Stromectol (Ivermectin)

Ivermectin is an anthelmintic (anti-parasite) used to treat infections caused by certain parasites.

Ivermectin is available under the following different brand names: Stromectol.

Dosages of Stromectol:

Adult and Pediatric Dosage Forms and Strengths

Tablet

• 3 g

Dosage Considerations – Should be Given as Follows:

Strongyloidiasis of the Intestinal Tract

Under 15 kg: Safety and efficacy not established

• 15-24 kg: 3 mg orally once
• 25-35 kg: 6 mg orally once
• 36-50 kg: 9 mg orally once
• 51-65 kg: 12 mg orally once
• 66-79 kg: 15 mg orally once
• Over 80 kg: 200 mcg/kg orally once

Dosing considerations

• In general repeat doses are not necessary; perform stool examinations to verify eradication of infection

River Blindness (Onchocerciasis)

Under 15 kg: Safety and efficacy not established

• 15-25 kg: 3 mg orally; may repeat in 3-12 months
• 26-44 kg: 6 mg orally; may repeat in 3-12 months
• 45-64 kg: 9 mg orally; may repeat in 3-12 months
• 65-84 kg: 12 mg orally; may repeat in 3-12 months
• 85 kg and greater: 150 mcg/kg orally; may repeat in 3-12 months

Dosing considerations

• Note: Does not treat adult worms (must be surgically excised)

Head Lice (Pediculosis capitis; Off-label)

• 200 mcg/kg orally once; may require 1-2 additional doses repeated after 7 days

Blepharitis (Demodex folliculorum; Off-label)

• 200 mcg/kg orally once as a single dose, THEN repeat dose once in 7 days

Filariasis Due to Mansonella ozzardi (Off-label)

• 6 mg orally as a single dose

Filariasis Due to Mansonella streptocera (Off-label)

• 150 mcg/kg as single dose

Scabies Due to Sarcoptes scabiel

• Immunocompromised patients: 200 mcg/kg as a single dose; may repeat in 14 days if necessary

Gnathostoma spinigerum

• Gnathostomiasis: 200 mcg/kg as a single dose

Administration

• Take on an empty stomach
• Monitor: Stool exams (Strongyloides)

Side effects of Stromectol include:

• Abdominal pain
• ALT/AST increased
• Blurred vision
• Conjunctival hemorrhage (with onchocerciasis)
• Diarrhea
• Dizziness
• Drowsiness
• Edema
• Elevated core body temperature (hyperthermia)
• Enlarged or tender lymph nodes
• Eosinophilia
• Eye damage
• Feeling as if something is in your eye(s)
• Fever
• Headache
• Hepatitis
• Hives
• Insomnia
• Itching
• Limbitis
• Low blood pressure (hypotension)
• Low white blood cell count (leukopenia)
• Mazzotti reaction (with onchocerciasis)
• Mild EKG changes
• Mild pink eye (conjunctivitis)
• Muscle pain
• Nausea
• Punctate opacity
• Rash
• Spinning sensation (vertigo)
• Tremor
• Vomiting
• Weakness/lack of energy

If you are being treated for "river blindness" (onchocerciasis), side effects include reactions to the dying parasites during the first 4 days of treatment, including:

• Joint pain
• Tender or swollen lymph nodes
• Eye swelling/redness/pain
• Weakness
• Vision changes
• Itching
• Rash
• Fever

Rare but very serious side effects of ivermectin include:

• Neck or back pain
• Swelling face/arms/hands/feet
• Chest pain
• Fast heartbeat
• Confusion
• Seizures
• Loss of consciousness

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Ivermectin has no known severe interactions with other drugs.
• Serious Interactions of ivermectin include:
  • ivacaftor
  • quinidine
• Ivermectin has moderate interactions with at least 47 different drugs.
• Ivermectin has no known mild interactions with other drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• This medication contains ivermectin. Do not take Stromectol if you are allergic to ivermectin or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity to ivermectin

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Stromectol?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Stromectol?"

Cautions

• May cause cutaneous and/or systemic reactions
• Does not kill adult Onchocerca volvulus, only microfilariae
• Not active against disseminated Strongyloides, only intestinal
• The potential risk of Mazzotti reactions (cutaneous and systemic adverse effects)
• May be required to repeat treatments in immunocompromised patients
• Suppressive therapy (monthly) may be necessary to control extraintestinal strongyloidiasis
• Perform pretreatment assessment for Loa loa infection in any patient with significant exposure to endemic areas; serious and/or fatal encephalopathy reported during treatment in patients with loiasis

Pregnancy and Lactation

• Use ivermectin with caution during pregnancy if benefits outweigh risks
• Animal studies show risk and human studies are not available or neither animal nor human studies were done
• Ivermectin enters breast milk
• The American Academy of Pediatrics (AAP) Committee states ivermectin is compatible with nursing