Ivermectine Sandoz (Ivermectin)

Ivermectin acts on a broad spectrum of parasitic organisms, interfering with their neuromuscular function. It is indicated for the following conditions:

• Onchocerciasis: reduces microfilarial load and prevents disease progression.
• Strongyloidiasis: eradicates intestinal larvae and prevents systemic dissemination.
• Scabies: eliminates Sarcoptes mites, relieving skin lesions and itching.
• Pediculosis: kills head lice and nits, controlling infestation.
• Other helminth infections: treats various nematode infections where ivermectin is approved.

• Ivermectin binds selectively to glutamate‑gated chloride channels in invertebrate nerve and muscle cells. This binding increases the permeability of the cell membrane to chloride ions, causing hyperpolarization, paralysis, and ultimately death of the parasite, while having minimal affinity for mammalian receptors.

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

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: loose stools occurring shortly after dosing.
• Dizziness: transient light‑headedness.
• Pruritus: skin itching unrelated to the treated condition.

Serious or Rare Side Effects

• Hypersensitivity reactions: rash, swelling, or anaphylaxis.
• Neurological signs: seizures, ataxia, or altered consciousness.
• Hepatotoxicity: elevated liver enzymes indicating liver stress.

Before initiating therapy, consider the following precautions:

• Pregnancy: avoid use unless the potential benefit outweighs the risk, as safety data are limited.
• Breastfeeding: consult a healthcare professional before use.
• Liver impairment: dose adjustment may be required in patients with hepatic dysfunction.
• Drug interactions: review concomitant medications for potential interactions.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Ivermectin may interact with several medicines, requiring careful management.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): may increase ivermectin plasma levels.
• P-glycoprotein inhibitors (e.g., verapamil): can raise systemic exposure.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): monitor coagulation parameters.
• CNS depressants (e.g., benzodiazepines): observe for enhanced sedation.
• Other antiparasitics: assess for additive toxicity.