Ivermectine Teva (Ivermectin)

Ivermectin is an antiparasitic agent used to treat several helminthic and ectoparasitic infections.

• Onchocerciasis (river blindness): reduces microfilarial load and helps prevent ocular and skin disease.
• Strongyloidiasis: eliminates intestinal larvae and prevents chronic infection.
• Lymphatic filariasis (in combination therapy): contributes to parasite clearance when used with other agents.
• Scabies: kills the Sarcoptes scabiei mite, relieving itching and skin lesions.
• Pediculosis (lice infestation): eradicates head lice and nits.
• Other intestinal helminth infections: treats a variety of nematode infections such as ascariasis and hookworm.

• Ivermectin binds selectively to glutamate‑gated chloride channels that are present on the membranes of many invertebrate parasites. The binding increases the permeability of the channel to chloride ions, causing an influx that hyperpolarizes the neuronal and muscular cells. This results in paralysis of the parasite, loss of attachment, and eventual death, while mammalian cells are largely unaffected because they lack these channels.

Ivermectin may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Nausea: mild stomach upset or queasiness.
• Diarrhea: loose stools, usually self‑limiting.
• Dizziness: transient light‑headedness or vertigo.
• Pruritus: skin itching, often related to parasite die‑off.

Serious or Rare Side Effects

• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Neurological events: seizures, ataxia or altered consciousness.
• Hepatic injury: elevated liver enzymes or hepatitis.

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

• Pregnancy: use only if the potential benefit outweighs the risk, as data are limited.
• Breastfeeding: assess risk versus benefit; small amounts may be excreted in milk.
• Concomitant CNS depressants: monitor for enhanced central nervous system effects.
• Renal or hepatic impairment: dose adjustment may be required; evaluate organ function.
• Known hypersensitivity: avoid in patients with documented allergy to ivermectin or related compounds.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Strong CYP3A4 inducers (e.g., rifampicin, carbamazepine): may markedly reduce ivermectin plasma concentrations.
• P‑glycoprotein inhibitors (e.g., clarithromycin, verapamil): can increase ivermectin exposure and risk of toxicity.

Moderate Interactions (Monitor Closely)

• Anticoagulants (warfarin): monitor INR as ivermectin may potentiate anticoagulant effect.
• Other antiparasitics (e.g., albendazole): assess for additive neurotoxicity.
• CNS depressants (benzodiazepines, alcohol): observe for enhanced sedation or dizziness.