From the Guidelines
For scabies treatment, the recommended dose of ivermectin is 200 micrograms per kilogram of body weight, taken as a single oral dose, repeated in 2 weeks, as stated in the 2015 MMWR Recommendations and Reports 1. To determine the number of tablets, we need to consider the strength of the tablets, which is commonly 3mg or 6mg.
- For a 3mg tablet, the dose would be approximately 66.7 tablets for a 200kg person, but for most adults, this typically means 2-4 tablets (depending on the patient's weight).
- For a 6mg tablet, the dose would be approximately 33.3 tablets for a 200kg person, but for most adults, this typically means 1-2 tablets (depending on the patient's weight). When taking ivermectin, it should be taken on an empty stomach with water. All household members and close contacts should be treated simultaneously to prevent reinfestation. It's essential to note that ivermectin kills the mites but doesn't relieve itching immediately, which may persist for several weeks as the body reacts to dead mites. Additionally, all bedding, clothing, and towels should be washed in hot water and dried on high heat to eliminate any mites in the environment. Ivermectin works by paralyzing and killing the scabies mites by enhancing inhibitory neurotransmission, but it doesn't affect the eggs, which is why a second dose is typically needed, as recommended in the guidelines 1. In cases of crusted scabies, combination treatment with a topical scabicide and oral ivermectin may be necessary, with a different dosing regimen, as suggested in the 2015 MMWR Recommendations and Reports 1.
From the Research
Ivermectin Dosage for Scabies Treatment
- The dosage of ivermectin for scabies treatment is typically 200 micrograms per kilogram of body weight, given in a single oral dose 2, 3, 4, 5.
- For example, a 70 kg person would require a dose of 15 mg, which is equivalent to 5 tablets of 3 mg ivermectin 4.
- The treatment may need to be repeated after 10-14 days to enhance effectiveness and reduce the risk of scabicide resistance 4.
- It is recommended to take the dose with food 4.
Efficacy of Ivermectin for Scabies Treatment
- Studies have shown that ivermectin is an effective treatment for scabies, with cure rates ranging from 60.8% to 91% after a single dose 2, 3, 4, 5.
- Ivermectin has been shown to be safe and effective for the treatment of scabies in both healthy patients and those with HIV infection 2.
- Oral ivermectin is considered a treatment of choice for scabies, especially in large populations, non-adherent patients, and those with crusted scabies 4.