Ivermectine Teva (Ivermectin)

Ivermectin is an antiparasitic agent that targets a variety of helminthic and ectoparasitic infections.

• Onchocerciasis: reduces microfilarial load and helps prevent disease progression.
• Strongyloidiasis: eliminates intestinal larvae and prevents disseminated infection.
• Lymphatic filariasis (combination therapy): contributes to microfilariae clearance when used with other agents.
• Scabies: eradicates Sarcoptes mites, relieving skin lesions.
• Pediculosis: kills head lice and nits, stopping infestation spread.
• Other intestinal helminth infections: provides broad‑spectrum deworming effect.

• Ivermectin binds selectively to glutamate‑gated chloride channels in the nerve and muscle cells of invertebrates. This binding increases chloride ion influx, hyperpolarizing the cell membrane, which leads to paralysis and death of the parasite while having minimal effect on mammalian cells.

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

Common Side Effects

• Dizziness: mild vertigo or light‑headedness.
• Nausea: occasional upset stomach.
• Diarrhea: loose stools during treatment.
• Abdominal pain: cramping or discomfort.
• Pruritus: mild itching.
• Headache: transient head pain.

Serious or Rare Side Effects

• Severe skin reactions: including Stevens‑Johnson syndrome.
• Hepatic dysfunction: elevated liver enzymes or hepatitis.
• Visual disturbances: blurred vision or optic neuritis.
• Seizures: rare central nervous system events.
• Anaphylaxis: life‑threatening allergic response.
• Neurological toxicity: ataxia or tremor in susceptible individuals.

Before prescribing Ivermectin, clinicians should consider several safety aspects.

• Assess hypersensitivity: avoid in patients with known allergy to ivermectin or excipients.
• Evaluate liver function: use caution in moderate to severe hepatic impairment.
• Consider co‑morbidities: monitor patients with compromised blood‑brain barrier or neurological disorders.
• Pregnancy and lactation: safety not established; weigh benefits against potential risks.
• Drug interactions: review concomitant medications for CYP3A4 substrates or inhibitors.
• Store at ambient temperature below 25°C: keep in the original container, protect from moisture and direct sunlight.

Ivermectin may interact with other medicines; awareness of interaction severity guides clinical decisions.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): may increase ivermectin plasma concentrations.
• Warfarin: concurrent use may enhance anticoagulant effect and increase bleeding risk.
• Neurotoxic agents (e.g., benzimidazoles): combined use may raise risk of central nervous system toxicity.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampicin, carbamazepine): may reduce ivermectin efficacy.
• P‑glycoprotein substrates (e.g., digoxin): may alter drug exposure requiring dose adjustment.
• Anticholinergic drugs: may increase risk of constipation when used together.