Ivermectol: Targeted Parasite Control with Precision Efficacy
Ivermectol
| Product dosage: 12mg | |||
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| 180 | $4.84
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Synonyms | |||
Ivermectol represents a significant advancement in antiparasitic therapy, offering healthcare professionals a potent and selective treatment option for a range of parasitic infestations. As a semi-synthetic derivative of avermectin, it exhibits high affinity for glutamate-gated chloride channels found in nerve and muscle cells of invertebrates, leading to increased cell permeability, paralysis, and death of parasites. Its broad-spectrum activity and well-characterized pharmacokinetic profile make it a cornerstone in both human and veterinary medicine for managing nematode and arthropod infections. This product card provides a comprehensive, evidence-based overview for medical practitioners considering Ivermectol therapy.
Features
- Active ingredient: Ivermectin 3mg, 6mg, or 12mg tablets
- Mechanism: Allosteric modulation of glutamate-gated chloride channels
- High lipid solubility with volume of distribution ~50L in adults
- Plasma half-life approximately 18 hours (range 12–36 hours)
- Metabolized primarily by CYP3A4 liver enzymes
- Excreted almost exclusively in feces with <1% renal clearance
- Manufactured under cGMP conditions with >99.5% purity
- Temperature-stable formulation with 36-month shelf life
Benefits
- Achieves rapid microfilaricidal and macrofilaricidal activity against Onchocerca volvulus
- Demonstrates high efficacy against Strongyloides stercoralis and other intestinal nematodes
- Provides sustained antiparasitic action with single-dose regimens in many indications
- Shows excellent tissue penetration, including the blood-brain barrier in juvenile forms
- Reduces transmission potential in community-based parasite control programs
- Offers favorable safety profile with predictable, dose-dependent adverse effects
Common use
Ivermectol is indicated for the treatment of strongyloidiasis caused by Strongyloides stercoralis and onchocerciasis (river blindness) caused by Onchocerca volvulus. It is also used off-label for cutaneous larva migrans, scabies (particularly crusted scabies), pediculosis, and certain filarial infections. In veterinary medicine, it is widely employed for heartworm prevention and treatment of various ecto- and endoparasites. The World Health Organization includes ivermectin in its List of Essential Medicines for its proven efficacy in mass drug administration programs for neglected tropical diseases.
Dosage and direction
Strongyloidiasis: 200 mcg/kg orally as a single dose. Repeat dosing may be required in hyperinfection syndrome.
Onchocerciasis: 150 mcg/kg orally as a single dose. Repeat every 6-12 months until asymptomatic.
Scabies (off-label): 200 mcg/kg as a single dose, repeated in 1-2 weeks for crusted scabies.
Administration should occur on an empty stomach with water to maximize absorption. Tablets should be swallowed whole and not crushed or chewed. Dosage adjustment is generally not required for renal impairment but should be considered in hepatic dysfunction. Pediatric dosing follows the same mcg/kg calculations as adults.
Precautions
Exercise caution in patients with central nervous system disorders due to potential increased permeability of the blood-brain barrier. Monitor patients with high parasite burdens (e.g., Loa loa co-infection) for encephalopathic reactions. Use with caution in elderly patients due to potential decreased hepatic function. Consider alternative therapies in pregnant women unless potential benefit justifies potential risk. Breastfeeding should be interrupted for 72 hours post-dose due to secretion in milk. Regular ophthalmologic examination is recommended in patients receiving repeated doses for onchocerciasis.
Contraindications
Hypersensitivity to ivermectin or any component of the formulation. Concomitant use with other agents that increase blood-brain barrier permeability (e.g., certain antiepileptics). Patients with meningeal or ocular involvement with Loa loa infection due to risk of severe encephalopathy. Avoid use in children weighing less than 15 kg unless no alternative exists.
Possible side effect
Common (≥1%): Pruritus, fever, rash, headache, dizziness, myalgia, arthralgia, diarrhea, nausea, transient eosinophilia.
Less common (0.1-1%): Orthostatic hypotension, tachycardia, blurred vision, edema, elevated liver enzymes.
Rare (<0.1%): Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatitis, seizures, ataxia, encephalopathy (particularly in Loa loa co-infection).
Mazzotti-type reactions (fever, urticaria, lymphadenopathy) occur frequently in onchocerciasis treatment due to parasite death.
Drug interaction
Strong CYP3A4 inhibitors (ketoconazole, ritonavir): May increase ivermectin concentrations—monitor for toxicity.
CNS depressants (benzodiazepines, barbiturates): Potential additive sedative effects.
Warfarin: Potential increased anticoagulant effect—monitor INR.
P-glycoprotein substrates: Ivermectin may increase concentrations of digoxin, cyclosporine.
Alcohol: May enhance CNS effects—avoid concomitant use.
Missed dose
If a dose is missed, administer as soon as possible. If near the time of the next dose, skip the missed dose and resume regular schedule. Do not double dose. For mass drug administration programs, implement catch-up dosing according to program guidelines.
Overdose
Symptoms may include nausea, vomiting, diarrhea, dizziness, urticaria, hypotension, and CNS depression including ataxia, seizures, and coma. Management is supportive with gastric lavage if presented early. Activated charcoal may be effective. No specific antidote exists. Hemodialysis is not effective due to high protein binding and extensive tissue distribution. Monitor vital signs and provide symptomatic treatment for at least 48 hours due to long half-life.
Storage
Store at controlled room temperature (20-25°C/68-77°F). Excursions permitted to 15-30°C (59-86°F). Keep container tightly closed and protect from moisture. Keep out of reach of children and pets. Do not use if tablets show signs of discoloration or deterioration. Discard any unused medication after treatment course completion.
Disclaimer
This information is intended for healthcare professionals only. Treatment decisions should be based on professional judgment, individual patient factors, and local prescribing information. Dosage may vary based on specific product formulation and regional guidelines. Always verify current prescribing information before administration. Not all uses described may be approved in your region.
Reviews
“Ivermectol has revolutionized our approach to mass drug administration for onchocerciasis. The single-dose regimen and excellent safety profile make it ideal for resource-limited settings.” — Tropical Medicine Specialist, Ghana
“In our gastroenterology practice, Ivermectol has proven highly effective for refractory strongyloidiasis, particularly in immunocompromised patients where eradication is critical.” — Infectious Disease Consultant, Brazil
“While generally safe, we’ve observed significant Mazzotti reactions in approximately 30% of onchocerciasis patients. Pre-treatment counseling and management protocols are essential.” — Dermatologist, Nigeria
“The veterinary applications continue to expand, though resistance patterns warrant careful stewardship and combination approaches in endemic areas.” — Veterinary Parasitologist, Australia