How it works
Ivermectin binds to specific glutamate-gated chloride channels in the nervous and muscular tissues of susceptible parasites. This increases chloride-ion permeability, disrupts nerve signaling, causes paralysis, and ultimately leads to the death of susceptible parasites.
The drug is particularly active against certain nematodes and their larval forms. In onchocerciasis, ivermectin primarily acts against microfilariae and does not kill adult worms.
Who may be prescribed this medicine
Clinical studies and evidence
Ivermectin has a substantial clinical evidence base for certain parasitic diseases. In clinical studies of intestinal strongyloidiasis, a single dose of approximately 200 mcg/kg produced cure rates of 64–100%, depending on the study and patient population. Comparative studies demonstrated strong efficacy against Strongyloides stercoralis.
Ivermectin has also been extensively studied for onchocerciasis. Randomized, double-blind, placebo-controlled, and comparative studies included more than 1,400 patients. In one study, a single 150 mcg/kg dose reduced skin microfilariae by 83.2% after 3 days and 99.5% after 3 months.
These data support ivermectin's efficacy for specific parasitic infections. They do not mean that ivermectin is effective against all parasites or all infectious diseases.
Ivermectin is used to treat certain parasitic infections.
Established oral ivermectin indications include:
Ivermectin paralyzes susceptible parasites and helps the body eliminate them. In onchocerciasis, it primarily affects microfilariae rather than adult worms, so follow-up and repeat treatment may be necessary.
Ivermectin should not be marketed as a treatment or preventive medicine for COVID-19. The FDA has not approved ivermectin for COVID-19, and available clinical evidence does not demonstrate effectiveness for this indication.
The tablets are taken orally with water. The dose and treatment schedule must be determined by a healthcare professional based on the diagnosis, body weight, and other clinical factors. Dosing regimens vary substantially between indications, so the 24 mg strength should not automatically be considered appropriate for every patient. Official prescribing information for oral ivermectin recommends administration on an empty stomach for certain indications.
Adverse effects
During treatment of onchocerciasis, reactions associated with the death of microfilariae may occur, including skin and ocular reactions.
