What is the proper dosage and usage of ivermectin for treating parasitic infections?

From the Guidelines

Ivermectin should be taken at a dosage of 200 μg/kg monthly for 3 months to target microfilariae and reduce micofilarodermia in the treatment of parasitic infections, with repeat doses every 3-6 months until asymptomatic and then annually if necessary. This dosage is based on the most recent guidelines for the investigation and management of eosinophilia in returning travelers and migrants, which suggest treating onchocerciasis with ivermectin PO 200 μg/kg monthly for 3 months, in combination with doxycycline PO 200 mg once daily for 6 weeks to target symbiotic Wolbachia 1. The treatment should be started under specialist input, with urgent ophthalmology assessment and exclusion of loiasis prior to treatment. It is essential to note that the specific dosing depends on the particular parasite being treated, and patients should inform their healthcare provider about any other medications they're taking and any medical conditions they have, particularly liver disease, as dosage adjustments may be necessary.

Some key points to consider when treating parasitic infections with ivermectin include:

• The medication should be taken on an empty stomach with water
• Side effects are usually mild and may include headache, dizziness, muscle pain, or gastrointestinal symptoms
• Ivermectin works by paralyzing and killing parasites by affecting their nervous system through glutamate-gated chloride channels, which are not present in mammals, making it relatively safe for humans at prescribed doses
• A healthcare provider should always determine the appropriate dosage based on the specific infection, the patient's weight, and overall health status

In the case of crusted scabies, combination treatment with a topical scabicide and oral ivermectin 200 μg/kg on days 1,2,8,9, and 15, with additional doses on days 22 and 29 for severe cases, may be recommended 1. However, the most recent guidelines suggest the dosage of 200 μg/kg monthly for 3 months for the treatment of parasitic infections such as onchocerciasis 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Strongyloidiasis The recommended dosage of STROMECTOL for the treatment of strongyloidiasis is a single oral dose designed to provide approximately 200 mcg of ivermectin per kg of body weight. Table 1: Dosage Guidelines for STROMECTOL for Strongyloidiasis Body Weight (kg) Single Oral Dose Number of 3-mg Tablets 15-241 tablet 25-35 2 tablets 36-50 3 tablets 51-65 4 tablets 66-79 5 tablets ≥80200 mcg/kg Onchocerciasis The recommended dosage of STROMECTOL for the treatment of onchocerciasis is a single oral dose designed to provide approximately 150 mcg of ivermectin per kg of body weight Table 2: Dosage Guidelines for STROMECTOL for Onchocerciasis Body Weight (kg)Single Oral Dose Number of 3-mg Tablets 15-251 tablet 26-44 2 tablets 45-64 3 tablets 65-84 4 tablets ≥85150 mcg/kg

The proper dosage of ivermectin for treating parasitic infections is as follows:

• For strongyloidiasis, a single oral dose of approximately 200 mcg of ivermectin per kg of body weight.
• For onchocerciasis, a single oral dose of approximately 150 mcg of ivermectin per kg of body weight. Key points:
• Patients should take tablets on an empty stomach with water.
• Follow-up stool examinations should be performed to verify eradication of infection.
• Retreatment may be considered at intervals as short as 3 months for individual patients with onchocerciasis. 2

From the Research

Proper Dosage and Usage of Ivermectin

• The proper dosage of ivermectin for treating parasitic infections, such as strongyloidiasis, is typically 150-200 micrograms/kg in a single dose or 200 micrograms/kg for 2 consecutive days 3, 4, 5.
• Ivermectin has been shown to be highly effective against strongyloidiasis, with cure rates ranging from 77% to 100% in different studies 3, 4, 6, 5.
• The usage of ivermectin for treating strongyloidiasis is generally well-tolerated, with mild to moderate side effects reported in some patients, such as dizziness, nausea, and disorientation 4, 6, 5.

Comparison with Other Treatments

• Ivermectin has been compared to other treatments, such as albendazole and thiabendazole, and has been shown to be more effective or at least as effective in treating strongyloidiasis 3, 4, 6, 5.
• Ivermectin has also been shown to have fewer side effects compared to thiabendazole 4, 6, 5.

Efficacy and Safety

• The efficacy and safety of ivermectin for treating strongyloidiasis have been evaluated in several studies, and it has been shown to be a safe and effective treatment option 3, 4, 6, 5, 7.
• Ivermectin has been used to treat other intestinal helminths, such as ascariasis, trichuriasis, and enterobiasis, and has been shown to be effective in treating these infections as well 7.