Stromectol (ivermectin) is used to treat certain parasitic roundworm infections. Curing parasitic infections helps to improve your quality of life. In people with weakened defense (immune) systems, curing roundworm infections can reduce the risk of developing a severe or life-threatening infection. Ivermectin belongs to a class of drugs known as antihelmintics. It works by paralyzing and killing parasites.

Indications and Usage

Stromectol is used to treat river blindness (onchocerciasis) and threadworm involving the intestines (intestinal strongyloidiasis). These are caused by worm infections. In onchocerciasis the worm infection mainly affects the skin, glands (lymph nodes) and eyes. Changes to the skin may include an itchy rash, pale or dark patches, nodules (small lumps under the skin), thickening of the skin and/or loss of elasticity. The infection can cause enlarged glands in the neck, armpits or groin. The infection can also affect the eye and may cause conjunctivitis, a gritty or painful eye and may lead to blindness. In the form of strongyloidiasis that is treated with Stromectol, the worm infection mainly affects the intestines and skin. Symptoms which may occur include itchy rash, vomiting, diarrhoea and stomach pain. Stromectol works by killing the developing worms. Stromectol is also used to treat scabies which is caused by the Sarcoptes scabiei mite.

Dosage and Administration

Your doctor will tell you how many tablets you need to take. The dose depends on your infection and your weight or height. The dose usually ranges from one tablet to five tablets taken as a single dose. For river blindness, you may need to take another dose in 6 to 12 months' time. Depending on whether you have typical or crusted scabies, your doctor will decide the best treatment for you. The most common course of treatment is two doses, 8-15 days apart. Stromectol can be used alone or in combination with other treatments for scabies.

Warnings and Precautions

Historical data have shown that microfilaricidal drugs, such as diethylcarbamazine citrate (DEC-C), might cause cutaneous and/or systemic reactions of varying severity (the Mazzotti reaction) and ophthalmological reactions in patients with onchocerciasis. These reactions are probably due to allergic and inflammatory responses to the death of microfilariae. Patients treated with Stromectol (ivermectin) for onchocerciasis may experience these reactions in addition to clinical adverse reactions possibly, probably, or definitely related to the drug itself.

The treatment of severe Mazzotti reactions has not been subjected to controlled clinical trials. Oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids have been used to treat postural hypotension. Antihistamines and/or aspirin have been used for most mild to moderate cases.

After treatment with microfilaricidal drugs, patients with hyperreactive onchodermatitis (sowda) may be more likely than others to experience severe adverse reactions, especially edema and aggravation of onchodermatitis.

Rarely, patients with onchocerciasis who are also heavily infected with Loa loa may develop a serious or even fatal encephalopathy either spontaneously or following treatment with an effective microfilaricide. In these patients, the following adverse experiences have also been reported: pain (including neck and back pain), red eye, conjunctival hemorrhage, dyspnea, urinary and/or fecal incontinence, difficulty in standing/walking, mental status changes, confusion, lethargy, stupor, seizures, or coma. This syndrome has been seen very rarely following the use of ivermectin. In individuals who warrant treatment with ivermectin for any reason and have had significant exposure to Loa loa-endemic areas of West or Central Africa, pretreatment assessment for loiasis and careful post-treatment follow-up should be implemented.

Contraindications

Stromectol (ivermectin) is contraindicated in patients who are hypersensitive to any component of this product.

Overdose

Significant lethality was observed in mice and rats after single oral doses of 25 to 50 mg/kg and 40 to 50 mg/kg, respectively. No significant lethality was observed in dogs after single oral doses of up to 10 mg/kg. At these doses, the treatment-related signs that were observed in these animals include ataxia, bradypnea, tremors, ptosis, decreased activity, emesis, and mydriasis.

In accidental intoxication with, or significant exposure to, unknown quantities of veterinary formulations of ivermectin in humans, either by ingestion, inhalation, injection, or exposure to body surfaces, the following adverse effects have been reported most frequently: rash, edema, headache, dizziness, asthenia, nausea, vomiting, and diarrhea. Other adverse effects that have been reported include: seizure, ataxia, dyspnea, abdominal pain, paresthesia, urticaria, and contact dermatitis.

In case of accidental poisoning, supportive therapy, if indicated, should include parenteral fluids and electrolytes, respiratory support (oxygen and mechanical ventilation if necessary) and pressor agents if clinically significant hypotension is present. Induction of emesis and/or gastric lavage as soon as possible, followed by purgatives and other routine anti-poison measures, may be indicated if needed to prevent absorption of ingested material.

What are the side effects of Ivermectin (Stromectol)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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