Ivercare (Ivermectin)

Ivermectin is an anthelmintic that targets parasitic organisms across several disease families.

• Strongyloidiasis: eliminates intestinal Strongyloides stercoralis, relieving infection symptoms.
• Onchocerciasis: reduces microfilarial load, helping control river blindness.
• Scabies: eradicates Sarcoptes scabiei mites, alleviating skin lesions and itching.
• Pediculosis (lice): kills head and body lice, preventing infestation spread.
• Other helminth infections: treats various nematode infections such as ascariasis and hookworm.

• Ivermectin binds selectively to glutamate‑gated chloride channels found in the nerve and muscle cells of invertebrates. This binding increases the permeability of the cell membrane to chloride ions, leading to hyperpolarization, paralysis, and ultimately death of the parasite. Mammalian cells lack these channels, which accounts for the drug’s selective toxicity. The effect is dose‑dependent and persists long enough to clear the infection with a single or short‑course regimen.

Ivermectin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild stomach upset.
• Diarrhea: loose stools.
• Dizziness: transient light‑headedness.
• Fatigue: feeling of tiredness.

Serious or Rare Side Effects

• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: elevated liver enzymes or jaundice.
• Neurologic effects: seizures, ataxia, or altered consciousness.
• Vision disturbances: blurred vision or optic neuritis.

When prescribing ivermectin, several safety considerations should be observed to minimize risk.

• Pregnancy: safety not established; avoid unless benefit outweighs potential risk.
• Breastfeeding: unknown excretion; consider discontinuation or monitor infant.
• Hepatic or renal impairment: dose adjustment may be required; assess function before use.
• Concomitant neurotoxic drugs: monitor for additive central nervous system effects.
• Drug interactions: review patient’s medication list for CYP3A4 or P‑glycoprotein inhibitors.
• Store at ambient temperature below 25°C: keep in original packaging, protect from moisture.

Ivermectin can interact with other medicines, altering its plasma concentration or toxicity.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase ivermectin levels and risk of toxicity.
• P‑glycoprotein inhibitors (e.g., verapamil, quinidine): can raise systemic exposure.

Moderate Interactions (Monitor Closely)

• Other antiparasitic agents (e.g., albendazole): may enhance adverse effects.
• Warfarin: potential increase in anticoagulant effect; monitor INR.
• CNS depressants (e.g., benzodiazepines): may augment sedation or dizziness.