Ivermectin (Systemic)

• Tell all of your health care providers that you take ivermectin. This includes your doctors, nurses, pharmacists, and dentists.
• You will need to have a stool exam after taking this medicine to make sure the infection is gone.
• Some patients may need to take another dose of ivermectin to treat the infection. Talk with the doctor.
• To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
• If you are taking warfarin, talk with your doctor. You may need to have your blood work checked more closely while you are taking it with this medicine.
• Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using ivermectin while you are pregnant.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Itching.
• Skin irritation.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
• Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about this medicine, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This information should not be used to decide whether or not to take ivermectin or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ivermectin. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Review Date: October 4, 2017

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Stromectol: 3 mg

Generic: 3 mg

• Anthelmintic

Onchocerciasis: Oral: 150 mcg/kg as a single dose; retreatment may be required every 3 to 12 months until asymptomatic

Strongyloidiasis, intestinal: Oral:

Manufacturer's labeling: 200 mcg/kg as a single dose

Alternate dosing: 200 mcg/kg/day for 1 to 2 days (CDC 2016)

Ascariasis due to Ascaris lumbricoides (off-label use): Oral: 200 mcg/kg as a single dose (Marti 1996; Naquira 1989)

Demodicosis due to Demodex folliculorum and Demodex brevis (off-label use): Oral: 200 mcg/kg as a single dose, followed by topical permethrin (Eismann 2010) or 200 mcg/kg as 2 doses, 1 week apart (Salem 2013)

Gnathostomiasis due to Gnathostoma spinigerum (off-label use): Oral: 200 mcg/kg as a single dose (Kraivichian 2004; Nontasut 2000)

Hookworm-related cutaneous larva migrans (off-label use): Oral: 200 mcg/kg as a single dose; patients with hookworm folliculitis will require additional doses (Vanhaecke 2013)

Lice (off-label use): Oral: Note: Treatment generally requires >1 dose; number of doses and dosage intervals have not been established

Pediculus humanus capitis: Oral: 400 mcg/kg/dose every 7 days for 2 doses (Chosidow 2010)

Pediculus humanus corporis: Oral: 200 mcg/kg/dose every 7 days for 3 doses (Foucault 2006)

Pediculosis pubis (due to Phthirus pubis; pubic lice): Oral: 250 mcg/kg/dose every 7 days for 2 doses (Burkhart 2004) or 250 mcg/kg/dose every 14 days for 2 doses (CDC [Workowski 2015])

Mansonella ozzardi infection (off-label use): Oral: 6 mg as a single dose (Gonzales 1999)

Mansonella streptocerca infection (off-label use): Oral: 150 mcg/kg as a single dose (Fischer 1997)

Scabies due to Sarcoptes scabiei (off-label use):

Classic scabies, treatment-resistant or unable to tolerate topical medications, treatment: Oral: 200 mcg/kg as a single dose (CDC [Workowski 2015]; Meinking 1995); repeat dose in 7 to 14 days (CDC 2017; CDC [Workowski 2015])

Crusted scabies (Norwegian Scabies), treatment: Oral: 200 mcg/kg as a single dose on days 1, 2, 8, 9, and 15 in combination with topical permethrin 5% cream. Severe cases may require additional ivermectin treatment on days 22 and 29 (CDC 2017; CDC [Workowski 2015]).

Prevention and control: Oral: 200 mcg/kg as a single dose (Romani 2015)

Trichuriasis due to Trichuris trichiura (off-label use): Oral: 200 mcg/kg/day for 3 days (CDC 2013)

Wucheria bancrofti infection (off-label use): Oral: 200 to 400 mcg/kg as a single dose in combination with albendazole (Addiss 1997; Ismail 2001)

There are no dosage adjustments provided in manufacturer’s labeling.

Store at temperatures below 30°C (86°F).