From the Guidelines
Ivermectin is an antiparasitic medication used to treat infections caused by certain parasites, with a typical dose of 200 μg/kg monthly for 3 months, as recommended for onchocerciasis treatment.
Key Points
- Ivermectin is used to treat conditions like strongyloidiasis, onchocerciasis, and some forms of scabies 1.
- The medication works by paralyzing and killing parasites by interfering with their nervous system function, binding to glutamate-gated chloride channels in invertebrate nerve and muscle cells.
- Ivermectin should only be taken under medical supervision with a valid prescription, as it can have side effects such as dizziness, nausea, diarrhea, and skin rash.
- In the context of onchocerciasis, ivermectin is given in combination with doxycycline to target symbiotic Wolbachia, with a suggested dose of 200 μg/kg monthly for 3 months 1.
Important Considerations
- Ivermectin is not approved for treating viral infections, and its effectiveness for this purpose is not supported by large clinical trials.
- The medication can have serious adverse events in individuals with high L. loa microfilaria, and its use should be cautious in areas co-endemic with loiasis 1.
- Alternative treatments, such as moxidectin, have been developed and may have superior clinical efficacy and safety profiles compared to ivermectin 1.
From the FDA Drug Label
Ivermectin is a member of the avermectin class of broad-spectrum antiparasitic agents which have a unique mode of action Ivermectin is derived from the avermectins, a class of highly active broad-spectrum, anti-parasitic agents isolated from the fermentation products of Streptomyces avermitilis Ivermectin is a semisynthetic, anthelmintic agent for oral administration.
- It is a mixture containing at least 90% 5-O-demethyl-22,23-dihydroavermectin A1a and less than 10% 5-O-demethyl-25-de(1-methylpropyl)-22,23-dihydro-25-(1-methylethyl)avermectin A1a.
- The empirical formulas are C48H74O14 and C47H72O14, with molecular weights of 875.10 and 861.07, respectively. Ivermectin is active against various life-cycle stages of many but not all nematodes 2
From the Research
What is Ivermectin
- Ivermectin is a derivative of avermectin, originally used to treat parasitic infections 3.
- It is highly effective against animal intestinal nematodes and is used in the treatment of onchocerciasis in humans 4.
- Ivermectin has been used to combat many parasitic diseases including filariasis, onchocerciasis, strongyloidiasis, scabies, and pediculosis, with approximately 250 million people using it annually 5.
Mechanism of Action
- Ivermectin's mechanism of action involves binding to ligand-gated ion channel receptors, including glutamate, GABA, and glycine, resulting in parasitic paralysis and death 6.
- It also has anti-inflammatory, anti-viral, and anticancer effects, with the ability to block the nuclear factor kappa-light-chain enhancer of the activated B (NF-κB) pathway and inhibit the proliferation of tumorigenic cells 3.
Uses and Efficacy
- Ivermectin is effective in treating strongyloidiasis, with a parasitological cure rate of 83% compared to 38% for albendazole 4.
- It is also used to treat onchocercal eye disease (river blindness), with evidence suggesting that it reduces the number of microfilariae in the skin and eye(s) and reduces the number of punctate opacities 7.
- Ivermectin has been evaluated for treating infections caused by viruses, such as SARS-CoV-2 and adenoviruses, although its efficacy for this use is still uncertain 5, 6.