Classes
DEA Class; Rx
Common Brand Names; Stromectol
- Anthelmintics
ivermectin topical (Rx, OTC)
- Classes: Acne Agents, Topical;
- Scabicidal Agents;
- Pediculicides, Topical
Description
Antiparasitic agent in avermectin class; similar to macrolide antibiotics but lacks antibacterial activity
Used orally for onchocerciasis or strongyloidiasis and topically for Pediculus capitis (head lice) or rosacea
Resistance to ivermectin has not been reported
Indications
Indicated for the treatment of onchocerciasis due to Onchocerca volvulus infection.
Contraindications
Hypersensitivity to ivermectin
Adverse Effects
- Abdominal pain
- Asthenia
- Hypotension
- Mild EKG changes
- Peripheral & facial edema
- Transient tachycardia
- Dizziness
- Headache
- Hyperthermia
- Insomnia
- Somnolence
- Vertigo
- Pruritus
- Rash
- Urticaria
- Diarrhea
- Nausea
- Vomiting
- Eosinophilia
- Leukopenia
- ALT/AST increased
- Limbitis
- Myalgia
- Tremor
- Blurred vision
- Mild conjunctivitis
- Punctate opacity
- Mazzotti reaction (with onchocerciasis)
- Edema
- Fever
- Lymphadenopathy
- Ocular damage
- Pruritus rash
- Conjunctival hemorrhage (with onchocerciasis)
- Hepatitis
Warnings
Strongyloidiasis: The patient should be reminded of the need for repeated stool examinations to document clearance of infection with Strongyloides stercoralis; not active against disseminated Strongyloides, only intestinal
Onchocerciasis: The patient should be reminded that treatment does not kill the adult Onchocerca volvulus parasite, and therefore repeated follow-up and retreatment is usually required
Long-term studies in animals have not been performed to evaluate carcinogenic potential of ivermectin
Therapy had no adverse effects on fertility in rats in studies at repeated doses of up to 3 times maximum recommended human dose of 200 mcg/kg (on mg/m2/day basis)
Immunocompromised patients may require repeated treatment; control of extraintestinal strongyloidiasis may require suppressive therapy (eg, once monthly)
Pregnancy and Lactation
Pregnancy category: C
There is information available on the presence of ivermectin in human milk in 4 lactating women after a single 150 mcg/kg oral dose of ivermectin; however, there is insufficient information from this study to determine effects of ivermectin on breastfed infant or on milk production
Maximum Dosage
150—200 mcg/kg single dose PO for most indications; up to 400 mcg/kg PO for Bancroft’s filariasis; 4 oz/topical application.
150—200 mcg/kg single dose PO for most indications; 4 oz/topical application.
150—200 mcg/kg single dose PO for most indications; 4 oz/topical application.
> 15 kg: 150—200 mcg/kg single dose PO for most indications; 4 oz/topical application.
<= 15 kg: Safety and efficacy have not been established for oral dosage forms; 4 oz/topical application.
>= 6 months: Safety and efficacy have not been established for oral dosage forms; 4 oz/topical application.
< 6 months: Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Ivermectin
tablet
- 3mg
topical lotion
- 0.5% (Sklice)
topical cream
- 1% (Soolantra)