Is a dose of seven tablets of ivermectin (antiparasitic medication) based on weight a usual dose?

From the Guidelines

Seven tablets of ivermectin for one dose is not a typical or recommended dose for most individuals, as it could potentially exceed the safe dosage and increase the risk of adverse reactions. Ivermectin dosing is based on weight, with the standard dose for parasitic infections in humans typically being 0.2-0.4 mg per kilogram of body weight as a single dose, as seen in the treatment of head lice 1. For most adults, this translates to 1-4 tablets (depending on the tablet strength, commonly 3mg per tablet) for a complete treatment. The study on head lice treatment with ivermectin 1 suggests that a single oral dose of 200 mg/kg, repeated in 10 days, has been shown to be effective, but this does not support the use of seven tablets as a standard dose. Taking seven tablets at once would likely exceed the recommended dosage for most individuals unless the person weighs significantly more than average or the tablets are of a very low strength. Exceeding the recommended dose increases the risk of side effects, which can include nausea, dizziness, diarrhea, or more serious adverse reactions. Some key points to consider when determining the appropriate dose of ivermectin include:

• The patient's weight, as ivermectin is dosed based on kilograms of body weight
• The condition being treated, as different conditions may require different doses or treatment regimens
• The strength of the medication, as different tablet strengths may be available
• Potential side effects and adverse reactions, which can be increased with excessive dosing. Always follow the dosing instructions provided by your healthcare provider or pharmacist, as they will calculate the appropriate dose based on your specific weight, the condition being treated, and the strength of the medication.

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 dose of seven tablets of ivermectin is not a usual dose based on the provided weight-based guidelines, as the maximum number of tablets recommended for strongyloidiasis is 5 tablets for patients weighing 66-79 kg, and for onchocerciasis is 4 tablets for patients weighing 65-84 kg 2.

From the Research

Dose of Ivermectin

• The usual dose of ivermectin is based on weight, with a typical dose range of 150 to 200 micrograms per kilogram of body weight 3, 4, 5.
• A dose of seven tablets of ivermectin is not a standard dose, and the number of tablets required would depend on the patient's weight and the strength of the tablets.
• The efficacy and safety of ivermectin have been established in various studies, including those for the treatment of scabies 3, strongyloidiasis 4, 5, and onchocerciasis.

Ivermectin Dosing Regimens

• A single dose of ivermectin (200 micrograms per kilogram) has been shown to be effective in treating scabies 3 and strongyloidiasis 4, 5.
• A double dose of ivermectin, given two weeks apart, may be more effective than a single dose in patients with concomitant illness 5.
• The maximum targeted dose of ivermectin is 600 μg/kg, as used in a study for the treatment of COVID-19 6.

Administration and Safety

• Ivermectin can be administered orally, and its safety profile is generally good, with few adverse reactions reported 3, 4, 5, 6.
• The drug has been shown to be well-tolerated in patients with various comorbidities, including HIV infection 3 and concomitant diseases such as diabetes and systemic lupus erythematosus 5.