Ivermectin topical

<1%

Conjunctivitis

Ocular hyperemia

Eye irritation

Dandruff

Dry skin

Skin burning sensation

Pediculicide;1 avermectin derivative.1 5 6 7

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

Cream, External:

Soolantra: 1% (30 g, 45 g) [contains cetyl alcohol, edetate disodium, methylparaben, propylene glycol, propylparaben]

Lotion, External:

Sklice: 0.5% (117 g) [contains methylparaben, propylparaben]

In pediculosis capitus treatment, ivermectin is a semisynthetic anthelminthic agent; it binds selectively and with strong affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to increased permeability of cell membranes to chloride ions then hyperpolarization of the nerve or muscle cell, and death of the parasite.

In rosacea treatment, the mechanism of action is unknown.

Metabolism

Metabolized hepatically by CYP3A4

Time to Peak

Cream: ~10 hours post application

Half-Life Elimination

Cream: ~6.5 days

Protein Binding

>99%

Head lice: Children ≥6 months and Adolescents: Topical: Lotion: Refer to adult dosing.

Topical lotion: For external use only. Apply to dry scalp and hair closest to scalp first, then apply outward towards ends of hair; completely covering scalp and hair. Leave on for 10 minutes (start timing treatment after the scalp and hair have been completely covered). The hair should then be rinsed thoroughly with warm water. Avoid contact with the eyes. Nit combing is not required, although a fine-tooth comb may be used to remove treated lice and nits. Lotion is for one-time use; discard any unused portion. Ivermectin should be a portion of a whole lice removal program, which should include washing or dry cleaning all clothing, hats, bedding, and towels recently worn or used by the patient and washing combs, brushes, and hair accessories in hot soapy water.

Topical cream: For external use only. Not for use in the eye, mouth or vagina. Wash hands with soap and water prior to application and after application. Apply a pea-size amount as a thin layer on each affected area (eg, forehead, chin, nose, each cheek).

Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Lotion: do not freeze.

Before using ivermectin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: skin conditions.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

The form of this medication taken by mouth passes into breast milk in small amounts. It is unknown if this form of ivermectin passes into breast milk. Consult your doctor before breast-feeding.

This medicine may be harmful if swallowed. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: rash, swelling, headache, dizziness, vomiting, diarrhea, numbness/tingling, seizures, loss of coordination, shortness of breath.

Notes

Do not share this medication with others.

To prevent the spread of lice, wash in hot water or dry clean all recently used clothing, hats, bedding, and towels. Soak and wash in hot water all hair care items such as brushes, combs, and hair clips.

Missed Dose

Not applicable.

Storage

Store at room temperature. Do not freeze. This medication is for single use only. Throw away any unused lotion. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.Information last revised August 2017. Copyright(c) 2017 First Databank, Inc.

A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Excreted into human milk: Unknown Excreted into animal milk: Data not available Comments: -Systemic exposure is much lower than that for the oral formulation. -Avoid application to the breast area where the infant may directly ingest this drug. -Developmental and health benefits of breastfeeding should be considered as well as the mother's clinical need for this drug. -Potential side effects in the breastfed child due to the drug or the mother's underlying condition should be considered.