From the Guidelines
There is no recommended daily preventive dose of ivermectin for general use. Ivermectin is not approved or recommended for daily preventive use against any condition. The FDA has only approved ivermectin for specific parasitic conditions in humans, such as strongyloidiasis and onchocerciasis, and for external parasites like head lice or skin conditions like rosacea. For these approved uses, dosing is typically based on weight (approximately 200 mcg/kg) and given as a one-time dose or according to a specific treatment schedule determined by a healthcare provider, not as a daily preventive medication, as seen in the guidelines for treating scabies and other parasitic infections 1.
Some key points to consider when prescribing ivermectin include:
- The appropriate treatment dose is typically 200 ug/kg orally, repeated in 2 weeks for certain conditions, such as scabies 1.
- Ivermectin should not be used in infants and young children aged <10 years for certain conditions, such as lindane treatment 1.
- Combination treatment with a topical scabicide and oral ivermectin may be recommended for crusted scabies, with ivermectin 200 ug/kg on days 1,2,8,9, and 15, and additional doses on days 22 and 29 for severe cases 1. Taking ivermectin without proper medical indication can lead to unnecessary side effects including nausea, vomiting, diarrhea, low blood pressure, allergic reactions, dizziness, problems with balance, seizures, and liver injury. Any medication use should be discussed with and prescribed by a healthcare provider based on individual medical needs and conditions.
From the Research
Daily Preventive Ivermectin Dose
- The optimal daily preventive ivermectin dose is not clearly established in the provided studies 2, 3, 4, 5, 6.
- A study published in the International Journal of Infectious Diseases found that a 5-day course of ivermectin (12 mg once daily) may reduce the duration of illness in patients with mild COVID-19 3.
- Another study published in the American Journal of Therapeutics reported that regular ivermectin use (dose not specified) may lead to large reductions in transmission of SARS-CoV-2 4.
- The Frontline COVID-19 Critical Care Alliance (FLCCC) recommends the use of oral ivermectin for both prophylaxis and early-treatment of COVID-19, but the optimal dose is not specified 5.
- A systematic review and meta-analysis published in BMC Infectious Diseases found that ivermectin did not show an effect in reducing mortality or mechanical ventilation requirement, but the quality of evidence was low to very low 6.
Ivermectin Dosing Regimens
- The dosing regimens used in the studies varied, with some using a single dose of 12 mg ivermectin, while others used a 5-day course of 12 mg once daily 3.
- The optimal dosing regimen for preventive use of ivermectin is not established, and further studies are needed to determine the efficacy and safety of different dosing regimens 2, 5, 6.
Safety and Efficacy
- The safety and efficacy of ivermectin for preventive use are not well established, and the quality of evidence is generally low to very low 2, 6.
- Further studies are needed to determine the optimal dose and dosing regimen for preventive use of ivermectin, as well as its safety and efficacy in different populations 2, 5, 6.