Ivermectin Stada (Ivermectin)

Ivermectin is an antiparasitic drug that acts against a range of helminth infections.

• Strongyloidiasis: eliminates intestinal Strongyloides stercoralis infection, reducing symptoms and preventing dissemination.
• Onchocerciasis: targets Onchocerca volvulus microfilariae, helping control river blindness.
• Lymphatic filariasis: reduces microfilarial load of Wuchereria bancrofti, aiding disease management.
• Other intestinal helminth infections: treats various nematode infections such as hookworm and ascariasis, improving gastrointestinal health.

• Ivermectin binds selectively to glutamate‑gated chloride channels found in invertebrate nerve and muscle cells. This binding increases the permeability of the membrane to chloride ions, causing hyperpolarization, paralysis, and ultimately death of the parasite. The drug has low affinity for mammalian GABA‑gated channels, which contributes to its safety profile in humans. It also interferes with parasite reproduction and reduces the ability of larvae to develop.

Ivermectin may cause a range of adverse reactions, which are generally categorized by frequency and severity.

Common Side Effects

• Nausea: mild stomach upset or queasiness.
• Diarrhea: loose stools occurring shortly after dosing.
• Dizziness: transient light‑headedness or vertigo.
• Pruritus: skin itching, often at the site of parasite death.
• Fatigue: general feeling of tiredness or weakness.

Serious or Rare Side Effects

• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Neurological events: seizures, confusion, or ataxia.
• Hepatotoxicity: elevated liver enzymes indicating liver stress.
• Hypersensitivity: anaphylactic reactions requiring immediate medical attention.
• Visual disturbances: blurred vision or optic neuritis.

Before prescribing Ivermectin, clinicians should consider several precautionary measures to ensure safe use.

• Assess infection type: confirm diagnosis of a helminth infection indicated for treatment.
• Evaluate liver function: consider baseline hepatic assessment in patients with known liver disease.
• Review concomitant medications: check for drugs that may interact with ivermectin metabolism.
• Monitor for neurologic symptoms: observe patients for signs of dizziness, seizures, or altered mental status.
• Pregnancy and lactation: use only if the potential benefit outweighs potential risk, as safety data are limited.
• Store at ambient temperature: keep tablets in the original container, protect from moisture and direct sunlight.

Ivermectin can interact with other medicines, and interactions are classified by their clinical significance.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors: such as ketoconazole or ritonavir, may increase ivermectin plasma levels.
• P-glycoprotein substrates: co‑administration with drugs like digoxin can raise systemic exposure.

Moderate Interactions (Monitor Closely)

• Anticoagulants: warfarin may have enhanced anticoagulant effect.
• CNS depressants: benzodiazepines or alcohol may potentiate dizziness or sedation.
• Other antiparasitics: concurrent use may increase risk of neurotoxicity.