Ivermectin (Oral)

Ivermectin is a tablet used to treat certain types of worm infections in patients whose intestines, blood, skin, or eyes is infected.

Overview

Ivermectin is an anti-parasite tablet taken by mouth to treat strongyloidiasis. This condition is caused when a certain type of roundworm lives in the intestines.

The tablet is also used to control a condition known as onchocerciasis (river blindness). This condition occurs due to infection by a certain type of roundworm that causes vision problems and bumps and rash under the skin.

In the treatment of strongyloidiasis, the medicine works by paralyzing and killing the younger worms in the intestines. In the treatment of onchocerciasis, the medicine kills worms which are developing but does not cure the infection.

The medicine may also be used to treat certain other roundworm infection and some types of parasitic infestation of the skin or head.

Ivermectin is the generic name for the US brand of the drug known as Stromectol. Patients are given this tablet by a pharmacy for the treatment of worm infections only if they have a doctor's prescription.

Conditions Treated

  • Strongyloidiasis
  • Onchocerciasis (river blindness)

Type Of Medicine

  • Antihelmintic

Side Effects

Ivermectin may cause certain expected side effects. Unwanted side effects may also occur and may or may not need medical attention.

Call your doctor right away if you develop the following side effects while you are being treated for onchocerciasis (river blindness).

Less commonly occur

  • Redness
  • Irritation
  • Pain or swelling of the eyelid or eye

There may be other side effects that occur that do not normally require medical attention. If they occur, they tend to go away on their own during treatment.

If you experience any of the following side effects and they become bothersome during your treatment for onchocerciasis (river blindness), tell your doctor:

More commonly occur

  • Rapid heartbeat
  • Pain in the muscle or joint
  • Fever
  • Itching or rash on the skin
  • Painful and tender glands in armpits, neck or groin

Less commonly occur

  • Swelling of the legs, feet, arms, hands or face
  • Headache

Rarely occur

  • Lightheadedness (especially when getting up from a sitting or lying position

If you experience any of the following side effects and they become bothersome during your treatment for strongyloidiasis, tell your doctor:

Less commonly

Rarely occur

  • Sleepiness
  • Shaking or trembling
  • Loss of appetite

Some patients may experience other side effects which are not listed in this medication guide. You should talk with your doctor or healthcare professional if you notice other side effects that bother you or do not go away.

You may also ask your healthcare professional about ways to reduce or prevent the occurrence of side effects.
You may also call the FDA at 1-800-FDA-1088 to report side effects.

Dosage

Ivermectin (Stromectol) is supplied as a tablet. Each tablet contains 3 mg of the medicine.

Dosage usually varies from one patient to the other. Your dosage information will be on the prescription label. It will be based on your weight and whether you are being treated for strongyloidiasis or onchocerciasis.

Follow all directions given to you by your doctor, pharmacist and prescription label. The label should tell you how strong your dose is, how often you should take it, the time between each dose, and the duration of your treatment.

The following is a general recommended dosage guide. You should stick to the dose prescribed for you by our doctor.

Onchocerciasis (river blindness) treatment

Adults:

Your doctor will use your weight to determine your dose. It is usually a single dose of 68 micrograms (mcg) for each pound of body weight. Your doctor may direct you to repeat the treatment every 3 to 12 months.

Teenagers:

Dosage is the same as adults

Children (weighing 33 pounds (15 kg) or more): Your doctor will use your weight to determine your dose. Children with this weight range are usually given a single dose equivalent to 68 micrograms (mcg) for each pound of body weight. Your child's doctor may direct a repeat treatment every 3 to 12 months.

Children (weighing 33 pounds (15 kg) or less): A doctor must determine use and dosage for children within this weight range.

Strongyloidiasis treatment

Adults:

Your doctor will use your weight to determine your dose. It is usually a single dose of 91 micrograms (mcg) for each pound of body weight. Repeat doses are not usually prescribed.

Teenagers:

Dosage is the same as adults

Children (weighing 33 pounds (15 kg) or more): Your doctor will use your weight to determine your dose. Children within this weight range are usually given a single dose equivalent to 91 micrograms (mcg) for each pound of body weight.

Children (weighing 33 pounds (15 kg) or less): A doctor must determine use and dosage for children weighing less than 33 pounds.

It is recommended that you take Ivermectin as a single dose with a full, 8-ounce glass of water on an empty stomach. This should be done 1 hour before breakfast unless your doctor tells you otherwise.

Certain patients with river blindness, especially whose symptoms are severe, may be prescribed another medicine called corticosteroid. Corticosteroid is used to reduce inflammation caused when the worms die.

If both medicines are prescribed together for you, take them together and do so exactly as directed by your doctor.

Missed dose

Take care to avoid missing your dose of Ivermectin. If you missed your single dose of this medicine, take it as soon as you possible. Remember to follow up with your repeat dose every 3 to 12 months, if directed by your doctor.

Overdose

Call your doctor, 911 and/or the local poison control center at 1-800-222-1222, if you overdose on this drug. If the patient collapses or is not breathing, call 911.

Symptoms of overdose include the following:

  • Weakness
  • Hives
  • Rash
  • Loss of coordination
  • Stomach pain
  • Nausea
  • Vomiting
  • Tingling of hands or feet
  • Diarrhea
  • Seizure
  • Headache
  • Shortness of breath
  • Dizziness
  • Swelling of the lower legs, ankles, feet, face, arms, and hands

Interactions

Food, alcohol, and tobacco or other medicines or medical problems may affect the way Ivermectin works.

Food, alcohol, and tobacco

Ivermectin works best when it is taken with a full, 8-ounce glass of water on an empty stomach. Your doctor may also caution you on the use of alcohol or tobacco during treatment.

Other medicines

Using Ivermectin with other medicines may cause adverse interaction. However, using them together may be best for your health.

The following are interactions which may occur and are mentioned in this guide because of their potential significance.

It is not usually recommended to use the following medication with Ivermectin. If its use cannot be avoided, your doctor may change your dose or how often you use any of your medicines.

  • Dasabuvir

If the following other medicine is used during treatment with Ivermectin, it may cause an increase in the risk of certain side effects. However, treatment with both drugs may be best for your health.

If they are prescribed together, your doctor may change the dose or how often you use one or both of your medicines.

  • Warfarin

The following other products may also interact with this medicine. Let your doctor know if you use any of them.

  • Benzodiazepines
  • Butalbital
  • Phenobarbital
  • Clonazepam
  • Lorazepam
  • Sodium oxybate (GHB)
  • Valproic acid

Other medical problems

Let your doctor know if you have any other medical problem. This is important since certain medical problems may interact with the medicine. Using the anti-parasitic medication may worsen the following medical problems in patients:

Due to a possible increase in the risk of side effects, use Ivermectin with caution in patients with the following medical problem. This is because the condition slows the removal of the drug from the body.

  • Liver problems

Warnings

  • Do not use Ivermectin unless your doctor prescribed it for treating strongyloidiasis or onchocerciasis (river blindness).
  • Do not use it if you are allergic to it. Also tell your doctor if you are allergic to other medicines.
  • Tell your doctor if you are allergic to certain foods, dyes, preservatives, or animals.
  • Tell your doctor if you are pregnant, may become pregnant or are breastfeeding. There may be a potential risk of harm to an unborn child or a breastfeeding infant.

Your doctor will consider the potential benefits and risks when deciding to treat you.

  • Do not use Ivermectin in children who weigh less than 15 kilograms (kg) (33 pounds). Safety and efficacy of use for this group of children have not been established.
  • Elderly patients may be treated with this medicine but may be at a higher risk for side effects due to their age.

Geriatric who have liver problems are more likely at risk for side effects. This is because their body takes a longer time to remove the drug from the bloodstream.

  • Do not use other medicines while taking Ivermectin unless your doctor approves.
  • Let your doctor know about all prescription or non-prescription medicines or vitamins or herbal products you take or plan to take.
  • Tell your doctor if you are taking sleeping pills, sedatives, muscle relaxants or tranquilizers or medications for seizures, mental illness or anxiety.

Your doctor may need to take precautions when setting your dose to accommodate all your medicines and may need to monitor you closely for side effects.

  • To avoid adverse interaction during treatment with Ivermectin, tell your doctor about any other medical problem you have or have a history of.
  • Tell your doctor especially if you have seizures, bronchial asthma or human immunodeficiency virus (HIV). These conditions may be affected by the use of the medicine. With this information, your doctor will be able to take necessary precautions when treating you.
  • If your immune system does not work as it should, or if you have human immunodeficiency virus (HIV), you may need repeated treatments with Ivermectin. One dose of the medicine may not effectively treat your parasitic infection.
  • To ensure the infection is cured (in the treatment of strongyloidiasis) or under control (in the treatment of river blindness), take your dose exactly as prescribed.
  • Also, give your child the correct dose of the medicine as directed by your child's doctor or pharmacist.
  • Avoid using alcohol if your doctor warns you not to.
  • Keep all your follow-up appointments if you are being treated for strongyloidiasis. Your doctor will examine your stool at least 3 times during the first 3 months after treatment to see if the infection is cured.

If not, your doctor may prescribe additional doses of Ivermectin.

Storage

Keep the medicine away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Safely dispose of medicine that is expired or no longer needed.

Summary

Ivermectin effectively paralyzes, kills, and stops the development of new worms in the body, in the treatment of strongyloidiasis and onchocerciasis (river blindness).

It may also reduce the rate at which adult worms reproduce their baby worms. This eventually decreases the number of worms in the blood, skin, and eyes.

However, in the treatment of river blindness, the medicine cannot cure the infection since it does not kill the adult worms that cause the infection in the first place. This medicine is more for controlling the infection.

While the infection may be cured or controlled after a single dose in some patients, certain patients may be required to take additional doses over time.

Ivermectin does not seem to trigger serious side effects if used properly. Known interactions with other drugs or other medical problems are few. Though safe and effective, Ivermectin cannot be used in children who weigh 15 kg (33 pounds) or less.