Ivermectin is used to treat infections of certain parasites and has been used as an alternative drug for the treatment of scabies. Most clinicians consider topical permethrin to be the scabicide of choice because of its safety and efficacy relative to other available drugs, particularly lindane. Recommendations for alternative therapy differ among various clinicians. Experts recommend topical lindane or oral ivermectin as alternative scabicides, but some clinicians recommend oral ivermectin or topical crotamiton as alternatives. This drug may be particularly useful in therapy-resistant infestations, for control of outbreaks in institutions, and when compliance with topical therapy is difficult.
ORIGINAL USES (ON-LABEL)
Treatment of intestinal strongyloidiasis (hookworm) and the immature form of onchocerciasis.
NEWLY DISCOVERED USES (OFF-LABEL)
Pediculosis capitis, scabies.
POTENTIAL SIDE EFFECTS
Low blood pressure, dizziness, headache, drowsiness, itching, rash, abdominal pain, diarrhea, changes in liver function, muscle aches, blurred vision, tremor, hives.
- Skin and/or systemic reactions called Mazzotti reactions can occur in patients with onchocerciasis; symptoms include joint aches, edema (swelling), ocular damage, swollen lymph glands, and fever.
- Serious and fatal encephalopathy has been reported rarely during ivermectin treatment for loiasis.
Consult your doctor.
PREGNANCY AND BREAST-FEEDING CAUTIONS
Category C. Excreted into breast milk. Breast-feeding not recommended during therapy.
Periodical eye exams should be performed. Take with water. Repeated stool examinations may be needed to document clearance of infection (strongyloidiasis). Other infections may require retreatment.
Some clinicians consider this drug, alone or in combination with a topical scabicide, the regimen of choice for treatment of crusted scabies in immunocompromised people. Because substantial treatment failure might occur with topical scabicide or oral ivermectin treatment alone, some clinicians recommend simultaneous therapy with a topical scabicide and oral ivermectin or repeated treatments with oral ivermectin. Other clinicians recommend this drug for therapy-resistant infections or in people who cannot tolerate topical therapy.
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