Ivermectin

General

• Type: antiparasitic
• Dosage Forms: Tablet, 3mg
• Common Trade Names: Stromectol

Adult Dosing

Strongyloidiasis

• 0.2mg/kg PO x1

Onchocerciasis

• 0.15mg/kg PO x1

Pediculosis capitis

• 0.2mg/kg pO q10 days x2 doses

Pediculosis corporis

• 12mg PO q7 days x3 doses

Pediculosis pubis

• 0.25mg/kg PO q2wk x2 doses

Indications by Disease

Disease	Dose	Context
Onchocerciasis	0.15mg/kg PO x1	Onchocerciasis
Scabies	200mcg/kg PO repeat in 2wks	Severe infection
Strongyloides stercoralis	0.2mg/kg PO x1	Strongyloidiasis

Pediatric Dosing

Indications by Disease

Disease	Dose	Context
Scabies	200mcg/kg PO, repeat in 2 weeks; only for children >15kg	Pediatric Severe (>15kg)

Special Populations

• Pregnancy Rating: C
• Lactation: Safety Unknown
• Renal Dosing- not defined
• Hepatic Dosing- not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• hypotension, orthostatic
• tachycardia
• seizures
• Stevens-Johnson syndrome
• toxic epidermal necrolysis
• asthma exacerbation
• vision loss
• conjunctival hemorrhage
• hepatitis

Common

• pruritus
• rash
• fever
• edema
• lymphadenopathy
• headache
• myalgia
• dizziness
• tachycardia
• abnormal eye sensation
• limbitis
• conjunctivitis
• ocular inflammation
• hypotension, orthostatic
• ALT, AST elevated
• eosinophilia

Pharmacology

• Half-life: 18h
• Metabolism: liver, CYP450: unknown
• Excretion: feces primarily, urine < 1%
• Mechanism of Action: increases invertebrate nerve and muscle cell membrane permeability by binding to chloride ion channels, resulting in paralysis and death of parasite