Ivermectin Orifarm (Ivermectin)

Ivermectin is an antiparasitic agent used for several well‑established infections.

• Onchocerciasis (river blindness): reduces microfilarial load and helps prevent disease progression.
• Strongyloidiasis: eliminates intestinal nematode infection caused by Strongyloides stercoralis.
• Scabies: treats both ordinary and crusted scabies caused by Sarcoptes scabiei.
• Pediculosis (lice infestation): eradicates head and body lice infestations.

• Ivermectin binds selectively to glutamate‑gated chloride channels found in the nerve and muscle cells of susceptible parasites. This binding increases the influx of chloride ions, hyperpolarizing the cell membrane, leading to paralysis, loss of motility, and ultimately death of the parasite without affecting mammalian cells.

Ivermectin is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Dizziness: transient feeling of light‑headedness.
• Nausea: mild to moderate upset stomach.
• Diarrhea: loose stools during treatment.
• Abdominal pain: cramping or discomfort.
• Pruritus: mild itching of the skin.
• Headache: occasional tension‑type headache.

Serious or Rare Side Effects

• Severe skin reactions: such as Stevens‑Johnson syndrome.
• Hepatotoxicity: elevated liver enzymes or hepatitis.
• Neurologic toxicity: seizures, ataxia, or altered mental status.
• Hypotension: marked drop in blood pressure.
• Anaphylaxis: acute allergic reaction requiring emergency care.
• Visual disturbances: blurred vision or optic neuritis.

Before prescribing Ivermectin, clinicians should consider several safety measures.

• Assess hypersensitivity: avoid in patients with known allergy to ivermectin or excipients.
• Review hepatic function: use caution in severe liver disease and adjust therapy if needed.
• Evaluate concomitant neurotoxic drugs: monitor for additive central nervous system effects.
• Pregnancy considerations: avoid unless the potential benefit justifies the risk to the fetus.
• Breastfeeding: weigh benefits against possible drug exposure to the infant.
• Store at ambient temperature below 25°C: keep in the original pack, protect from moisture and direct sunlight.

Ivermectin may interact with other medicines, requiring attention to the level of risk.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase ivermectin plasma concentrations.
• P‑glycoprotein inhibitors (e.g., verapamil, quinidine): can raise systemic exposure.
• Co‑administration with other neurotoxic agents (e.g., albendazole, levamisole): may enhance neurotoxicity.

Moderate Interactions (Monitor Closely)

• Warfarin: potential increase in anticoagulant effect; monitor INR.
• Macrolide antibiotics (e.g., erythromycin, clarithromycin): may modestly elevate ivermectin levels.
• Antihistamines: may mask mild itching; observe for skin reactions.