Ivermectin Dosage: Anti-Parasitic vs. Anti-Cancer Use
For anti-parasitic treatment, ivermectin is typically administered at 150-200 μg/kg as a single dose, while potential anti-cancer applications would likely require significantly higher and more frequent dosing, though no standardized anti-cancer dosing regimen has been established in clinical trials. 1, 2
Anti-Parasitic Dosing Regimens
Standard Parasitic Infections
- For most parasitic infections including scabies, ivermectin is administered at 200 μg/kg orally as a single dose 1, 2, 3
- For pediculosis pubis (pubic lice), a dose of 250 μg/kg is recommended, repeated in 2 weeks 2
- For strongyloidiasis in immunocompetent patients, a single dose of 200 μg/kg is effective, with cure rates of 96.8% 4
- For immunocompromised patients with strongyloidiasis, a double-dose regimen (200 μg/kg repeated after 2 weeks) may be more effective 4
Specific Parasitic Conditions
- For onchocerciasis, ivermectin is given at 200 μg/kg monthly for 3 months 1, 2, 5
- For cutaneous larva migrans, a single dose of 200 μg/kg is recommended 2
- For loiasis, ivermectin dosing ranges from 150-200 μg/kg, typically as a single dose, but in some cases administered daily for up to 10 days 1
- For microfilarial loads below 8,000 mf/ml, ivermectin is generally considered safe at standard dosing 1
Anti-Cancer Applications
- Currently, there are no established clinical dosing regimens for ivermectin in cancer treatment 6
- Despite promising preclinical data showing anticancer effects (inhibition of cancer cell proliferation, induction of apoptosis, modulation of signaling pathways), there is a critical translational gap between laboratory findings and clinical application 6, 7
- No large-scale randomized controlled trials have confirmed therapeutic benefits for cancer 6
- The dosages used in preclinical cancer studies would likely be significantly higher than those used for anti-parasitic treatment, potentially raising safety concerns 6, 7
Important Clinical Considerations
- Ivermectin should be taken with food to increase bioavailability and enhance penetration into tissues 1, 2
- Ivermectin has limited ovicidal activity, which is why repeat dosing is sometimes necessary for certain parasitic infections 1, 2
- No dose adjustments are required in patients with renal impairment 1, 2
- The safety of multiple high doses in patients with severe liver disease is not established 1, 2
- Self-medication with ivermectin for cancer treatment based on social media claims poses significant risks and may lead to toxicity 6
Conclusion for Clinical Practice
- For parasitic infections, follow established guidelines using 150-200 μg/kg dosing, with specific regimens based on the particular parasite and patient factors 1, 2
- For cancer treatment, ivermectin should not be recommended outside of clinical trials due to insufficient evidence of efficacy and unknown optimal dosing 6
- Healthcare providers should caution patients against self-medicating with ivermectin for cancer treatment and guide them toward evidence-based interventions 6