Ivermectin Stada (Ivermectin)

Ivermectin is an anthelmintic that targets parasitic helminths and ectoparasites.

• Onchocerciasis: reduces microfilarial load and helps prevent blindness in affected individuals.
• Strongyloidiasis: eliminates intestinal Strongyloides stercoralis infection and prevents dissemination.
• Scabies: eradicates Sarcoptes scabiei mites, relieving itching and skin lesions.
• Lymphatic filariasis (combination therapy): contributes to parasite clearance when used with albendazole and diethylcarbamazine.
• 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 parasites. This binding increases the permeability of the cell membrane to chloride ions, causing hyperpolarization, paralysis, and ultimately death of the parasite. Mammalian cells lack these channels, which accounts for the drug’s selective toxicity. The drug is absorbed systemically after oral administration and distributes widely, reaching effective concentrations in skin and soft tissues where parasites reside.

Ivermectin may cause adverse reactions, which are generally mild but can be serious in rare cases.

Common Side Effects

• Nausea: mild stomach upset or queasiness.
• Diarrhea: loose stools occurring shortly after dosing.
• Dizziness: transient light‑headedness or vertigo.
• Pruritus: itching at the site of parasite die‑off.

Serious or Rare Side Effects

• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: elevated liver enzymes or hepatitis.
• Neurological events: seizures, confusion, or ataxia.
• Hypersensitivity: anaphylactic reactions requiring emergency care.

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

• Pregnancy: use only if potential benefit justifies risk, as safety data are limited.
• Breastfeeding: assess risk versus benefit; drug may be excreted in milk.
• Concomitant CNS depressants: avoid or monitor for enhanced central nervous system effects.
• Pre‑existing liver disease: adjust monitoring as ivermectin is metabolized hepatically.
• Drug interactions: review patient’s medication list for known interactions.
• Store at ambient temperature: keep below 25 °C in the original packaging, protect from moisture and light.

Ivermectin can interact with other medicines, influencing its efficacy or safety.

Major Interactions (Avoid)

• P‑glycoprotein inhibitors (e.g., clarithromycin, ketoconazole): may increase ivermectin plasma levels.
• Strong inducers of CYP3A4 (e.g., rifampicin, carbamazepine): may reduce efficacy.

Moderate Interactions (Monitor Closely)

• Anticoagulants (warfarin): monitor INR as ivermectin may potentiate anticoagulant effect.
• CNS depressants (benzodiazepines, alcohol): observe for enhanced sedation.
• Antiparasitic combination therapy (albendazole, diethylcarbamazine): adjust dosing per guidelines.