What is the dosing for ivermectin (antiparasitic medication)?

From the Guidelines

Ivermectin should be dosed at 200ug/kg orally, repeated in 2 weeks, for the treatment of parasitic infections. This dosing recommendation is based on the most recent and highest quality study available, which is the 2015 sexually transmitted diseases treatment guidelines published in the MMWR Recommendations and Reports 1.

Key Considerations

• The dose of 200ug/kg is a standard recommendation for ivermectin treatment, and it is essential to follow this guideline to ensure effective treatment and minimize potential side effects.
• The treatment should be repeated in 2 weeks to ensure that all parasites are eliminated.
• It is crucial to note that infants and young children should not be treated with ivermectin, and instead, permethrin 5% cream should be used for this age group.

Important Details

• Ivermectin should be taken orally on an empty stomach with water.
• The medication works by paralyzing and killing parasites by affecting their nervous system.
• Common side effects of ivermectin include headache, dizziness, muscle pain, nausea, or diarrhea.
• It is essential to use ivermectin only for FDA-approved indications, as its use for other conditions lacks sufficient evidence of efficacy.

Clinical Decision Making

• Healthcare providers should determine the appropriate dosage based on the patient's specific condition, weight, and medical history.
• It is crucial to follow the recommended dosing guidelines to ensure effective treatment and minimize potential side effects.

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 15-24 1 tablet 25-35 2 tablets 36-50 3 tablets 51-65 4 tablets 66-79 5 tablets ≥80 200 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 15-25 1 tablet 26-44 2 tablets 45-64 3 tablets 65-84 4 tablets ≥85 150 mcg/kg

The dosing for ivermectin is as follows:

• Strongyloidiasis: a single oral dose of approximately 200 mcg of ivermectin per kg of body weight.
• Onchocerciasis: a single oral dose of approximately 150 mcg of ivermectin per kg of body weight. Specific dosage guidelines are provided in Table 1 for strongyloidiasis and Table 2 for onchocerciasis, based on the patient's body weight 2.

From the Research

Ivermectin Dosing

• The dosing for ivermectin varies depending on the condition being treated.
• For strongyloidiasis, a single dose of 150-200 micrograms/kg is effective 3, 4.
• For onchocerciasis, a single oral dose of 150 micrograms/kg repeated once a year is recommended 5.
• For scabies, a single oral dose of 200 micrograms/kg is effective 6.
• Higher doses of up to 800 micrograms/kg have been studied for onchocerciasis and were found to be well tolerated 7.

Dosing Regimens

• A single dose of ivermectin may be sufficient for some conditions, such as strongyloidiasis and scabies 3, 6, 4.
• For onchocerciasis, a single dose of 150 micrograms/kg repeated once a year is recommended 5.
• In some cases, a second dose of ivermectin may be necessary, such as in patients with HIV infection and scabies 6.

Tolerance and Safety

• Ivermectin is generally well tolerated, with minimal side effects and no severe reactions 3, 5, 6, 4, 7.
• High doses of ivermectin, up to 800 micrograms/kg, have been found to be well tolerated 7.