Ivermectin
Ivermectin (Stromectol)
Ivermectin
(eye-ver- MEK-tin)
Pregnancy Category: C Stromectol (Rx)

Classification: Anthelmintic

Action/Kinetics: Binds selectively to glutamate-gated chloride channels that occur in invertebrate nerve and muscle cells. This leads to increase in permeability of cell membrane to chloride ions and hyperpolarization of nerve or muscle cell, resulting in paralysis and death of parasite. Peak plasma levels: About 4 hr. t 1/2: About 19 hr. Metabolized in liver and excreted through feces.

Uses: Intestinal strongyloidiasis due to Strongyloides stercoralis. Onchocerciasis due to Onchocerca volvulus.

Special Concerns: Use during lactation only if benefits outweigh risks. Those with hyperreactive onchodermatitis (sowdah) may be more likely to have severe side effects. Control of extraintestinal strongyloidiasis is difficult in immunocompromised clients.

Side Effects: When used to treat strongyloidiasis. GI: Diarrhea, nausea, anorexia, constipation, vomiting, abdominal pain. CNS: Dizziness, somnolence, tremor, vertigo. Dermatologic: Pruritus, rash, urticaria. Miscellaneous: Asthenia, fatigue.
When used to treat onchocerciasis. Mazzotti reaction: Pruritus, edema, papular and pustular or frank urticarial rash, fever, inguinal lymph node enlargement and tenderness, axillary lymph node enlargement and tenderness, arthralgia, synovitis, cervical lymph node enlargement and tenderness. Ophthalmic: Limbitis, punctate opacity, abnormal sensation in the eyes, anterior uveitis, chorioretinitis, choroiditis, conjunctivitis, eyelid edema, keratitis. Miscellaneous: Tachycardia, peripheral edema, facial edema, orthostatic hypotension, headache, myalgia, worsening of bronchial asthma.

Laboratory Test Alterations: ALT, AST, hemoglobin. Leukocyte count. Eosinophilia.

Overdose Management: Symptoms: Asthenia, diarrhea, dizziness, edema, headache, nausea, rash, vomiting, abdominal pain, ataxia, dyspnea, paresthesia, seizure, urticaria. Treatment: Supportive therapy, including parenteral fluids and electrolytes, respiratory support, and pressor agents (if significant hypotension). Induce emesis or gastric lavage as soon as possible, followed by laxatives and other anti-poison measures.

How Supplied: Tablet: 6 mg

Dosage
?Tablets Strongyloidiasis.
Single oral dose to provide about 200 mcg/kg: 15-24 kg: 0.5 tablet; 25-35 kg: 1 tablet; 36-50 kg: 1.5 tablets; 51-65 kg: 2 tablets; 66-79 kg: 2.5 tablets.
Onchocerciasis.
Single oral dose to provide about 150 mcg/kg: 15-25 kg: 0.5 tablet; 26-44 kg: 1 tablet; 45-64 kg: 1.5 tablets; 65-84 kg: 2 tablets.