Ivermectin

KEY POINTS

Ivermectin (Stromectol) is an antihelmintic (anti-worm) medication
Binds selectively to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, which leads to increased cell membrane permeability to chloride ions, which then causes hyperpolarization of the nerve or muscle cell and parasitic death.
Can be used for onchocerciasis, strongyloidiasis, ascariasis, filariasis, gnathostomiasis, lice, scabies and more.
- Ivermectin does not have activity versus the adult Onchocerca volvulus parasite.
Available topical and oral for humans
- In severe circumstances when humans require injectable ivermectin, it can be acquired from a livestock store. See example picture above. This usually requires some form of informed consent and/or institutional approval.
Commonly given as a single dose or two doses
- Dose depends on indication, but a common dose is 200 mcg/kg
- Manufacturer does not give dose adjustment for kidney or liver dysfunction
May cause Mazzoti reaction with onchocerciasis: reaction to proteins released by dying onchocerca, which can lead to fever, rash, ocular damage, joint or muscle pain, lymphangitis, hypotension, respiratory distress and prostration.
Some of the more common adverse effects are: pruritis (itching), fever, rash, lymph node tenderness/enlargement, arthralgia/synovitis and tachycardia
Pregnancy category: C

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