Ivermectin

Generic Name: Ivermectin

Brand Names:

Availability: Available with Prescription

Therapeutic action

Onchocerciasis

Child over 15 kg and adult: 150 micrograms/kg single dose. A 2nd dose should be administered after 3 months if clinical signs persist. Repeat the treatment every 6 or 12 months to maintain the parasite load below the threshold at which clinical signs appear.

Height Weight	0 to <90 cm < 15 kg	90 to < 120 cm 15 to < 25 kg	120 to < 140 cm 25 to < 45 kg	140 to < 160 cm 45 to < 65 kg	≥ 160 cm ≥65 kg
3 mg tablet	Do not administer	1 tab	2 tab	3 tab	4 tab

Ordinary scabies

Child over 15 kg and adult: 200 micrograms/kg single dose. A single dose may be sufﬁcient; a 2nd dose one week later reduces the risk of treatment failure.

Crusted scabies

Child over 15 kg and adult: 2 doses of 200 micrograms/kg one week apart, in combination with a topical keratolytic and topical scabicide; additional doses may be necessary.

May cause:
- increased itching;
- moderate reactions in patients with onchocerciasis: ocular irritation, headache, arthralgia, myalgia, lymphadenopathy, fever, oedema;
- severe reactions in patients co-infected with Loa loa: marked functional impairment if Loa loa microﬁlaraemia > 8,000 mf/ml; encephalopathy if Loa loa microﬁlaraemia > 30,000 mf/ml.
Administer with caution in regions where loiasis is endemic:
For symptomatic onchocerciasis:
Evaluate the severity of Loa loa microﬁlaraemia and manage accordingly: either treat as an out- patient under supervision, or hospitalise, or choose an alternative treatment (doxycycline). If it is not possible to perform a thick ﬁlm examination: ivermectin may be administered if the patient has no history of loiasis (migration of an adult worm under the conjunctiva or transient « Calabar » swellings), nor history of severe adverse reactions following a previous treatment with ivermectin. In other cases, it is wiser either to treat under supervision, or to choose an alternative treatment (doxycycline), or decide not to treat, according to the severity of the onchocerciasis and the previous history.
For ordinary scabies:
Review the patient’s history and if in doubt, topical scabicidal treatment is preferred.
Pregnancy: avoid (safety is not established)
Breast-feeding: no contra-indication

Take tablets on an empty stomach. Tablets may be crushed for administration to small children.
Ivermectin is also used for the treatment of strongyloidiasis (200 micrograms/kg single dose) and cutaneous larva migrans(200 micrograms/kg dailyfor 1 to 2 days).

- Below 25 °C