Ivermectin

General

• Type: antiparasitic
• Dosage Forms: 3
• Common Trade Names: Stromectol

Adult Dosing

Strongyloidiasis

• 0.2mg/kg PO x1

Onchocerciasis

• 0.15mg/kg PO x1

Scabies, non-crusted

• 0.2mg/kg PO x1

Scabies, crusted

• 0.2mg/kg PO x1 on days 1,2,8,9,15

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

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

References

Authors

Tasha Fernando, Ross Donaldson, Neil Young, Daniel Ostermayer, Claire, Kurt Hansen