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Ivermectin: Brands, Price & Uses in Bangladesh
Ivermectin is an antiparasitic (anthelmintic) medicine.
About Ivermectin
Indications of Ivermectin
Ivermectin is an antiparasitic (anthelmintic) medicine. Its evidence-supported uses are classified below by strength of evidence.
Established / FDA-approved oral uses
- Strongyloidiasis: Treatment of intestinal infection caused by Strongyloides stercoralis.
- Onchocerciasis (river blindness): Treatment of infection caused by Onchocerca volvulus microfilariae. Ivermectin has no activity against adult worms, so periodic retreatment is usually required, and surgical removal of nodules may be used as adjunct therapy.
Guideline-supported uses (WHO / national scabies and lice programmes)
- Scabies: Oral Ivermectin is used, often together with topical scabicides, for classical and crusted (Norwegian) scabies, particularly in outbreak settings or when topical treatment fails or cannot be used.
- Lymphatic filariasis: Used as part of WHO mass drug administration programmes, typically in combination with albendazole and/or diethylcarbamazine (combination therapy required; not effective as monotherapy for this indication).
- Pediculosis (head lice): A topical lotion formulation of Ivermectin is approved for head lice in patients above a defined minimum age; oral Ivermectin is used off-label for resistant infestations under medical supervision.
Off-label / dermatological use
- A topical cream formulation of Ivermectin is approved for inflammatory lesions of rosacea; this is a distinct, separate indication from the antiparasitic oral use.
Ivermectin should be used strictly for these established and guideline-supported parasitic and dermatological indications. It should not be used for the prevention or treatment of viral illnesses, as this is not an approved or evidence-supported use.
Dosage & Administration of Ivermectin
General instructions
Ivermectin tablets should be taken orally with a full glass of water, on an empty stomach (at least 1 hour before a meal), as food increases systemic absorption. Doses are calculated based on body weight.
| Indication | Adult dose | Notes |
|---|---|---|
| Strongyloidiasis | Single oral dose of approximately 200 mcg/kg body weight | Follow-up stool examinations are recommended to confirm parasitological cure; a repeat course may be needed if follow-up examination shows persistent infection. |
| Onchocerciasis | Single oral dose of approximately 150 mcg/kg body weight | Retreatment is generally recommended, commonly at intervals of about 12 months (as short as 3 months has been used in specific programme settings), because Ivermectin does not kill the adult worm. |
| Scabies | Single oral dose of approximately 200 mcg/kg, often repeated after 8-14 days | Usually combined with topical scabicide; two-dose regimen improves cure rate. Crusted scabies may need additional doses per specialist guidance. |
| Lymphatic filariasis (mass drug administration) | Weight/age-based single dose, given in combination with albendazole (and/or diethylcarbamazine per national programme) | Ivermectin is used as combination therapy for this indication, not as monotherapy. |
See Use in Special Populations for pediatric, renal and hepatic considerations, and Contraindications/Precautions for the Loa loa caution relevant to onchocerciasis treatment.
Side Effects of Ivermectin
Most patients tolerate Ivermectin well. Reported adverse effects vary somewhat by indication because some reactions reflect the host response to dying parasites (Mazzotti-type reaction) rather than direct drug toxicity.
Common (strongyloidiasis/general use)
- Dizziness
- Pruritus (itching)
- Nausea, diarrhea, abdominal pain
- Headache
- Fatigue/asthenia
Common with onchocerciasis treatment (Mazzotti-type reaction to dying microfilariae)
- Pruritus and worsening skin rash
- Fever
- Lymph node tenderness/swelling
- Joint and muscle pain
- Peripheral edema, tachycardia, postural hypotension (less common)
- Eye symptoms such as limbitis or punctate opacity in patients with ocular onchocerciasis
Rare / serious (post-marketing)
- Seizures
- Hepatitis, elevated liver enzymes
- Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis) - rare
- Neurotoxicity (confusion, altered consciousness) - see Precautions and Warnings
Patients should seek medical attention promptly for severe rash, breathing difficulty, yellowing of skin/eyes, or altered mental status.
Contraindications of Ivermectin
Ivermectin is contraindicated in patients with a known hypersensitivity to Ivermectin or to any component of the formulation.
Frequently Asked Questions about Ivermectin
What is Ivermectin used for?
Ivermectin is an antiparasitic medicine used to treat certain worm infections such as strongyloidiasis and onchocerciasis (river blindness), and it is also used, often together with other treatments, for scabies, head lice and as part of combination therapy for lymphatic filariasis. It is not approved or recommended for preventing or treating viral illnesses.
How should I take Ivermectin?
Take Ivermectin tablets by mouth with a full glass of water on an empty stomach, generally at least one hour before a meal, exactly as directed by your physician. Do not take more than the prescribed dose or repeat doses without medical advice.
Can Ivermectin be taken during pregnancy or while breastfeeding?
Ivermectin should be used during pregnancy only if clearly needed and if the potential benefit justifies the potential risk to the fetus, since safety in human pregnancy has not been firmly established and animal studies have shown risk at high doses; treatment is often deferred until after delivery when possible. Ivermectin passes into breast milk in low amounts, so it should be used while breastfeeding only if the benefit to the mother is judged to outweigh possible risk to the infant. Always consult your physician before use in pregnancy or lactation.
Who should not take Ivermectin?
Ivermectin is contraindicated in anyone with a known hypersensitivity (allergy) to Ivermectin or to any ingredient in the product. Your physician will also assess other factors, such as heavy Loa loa infection in onchocerciasis patients from endemic parts of Africa, before prescribing it, because of a rare but serious risk of encephalopathy in that specific situation.
What are the possible side effects of Ivermectin?
Common side effects of Ivermectin include dizziness, itching, nausea, diarrhea and headache. When used for onchocerciasis, many patients experience a Mazzotti-type reaction (itching, rash, fever, joint pain, swollen lymph nodes) caused by the immune response to dying parasites, not the drug itself. Rarely, serious effects such as severe skin reactions, liver problems, seizures or confusion/altered consciousness can occur; seek medical attention promptly if these happen.
What should I do if I take too much Ivermectin?
An overdose of Ivermectin can cause drowsiness, unsteadiness, tremor, confusion, low blood pressure or, rarely, coma. If an overdose is suspected, seek immediate medical attention or contact a poison control center/emergency services right away; do not attempt to treat an overdose at home.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.