosis ciliaris. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022b.
  45. Goldstein BG, Goldstein AO. Scabies: management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022c.
  46. Gonzalez AA, Chadee DD, Rawlins SC. Ivermectin treatment of mansonellosis in Trinidad. West Indian Med J. 1999;48(4):231-234. [PubMed 10639847]
  47. González Canga A, Sahagún Prieto AM, Diez Liébana MJ, et al, The pharmacokinetics and interactions of ivermectin in humans--a mini-review. AAPS J. 2008;10(1):42-46. [PubMed 18446504]
  48. Guzzo CA, Furtek CI, Porras AG, et al. Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects. J Clin Pharmacol. 2002;42(10):1122-1133. doi:10.1177/009127002401382731 [PubMed 12362927]
  49. Gyapong JO, Chinbuah MA, Gyapong M. Inadvertent exposure of pregnant women to ivermectin and albendazole during mass drug administration for lymphatic filariasis. Trop Med Int Health. 2003;8(12):1093-1101. doi:10.1046/j.1360-2276.2003.01142.x [PubMed 14641844]
  50. Henriquez-Camacho C, Gotuzzo E, Echevarria J, et al. Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection. Cochrane Database Syst Rev. 2016;2016(1):CD007745. doi:10.1002/14651858.CD007745.pub3 [PubMed 26778150]
  51. Herman JS, Chiodini PL. Gnathostomiasis, another emerging imported disease. Clin Microbiol Rev. 2009;22(3):484-92. doi:10.1128/CMR.00003-09 [PubMed 19597010]
  52. Ismail MM, Jayakody RL, Weil GJ, et al, "Long-Term Efficacy of Single-Dose Combinations of Albendazole, Ivermectin and Diethylcarbamazine for the Treatment of Bancroftian Filariasis," Trans R Soc Trop Med Hyg, 2001, 95(3):332–5. [PubMed 11491010]
  53. Ito T. Mazzotti reaction with eosinophilia after undergoing oral ivermectin for scabies. J Dermatol. 2013;40(9):776-777. doi:10.1111/1346-8138.12243 [PubMed 23855317]
  54. Ivermectin tablets [prescribing information]. Parsippany, NJ: Edenbridge Pharmaceuticals, LLC; March 2022.
  55. Jackson JD. Infectious folliculitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022.
  56. Jittamala P, Monteiro W, Smit MR, et al. A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication? PLoS Negl Trop Dis. 2021;15(3):e0009144. doi:10.1371/journal.pntd.0009144 [PubMed 33730099]
  57. Kerneuzet I, Blind E, Darrieux L, Moreau S, Safa G. Ivermectin-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. JAAD Case Rep. 2018;4(6):524-527. doi:10.1016/j.jdcr.2018.05.002 [PubMed 30023418]
  58. Kraivichian K, Nuchprayoon S, Sitichalernchai P, Chaicumpa W, Yentakam S. Treatment of cutaneous gnathostomiasis with ivermectin. Am J Trop Med Hyg. 2004;71(5):623-628. [PubMed 15569795]
  59. Leder K, Weller PF. Enterobiasis (pinworm) and trichuriasis (whipworm). Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022c.
  60. Leder K, Weller PF. Strongyloidiasis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022b.
  61. Leder K, Weller PF, Nageshwar Reddy D. Ascariasis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022a.
  62. Levy M, Martin L, Bursztejn AC, et al; Groupe de Recherche de la Société Française de Dermatologie Pédiatrique. Ivermectin safety in infants and children under 15 kg treated for scabies: A multicentric observational study. Br J Dermatol. 2020;182(4):1003-1006. doi: 10.1111/bjd.18369 [PubMed 31344258]
  63. Lima NF, Veggiani Aybar CA, Dantur Juri MJ, Ferreira MU. Mansonella ozzardi: a neglected New World filarial nematode. Pathog Glob Health. 2016;110(3):97-107. doi:10.1080/20477724.2016.1190544 [PubMed 27376501]
  64. Mackenzie CD, Geary TG, Gerlach JA. Possible pathogenic pathways in the adverse clinical events seen following ivermectin administration to onchocerciasis patients. Filaria J. 2003;2 suppl 1(suppl 1):S5. doi:10.1186/1475-2883-2-S1-S5 [PubMed 14975062]
  65. Marti H, Haji HJ, Savioli L, et al. A comparative trial of a single-dose ivermectin versus three days of albendazole for treatment of Strongyloides stercoralis and other soil-transmitted helminth infections in children. Am J Trop Med Hyg. 1996;55(5):477-481. doi:10.4269/ajtmh.1996.55.477 [PubMed 8940976]
  66. Matamoros G, Sánchez A, Gabrie JA, et al. Efficacy and safety of albendazole and high-dose ivermectin coadministration in school-aged children infected with Trichuris trichiura in Honduras: a randomized controlled trial. Clin Infect Dis. 2021;73(7):1203-1210. doi:10.1093/cid/ciab365 [PubMed 33906234]
  67. Meinking TL, Taplin D, Hermida JL, et al, “The Treatment of Scabies With Ivermectin,” N Engl J Med, 1995, 333(1):26-30. [PubMed 7776990 ]
  68. Meyers RS, Thackray J, Matson KL, et al. Key Potentially Inappropriate Drugs in Pediatrics: The KIDs List. J Pediatr Pharmacol Ther. 2020;25(3):175-191. [PubMed 32265601]
  69. Miyajima A, Hirota T, Sugioka A, et al. Effect of high-fat meal intake on the pharmacokinetic profile of ivermectin in Japanese patients with scabies. J Dermatol. 2016;43(9):1030-1036. doi:10.1111/1346-8138.13321 [PubMed 26918286]
  70. Monsel G, Caumes E. What's new in travel-associated dermatology? J Travel Med. 2015;22(4):221-224. doi:10.1111/jtm.12224 [PubMed 26146819]
  71. Murdoch ME. Onchocerciasis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022.
  72. Naquira C, Jimenez G, Guerra JG. Ivermectin for human strongyloidiasis and other intestinal helminths. Am J Trop Med Hyg. 1989;40(3):304-309. doi:10.4269/ajtmh.1989.40.304 [PubMed 2929853]
  73. National Institute for Health and Care Excellence (NICE). Drug allergy: diagnosis and management. Clinical guideline 183. Published September 3, 2014. Accessed April 12, 2022. www.nice.org.uk/guidance/cg183.
  74. Ndyomugyenyi R, Kabatereine N, Olsen A, Magnussen P. Efficacy of ivermectin and albendazole alone and in combination for treatment of soil-transmitted helminths in pregnancy and adverse events: a randomized open label controlled intervention trial in Masindi district, western Uganda. Am J Trop Med Hyg. 2008;79(6):856-863. [PubMed 19052293]
  75. Nicolas P, Maia MF, Bassat Q, Kobylinski KC, Monteiro W, Rabinovich NR, Menéndez C, Bardají A, Chaccour C. Safety of oral ivermectin during pregnancy: a systematic review and meta-analysis. Lancet Glob Health. 2020;8(1):e92-e100. doi:10.1016/S2214-109X(19)30453-X [PubMed 31839144]
  76. Nolt D, Moore S, Yan AC, Melnick L; Committee on Infectious Diseases, Committee on Practice And Ambulatory Medicine, Section on Dermatology. Head lice. Pediatrics. 2022;150(4):e2022059282. doi:10.1542/peds.2022-059282 [PubMed 36156158]
  77. Nontasut P, Bussaratid V, Chullawichit S, Charoensook N, Visetsuk K. Comparison of ivermectin and albendazole treatment for gnathostomiasis. Southeast Asian J Trop Med Public Health. 2000;31(2):374-377. [PubMed 11127342]
  78. Nontasut P, Claesson BA, Dekumyoy P, Pakdee W, Chullawichit S. Double-dose ivermectin vs albendazole for the treatment of gnathostomiasis. Southeast Asian J Trop Med Public Health. 2005;36(3):650-652. [PubMed 16124432]
  79. Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breast milk. Eur J Clin Pharmacol. 1994;46(1):89-90. doi:10.1007/BF00195923 [PubMed 8005194]
  80. Okonkwo PO, Ogbuokiri JE, Ofoegbu E, Klotz U. Protein binding and ivermectin estimations in patients with onchocerciasis. Clin Pharmacol Ther. 1993;53(4):426-430. doi:10.1038/clpt.1993.46 [PubMed 8477558]
  81. Oshikoya KA, Ogunyinka IA, Ogar CK, Abiola A, Ibrahim A, Oreagba IA. Severe cutaneous adverse drug reactions manifesting as Stevens-Johnson syndrome and toxic epidermal necrolysis reported to the national pharmacovigilance center in Nigeria: a database review from 2004 to 2017. Ther Adv Drug Saf. 2020;11:2042098620905998. doi:10.1177/2042098620905998 [PubMed 32110375]
  82. Ottesen EA and Campbell WC, “Ivermectin in Human Medicine,” J Antimicrob Chemother, 1994, 34(2):195-203. [PubMed 7814280]
  83. Pacqué M, Muñoz B, Poetschke G, Foose J, Greene BM, Taylor HR. Pregnancy outcome after inadvertent ivermectin treatment during community-based distribution. Lancet. 1990;336(8729):1486-9. doi:10.1016/0140-6736(90)93187-t [PubMed 1979100]
  84. Ramirez-Avila L, Slome S, Schuster FL, et al. Eosinophilic meningitis due to Angiostrongylus and Gnathostoma species. Clin Infect Dis. 2009;48(3):322-327. doi:10.1086/595852 [PubMed 19123863]
  85. Refer to manufacturer's labeling.
  86. Repetto SA, Ruybal P, Batalla E, et al. Strongyloidiasis outside endemic areas: long-term parasitological and clinical follow-up after ivermectin treatment. Clin Infect Dis. 2018;66(10):1558-1565. doi:10.1093/cid/cix1069 [PubMed 29360939]
  87. Richard-Lenoble D, Kombila M, Rupp EA, Pappayliou ES, Gaxotte P, Nguiri C, Aziz MA. Ivermectin in loiasis and concomitant O. volvulus and M. perstans infections. Am J Trop Med Hyg. 1988;39(5):480-483. [PubMed 3195695]
  88. Rodari P, Buonfrate D, Pomari E, et al. Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection. Acta Trop. 2020;202:105249. doi:10.1016/j.actatropica.2019.105249 [PubMed 31678122]
  89. Romani L, Whitfield MJ. Koroiyueta J, Kama M, Wand H, et al. Mass drug administration for scabies control in a population with endemic disease. N Engl J Med. 2015;373:2305-2313. [PubMed 26650152]
  90. Salavastru CM, Chosidow O, Boffa MJ, Janier M, Tiplica GS. European guideline for the management of scabies. J Eur Acad Dermatol Venereol. 2017;31(8):1248-1253. doi:10.1111/jdv.14351 [PubMed 28639722]
  91. Salem DA, El-Shazly A, Nabih N, El-Bayoumy Y, Saleh S. Evaluation of the efficacy of oral ivermectin in comparison with ivermectin-metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum. Int J Infect Dis. 2013;17(5):e343-347. doi:10.1016/j.ijid.2012.11.022 [PubMed 23294870]
  92. Schrijvers R, Gilissen L, Chiriac AM, Demoly P. Pathogenesis and diagnosis of delayed-type drug hypersensitivity reactions, from bedside to bench and back. Clin Transl Allergy. 2015;5:31. doi:10.1186/s13601-015-0073-8 [PubMed 26339470]
  93. Schulz JD, Coulibaly JT, Schindler C, Wimmersberger D, Keiser J. Pharmacokinetics of ascending doses of ivermectin in Trichuris trichiura-infected children aged 2-12 years. J Antimicrob Chemother. 2019;74(6):1642-1647. doi:10.1093/jac/dkz083 [PubMed 30859185]
  94. Seegobin K, Bueno E, Maharaj S, Ashby T, Brown M, Jones L. Toxic epidermal necrolysis after ivermectin. Am J Emerg Med. 2018;36(5):887-889. doi:10.1016/j.ajem.2017.09.021 [PubMed 28927997]
  95. Segarra-Newnham M. Manifestations, diagnosis, and treatment of Strongyloides stercoralis infection. Ann Pharmacother. 2007;41(12):1992-2001. doi:10.1345/aph.1K302 [PubMed 17940124]
  96. Stromectol (ivermectin) [prescribing information]. Rahway, NJ: Merck Sharp & Dohme; May 2022.
  97. Twum-Danso NA. Serious adverse events following treatment with ivermectin for onchocerciasis control: a review of reported cases. Filaria J. 2003;2(suppl 1):S3. doi:10.1186/1475-2883-2-S1-S3 [PubMed 14975060]
  98. Vanhaecke C, Perignon A, Monsel G, Regnier S, Bricaire F, Caumes E. The efficacy of single dose ivermectin in the treatment of hookworm related cutaneous larva migrans varies depending on the clinical presentation. J Eur Acad Dermatol Venereol. 2014;28(5):655-357. doi:10.1111/jdv.12097 [PubMed 23368818]
  99. Veit O, Beck B, Steuerwald M, Hatz C. First case of ivermectin-induced severe hepatitis. Trans R Soc Trop Med Hyg. 2006;100(8):795-797. doi:10.1016/j.trstmh.2006.02.003 [PubMed 16682062]
  100. Weller PF. Eosinophilic meningitis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 13, 2022.
  101. Westlake CS, Aronoff DM. Evaluating the risks of systemic maternal ivermectin exposure during pregnancy in human and vertebrate animals: a scoping review. Curr Drug Saf. Published August 20, 2020. doi:10.2174/1574886315999200820125001 [PubMed 33109066]
  102. Wilkins AL, Steer AC, Cranswick N, Gwee A. Question 1: Is it safe to use ivermectin in children less than five years of age and weighing less than 15 kg? Arch Dis Child. 2018;103(5):514-519. doi:10.1136/archdischild-2017-314505 [PubMed 29463522]
  103. Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1 [PubMed 34292926]
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