Endo-Mectin Plus

Oral:

Serious side effects have been reported with this medication, and certain precautions should be followed:

• fever
• blistering or peeling skin
• rash
• hives
• itching

If treating specifically for the parasite loa loa (endemic in West or Central Africa), you may also experience certain serious adverse effects that should be addressed immediately if they occur. These effects have been seen very rarely following the use of ivermectin.

• swelling of the eyes, face, arms, hands, feet, ankles, or lower legs
• joint pain and swelling
• painful and swollen glands of the neck, armpit or groin
• rapid heartbeat
• eye pain, redness, or tearing
• swelling of the eye or eyelids
• abnormal sensation in the eyes

Do not use ivermectin tablets if you are allergic to any of its ingredients.

Ivermectin tablets can cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Do not drive or operate heavy machinery until you know how this medication affects you.

Topical:

 Certain precautions should be followed when using ivermectin lotion:

• Ivermectin lotion is for use on scalp hair and scalp only. Do not get ivermectin lotion in your eyes, mouth, or vagina.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Ivermectin has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from ivermectin, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Oral:

• Ivermectin comes as a tablet to take by mouth. It is usually taken as a single dose on an empty stomach with water. If you are taking ivermectin to treat onchocerciasis, additional doses 3, 6, or 12 months later may be necessary to control your infection. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ivermectin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
• If you are taking ivermectin to treat strongyloidiasis, you will need to have a stool exam at least three times during the first 3 months after your treatment to see if your infection has cleared. If your infection has not cleared, your doctor will probably prescribe additional doses of ivermectin.
• Ivermectin tablets are usually taken as a single dose. Tell your doctor if you do not take your medication.

Topical:

• Use ivermection lotion exactly as prescribed. Your healthcare provider will prescribe the treatment that is right for you. Do not change your treatment unless you talk to your healthcare provider.
• Use ivermection lotion when your hair is dry.
• It is important to use enough ivermection lotion to completely coat all of your hair and scalp. Leave lotion on your hair and scalp for a full 10 minutes.
• You need to completely cover all the scalp and hair with lotion.
• Children will need an adult to apply ivermection lotion for them.
• Do not swallow ivermection lotion. If swallowed, call your healthcare provider or go to the nearest emergency room right away.
• Do not get ivermection lotion into your eyes. If ivermection lotion gets in your eye, gently flush with water.
• Wash your hands after applying ivermection lotion.

When you complete your dose of ivermection lotion, do not use ivermection lotion again without talking to your healthcare provider first.

Before you use ivermection lotion, ask your healthcare provider or pharmacist if you have questions about the right way to use ivermection lotion.

• Your hair and scalp must be dry before applying ivermection lotion.
• Use the top of cap to break the tamper seal on the tube.
• Apply ivermection lotion directly to dry hair and scalp.
• Completely cover your scalp and hair closest to the scalp first, and then apply outwards towards the ends of your hair.
• Rub ivermection lotion throughout hair.
• It is important to completely cover your entire head so that all lice and eggs are exposed to the lotion. Be sure that each hair is coated from the scalp to the tip.
• Use up to 1 entire tube (4 oz) to completely cover hair and scalp.
• Allow ivermection lotion to stay on your hair and scalp for 10 minutes after it has been applied. Use a timer or clock. Start timing after you have completely covered your hair and scalp with ivermection lotion.
• After 10 minutes, completely rinse ivermection lotion from your hair and scalp using only water.
• You or anyone who helps you apply ivermection lotion should wash their hands after application.
• Do not use ivermection lotion again without talking to your healthcare provider first.

To help prevent the spread of lice from one person to another, here are some steps you can take:

• Avoid direct head-to-head contact with anyone known to have live, crawling lice.
• Do not share combs, brushes, hats, scarves, bandannas, ribbons, barrettes, hair bands, towels, helmets, or other hair-related personal items with anyone else, whether they have lice or not.
• Avoid sleepovers and slumber parties during lice outbreaks. Lice can live in bedding, pillows, and carpets that have recently been used by someone with lice.
• After finishing treatment with lice medicine, check everyone in your family for lice after one week. Be sure to talk to your healthcare provider about treatments for those who have lice.
• Machine wash any bedding and clothing used by anyone having lice. Machine wash at high temperatures (150°F) and tumble in a hot dryer for 20 minutes.

The ability of ivermectin to deliver internal and external parasite control has been proven in cattle markets around the world. Now, Endo-Mectin® Plus combines ivermectin with clorsulon, an effective adult flukicide.

A single injection of Endo-Mectin® Plus (ivermectin and clorsulon) offers all the benefits of an ivermectin injection plus control of adult Fasciola hepatica.

The dosage level of clorsulon supplied by Endo-Mectin® Plus is effective only against adult liver flukes (Fasciola hepatica).

Transitory discomfort has been observed in some cattle following subcutaneous administration. Soft-tissue swelling at the injection site has also been observed. These reactions have disappeared without treatment. Divide doses greater than 10 mL between two injection sites to reduce occasional discomfort or site reaction. Different injection sites should be used for other parenteral products.

Endo-Mectin® Plus Injection has been developed specifically for use in cattle only. This product should not be used in other animal species as severe adverse reactions, including

fatalities in dogs, may result.

For subcutaneous injection in cattle only.

This product is not for intravenous or intramuscular use.

When to Treat Cattle with Grubs

Endo-Mectin® Plus effectively controls all stages of cattle grubs. However, proper timing of treatment is important. For most effective results, cattle should be treated as soon as possible after the end of the heel fly (warble fly) season. Destruction of Hypoderma larvae (cattle grubs) at the period host-parasite reactions including the possibility of fatalities. Killing Hypoderma lineatum when it is in the tissue surrounding the esophagus (gullet) may cause bloat; killing H. bovis when it is in the vertebral canal may cause staggering or paralysis. These reactions are not specific to treatment with Endo-Mectin® Plus, but can occur with any successful treatment of grubs. Cattle should be treated either before or after these stages of grub development. Consult your veterinarian concerning the proper time for treatment. Cattle treated with Endo-Mectin® Plus after the end of the heel fly season may be retreated with ivermectin during the winter for internal parasites, mange mites, or sucking lice, without danger of grub-related reactions. A planned parasite control program is recommended.