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. 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
The recommended doses for ivermectin are:
- 200 mcg/kg for strongyloidiasis
- 150 mcg/kg for onchocerciasis Specific dosage guidelines are provided in Tables 1 and 2, based on body weight. 1
From the Research
Ivermectin dosing for parasitic infections in humans is typically 200 micrograms per kilogram (mcg/kg) of body weight as a single dose, with the most recent and highest quality study supporting this dosage regimen for strongyloidiasis 2. For strongyloidiasis, one dose is usually sufficient, while for onchocerciasis, doses may be repeated every 6-12 months. For scabies, a single dose may be given, sometimes repeated after 1-2 weeks. When prescribed for off-label uses, dosing regimens vary significantly. Ivermectin should be taken on an empty stomach with water. Side effects are generally mild but can include dizziness, nausea, diarrhea, and skin rash. The medication works by paralyzing and killing parasites by affecting their nervous system through glutamate-gated chloride channels. It's essential to note that self-medication with ivermectin is not recommended, and it should only be taken under medical supervision as inappropriate use can lead to toxicity. Weight-based dosing is crucial for safety and efficacy, as supported by recent studies 3. Some key points to consider when administering ivermectin include:
- The standard dose of ivermectin is 200 µg/kg single dose orally, but multiple doses might be needed in immunosuppressed patients 3.
- In the case of hyperinfection, repeated doses are recommended up to 2 weeks after clearance of larvae from biological fluids, with close monitoring and further dosing based on review 3.
- Subcutaneous ivermectin is used where there is impaired intestinal absorption/paralytic ileus 3.
- In pregnant or lactating women, studies have not identified increased risk with ivermectin use, but a risk-benefit assessment should be considered for each case 3. Overall, the most recent and highest quality study supports the use of a single dose of ivermectin for strongyloidiasis, with weight-based dosing being crucial for safety and efficacy 2.