What is the recommended dose of ivermectin (antiparasitic medication) for an 8-year-old pediatric patient?

Ivermectin Dosing for an 8-Year-Old Child

For an 8-year-old child, ivermectin should be dosed at approximately 200 mcg/kg as a single oral dose for strongyloidiasis or 150 mcg/kg for onchocerciasis, taken on an empty stomach with water. 1

Weight-Based Dosing Algorithm

The specific dose depends on the child's body weight, which is essential for accurate dosing 2:

For Strongyloidiasis (200 mcg/kg):

• 15-24 kg: 1 tablet (3 mg) 1
• 25-35 kg: 2 tablets (6 mg) 1
• 36-50 kg: 3 tablets (9 mg) 1

For Onchocerciasis (150 mcg/kg):

• 15-25 kg: 1 tablet (3 mg) 1
• 26-44 kg: 2 tablets (6 mg) 1
• 45-64 kg: 3 tablets (9 mg) 1

A typical 8-year-old weighs approximately 25-30 kg, which would translate to 2 tablets (6 mg total) for either indication. 1

Administration Guidelines

• Administer on an empty stomach with water to optimize absorption 1
• Single dose is typically sufficient for strongyloidiasis, though follow-up stool examinations should verify eradication 1
• For onchocerciasis, retreatment may be considered at intervals as short as 3 months for individual patients 1

Safety Profile in Children

Ivermectin exhibits excellent safety in pediatric populations due to P-glycoprotein limiting neurological penetration 3. The drug causes paralysis in parasites through binding to ligand-gated ion channel receptors (glutamate, GABA, glycine), but these receptors have different expression patterns in vertebrates, making toxicity rare in mammals 3.

Common mild adverse effects include: edema, rash, headache, dizziness, nausea, and ocular complaints, which are typically short in duration 3, 4. Serious adverse events are not expected with therapeutic dosing 4.

Clinical Efficacy

Ivermectin demonstrates superior efficacy compared to albendazole for strongyloidiasis (parasitological cure rate 1.79 times higher) and comparable efficacy to thiabendazole with significantly fewer adverse events 4. It is currently the drug of choice for human onchocerciasis and shows potent activity against major filarial parasites 5.

Critical Prescribing Requirement

Patient weight in kilograms must be documented on the prescription to enable the pharmacist to verify appropriate dosing, as weight-based calculations are essential for pediatric safety 2.