Ivermectin

Ivermectin

February 10, 2020

Ivermectin is an anti-parasitic medication used in treating several types of worm infections in the skin and intestine such as:

  • Strongyloidiasis- an infection caused by a type of roundworm (threadworm) that gets inside the body through the skin and moves through the airways and lives in the intestine.
  • Onchocerciasis/ River blindness- infection with a certain type of roundworm that may cause bumps under the skin, rash, vision problems such as vision loss or blindness.
  • Trichuriasis- is the third most common intestinal infection (large intestine) worldwide caused by the whipworm parasite.
  • Lymphatic filariasis- also known as elephantiasis caused by the filarial worm. In most cases, this condition has no symptoms but some people developed symptoms such as severe swelling in the legs, arms, breast or genitals.
  • Loa loa filariasis- a parasitic infection in the eye
  • It is sometimes used to treat certain other roundworm infections such as pubic lice infestation.
  • Scabies- a skin infection caused by the mite Sarcoptes scabei. This condition is characterized by red rashes and itching on the affected area of the skin.

Ivermectin is a type of anthelmintic medication that works by paralyzing and killing the worm in the intestine. It helps control onchocerciasis by killing the developing egg.  However, Ivermectin will not cure onchocerciasis as it can’t kill the adult worms that cause this type of parasitic infection.  Curing parasitic infection can reduce the risk of developing life-threatening infections among those with a weakened immune system.

It’s more effective than Albendazole and equally effective as thiabendazole in treating threadworm infections. It is generally well-tolerated with fewer adverse effects and more cost-effective. Ivermectin cream is also effective in treating rosacea and was approved by the FDA in treating inflammatory lesions of rosacea.

How to Use It

Ivermectin comes as an oral tablet, topical lotion, and topical cream form and is available as a brand-name drug and generic name. The generic version of this drug usually costs less than the brand name version while their mechanism of actions and efficacy are the same.

Take the tablet by mouth on an empty stomach. The recommended dose for adult in treating parasite infection in the intestinal tract is 200 mcg per kg. The dose for parasite infection in the skin and in eyes is 150 mcg per kg. For river blindness, it is usually taken as a single dose. If you are taking it in treating river blindness, additional doses of 3, 6 or 12 months may later be necessary to control your infection. If you are taking it to treat Strongyloidiasis, you need to have your stool check for at least three times during the first 3 months of your treatment after your treatment to see if your infection has cleared up. This medicine stays in your body for an average of 2 to 3 days.

Possible Side Effects

This medicine can cause side effects. Inform your doctor if any of the following symptoms are severe or do not go away.

  • Nausea
  • Vomiting
  • Weakness
  • Loss of appetite
  • Diarrhea
  • Sleepiness
  • Stomach pain
  • Chest discomfort
  • Constipation
  • Uncontrollable shaking of some of the body parts

You may also experience unwanted side effects if you are taking this in treating river blindness like:

  • Eye pain, redness or tearing
  • Swelling of the eyelid or eye
  • Swelling of the eyes, face, arms, feet, hands, lower legs or ankles
  • Rapid heartbeat
  • Swollen and painful glands of the armpit, neck or groin
  • Abnormal sensation in the eye
  • Pain and swelling of the joint

Some side effects can be serious. These side effects need immediate medical attention.

  • Signs of allergic reaction like hives, itching
  • Blistering or peeling of skin
  • Fever

What should I know before taking Ivermectin?

  • The peak effect of Ivermectin in treating river blindness can be observed in 3 to 6 months and 3 months in treating Strongyloidiasis. Do not stop taking this medication even if you feel well. Continue taking this unless you are told by your doctor to stop.
  • Pregnant women should not take Ivermectin unless deemed necessary by your physician. It’s neither recommended for breastfeeding women as this can pass unto breast milk. Avoid direct contact of this medicine with the baby.
  • Ivermectin does not kill adult onchocerca worn, only the microfilariae. It’s not also active against disseminated strongyloides, only the intestinal.
  • Use this drug with care for patients with:
    • Asthma, as this can make asthma worse
    • Liver problems or history of liver issues
    • Seizures, as this can cause a seizure
    • HIV
    • Patients who are aged 60 years and above as their liver may not work well as it used to. It may also increase the risk of side effects.

Getting the Best Result from Ivermectin

  • Do not drink alcoholic beverages if you are taking Ivermectin as this can increase the concentration of the medicine causing headaches, dizziness, skin rash, vomiting, abdominal pain and diarrhea.
  • An immunocompromised patient may require repeat treatment.
  • Pre-treatment assessment for loa loa infection is necessary for a patient with significant exposure to the endemic areas.
  • Ivermectin may interact with other medications and may cause interaction. To help avoid possible interactions, inform your doctor if you are taking any other medications including vitamins and herbal supplements. Drug interaction can be harmful and may prevent the drug from working well.
  • Do not take more or less than what is recommended by your physician. If your dose is too high, you could have a dangerous level of drug in your body.
  • This medicine can make you dizzy. Avoid alcoholic beverages as it can make you even dizzier. Do not drive or use machinery or do anything that needs alertness until you can do it safely.

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