Ivermectin Al (Ivermectin)

Ivermectin is an antiparasitic agent used to treat infections caused by nematodes and ectoparasites.

• Onchocerciasis: reduces microfilarial load and prevents disease progression.
• Strongyloidiasis: eradicates intestinal larvae and prevents chronic infection.
• Scabies: eliminates Sarcoptes scabiei mites and resolves skin lesions.
• Lice infestations: clears Pediculus humanus capitis and Pediculus humanus corporis.
• Other intestinal helminth infections: treats a variety of worm infections such as ascariasis and hookworm.

• Ivermectin binds selectively to glutamate‑gated chloride channels in the nerve and muscle cells of parasites. This binding increases chloride ion influx, leading to hyperpolarization of the cell membrane, paralysis, and ultimately death of the parasite. The drug shows minimal affinity for mammalian chloride channels, providing a favorable safety margin in humans.

Ivermectin may cause a range of adverse reactions, most of which are mild and self‑limiting.

Common Side Effects

• Dizziness: transient feeling of light‑headedness.
• Nausea: mild to moderate upset stomach.
• Headache: occasional throbbing pain.

Serious or Rare Side Effects

• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Hepatotoxicity: elevated liver enzymes or hepatitis.
• Anaphylaxis: rapid onset of allergic symptoms requiring emergency care.

Before prescribing Ivermectin, clinicians should consider several safety measures.

• Assess contraindications: avoid use in patients with known hypersensitivity to ivermectin.
• Monitor liver function: check hepatic enzymes in patients with pre‑existing liver disease.
• Caution with Loa loa co‑infection: risk of severe neurologic events.
• Review concomitant medications: evaluate for potential drug interactions.
• Adjust in pediatric patients: dose according to weight and age as directed.
• Store at ambient temperature: keep in the original pack, protect from moisture and direct sunlight.

Ivermectin can interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole): may increase ivermectin plasma levels.
• P‑glycoprotein inhibitors (e.g., verapamil): can raise systemic exposure.
• Warfarin: concurrent use may enhance anticoagulant effect and bleeding risk.

Moderate Interactions (Monitor Closely)

• Antacids: may reduce absorption of ivermectin.
• Macrolide antibiotics (e.g., erythromycin): potential modest increase in levels.
• Enzyme‑inducing anticonvulsants (e.g., carbamazepine): may lower ivermectin concentrations.