Ivermectin


- TRADE NAMES: Sklice (Sanofi Pasteur); Soolantra (Galderma); Stromectol (Merck)
- INDICATIONS: Various infections caused by susceptible helmintic organisms
- CLASS: Anthelmintic, Covid-19 putative drug
- HALF-LIFE: 16–35 hours
Alprazolam, Barbiturates, Benzodiazepines, Diazepam, Midazolam, Valproic Acid
PREGNANCY CATEGORY: C
See adverse reactions attributed to class:
Eczema / eczematous reaction / eczematous eruption
(2017): Sanz-Navarro J+, Actas Dermosifiliogr 108(7), 64348%
Edema / fluid retention (see also peripheral edema) 10–53%
(1998): Jaramillo-Ayerbe F+, Arch Dermatol 134, 143
(1995): Darge K+, Trop Med Parasitol 46, 20610% (arms and legs)
(1993): Burnham GM, Trans R Soc Trop Med Hyg 87, 313
(1992): Chijioke CP+, Trans R Soc Trop Med Hyg 86, 284
(1992): Zea-Flores R+, Trans R Soc Trop Med Hyg 86, 66353%
(1991): Bryan RT+, Lancet 337, 304
(1991): Guderian RH+, Lancet 337, 188 (leg)
Exanthems <34%
(1993): Burnham GM, Trans R Soc Trop Med Hyg 87, 313
(1991): Whitworth JAG+, Lancet 337, 625
(1990): Ette EI+, Drug Intell Clin Pharm 24, 42634%
Facial edema 1%
(1998): Jaramillo-Ayerbe F+, Arch Dermatol 134, 143
(1993): Burnham GM, Trans R Soc Trop Med Hyg 87, 313
(1992): Collins RC+, Am J Trop Med Hyg 47(2), 15632%
Pruritus (itching) 38–71%
(2013): Deeks LS+, Ann Pharmacother 47(9), 1161 [REVIEW]1%
(2012): Pariser DM+, N Engl J Med 367(18), 16871%
(2011): Hassan AA+, Korean J Parasitol 49(2), 153 (scalp)
(2005): Nontasut P+, Southeast Asian J Trop Med Public Health 36(2), 442
(1998): Jaramillo-Ayerbe F+, Arch Dermatol 134, 143
(1995): Darge K+, Trop Med Parasitol 46, 206
(1993): Burnham GM, Trans R Soc Trop Med Hyg 87, 313
(1993): Kar SK+, Acta Trop 55, 21
(1992): Chijioke CP+, Trans R Soc Trop Med Hyg 86, 28471%
(1992): Collins RC+, Am J Trop Med Hyg 47, 15634%
(1991): Bryan RT+, Lancet 337, 304
(1991): Whitworth JAG+, Lancet 337, 6258%
(1990): Ette EI+, Drug Intell Clin Pharm 24, 42610%
(1989): Guderian RH+, Eur J Epidemiol 5, 2944%
Rash <93%
(1998): Jaramillo-Ayerbe F+, Arch Dermatol 134, 143
(1993): Kar SK+, Acta Trop 55, 21
(1991): Bryan RT+, Lancet 337, 30493%
(1991): Guderian RH+, Lancet 337, 188
(1991): Whitworth JAG+, Lancet 337, 6258%
(1989): Guderian RH+, Eur J Epidemiol 5, 2944%
Toxic epidermal necrolysis (Lyell's syndrome)
(2017): Seegobin K+, Am J Emerg Med Sep, Epub ahead of print
Urticaria / hives 23%
(2006): Olson BG+, Pediatr Infect Dis J 25(5), 466 (with praziquantel and albendazole)
Fever (pyrexia) (includes hyperpyrexia) 23%
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
(2006): Olson BG+, Pediatr Infect Dis J 25(5), 466 (with praziquantel and albendazole)
(2004): Pani SP+, J Commun Dis 36(4), 240
Headache
(2020): Dubray CL+, PLoS Negl Trop Dis 14(6), e0008298 (with diethylcarbamazine and albendazole)
(2020): Hardy M+, PLoS Negl Trop Dis 14(3), e0008106 (with diethylcarbamazine and albendazole)
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
(2015): Speich B+, Lancet Infect Dis Jan, Epub5%
(2011): Anto F+, Trop Med Int Health 16(9), 1112 (with albendazole and praziquantel)
(2004): Pani SP+, J Commun Dis 36(4), 240
Psychosis
(2015): Mohapatra S+, J Child Adolesc Psychopharmacol 25(10), 817 (with albendazole)
(2012): Sinha P+, Gen Hosp Psychiatry 34(5), 578.e9 (with albendazole)
Vertigo / dizziness 3%
(2020): Dubray CL+, PLoS Negl Trop Dis 14(6), e0008298 (with diethylcarbamazine and albendazole)
(2020): Hardy M+, PLoS Negl Trop Dis 14(3), e0008106 (with diethylcarbamazine and albendazole)
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
(2011): Bisoffi Z+, PLoS Negl Trop Dis 5(7), e125450%
(2011): Hassan AA+, Korean J Parasitol 49(2), 153
(2004): Igual-Adell R+, Expert Opin Pharmacother 5(12), 26159%
Abdominal pain
(2020): Dubray CL+, PLoS Negl Trop Dis 14(6), e0008298 (with diethylcarbamazine and albendazole)
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
(2015): Speich B+, Lancet Infect Dis 15(3), 27712%
(2011): Hassan AA+, Korean J Parasitol 49(2), 153
(2006): Olson BG+, Pediatr Infect Dis J 25(5), 466 (with praziquantel and albendazole)
Black stools / melena
(2016): Abegunde AT+, Cochrane Database Syst Rev 1, CD011146 [REVIEW] (with doxycycline)
Dyspepsia / functional dyspepsia / gastroparesis
(2004): Igual-Adell R+, Expert Opin Pharmacother 5(12), 26159%
Nausea
(2020): Hardy M+, PLoS Negl Trop Dis 14(3), e0008106 (with diethylcarbamazine and albendazole)
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
Arthralgia 9%
(2020): Hardy M+, PLoS Negl Trop Dis 14(3), e0008106 (with diethylcarbamazine and albendazole)
Asthenia / fatigue
(2020): Hardy M+, PLoS Negl Trop Dis 14(3), e00081069% (with diethylcarbamazine and albendazole)
(2019): Weil GJ+, PLoS Med 16(6), e1002839 (with diethylcarbamazine and albendazole)
(2011): Anto F+, Trop Med Int Health 16(9), 1112 (with albendazole and praziquantel)
Myalgia/Myositis/Myopathy/Myotoxicity (see also necrotizing myopathy) 20%
(2004): Pani SP+, J Commun Dis 36(4), 240
(1995): Darge K+, Trop Med Parasitol 46, 20620%
(1993): Kar SK+, Acta Trop 55, 21
Adverse effects / adverse reactions
(2019): Levy M+, Br J Dermatol Jul, Epub ahead of print4%
(2019): Weil GJ+, PLoS Med 16(6), e100283912% (<1% serious) (with diethylcarbamazine and albendazole)
(2015): Cliff-Eribo KO+, Expert Opin Drug Saf 14(12), 1827 [REVIEW]
(2015): Romani L+, N Engl J Med 373(24), 230516% (mild)
(2013): Ito T, J Dermatol 40(9), 776
(2011): Namwanje H+, Trans R Soc Trop Med Hyg 105(4), 181
Side effects
(mild)
(2011): Bisoffi Z+, PLoS Negl Trop Dis 5(7), e125421%
(2004): Develoux M, Ann Dermatol Venereol (French) 131(6-7 Pt 1), 561 [REVIEW]
(2002): Prescrire Int 11(61), 137
Adverse reactions attributed to entire drug class Covid-19 putative drug
Cutaneous adverse reaction (includes severe cutaneous adverse drug reaction (SCAR))
(2020): Tursen U+, Dermatol Ther May, Epub ahead of print [REVIEW]
Cardiovascular adverse effect
(2022): Hamidian M+, J Res Med Sci 27, 92 [REVIEW] (with underlying comorbidities)
(2020): Carpenter A+, Front Cardiovasc Med 7, 85 [REVIEW]
(2020): Giudicessi JR+, Mayo Clin Proc May, Online ahead of print [REVIEW]
(2020): Naksuk N+, Eur Heart J Acute Cardiovasc Care May, Epub ahead of print [REVIEW]
(2020): Sarayani A+, Res Social Adm Pharm Apr, Epub ahead of print [REVIEW]
(2020): Zhang D+, Zhongguo Zhong Yao Za Zhi (Chinese) 45(10), 2275-2286 [REVIEW]
Neuropsychiatric / neuropsychological adverse effect
(2021): Borah P+, Front Mol Biosci 8, 627723
(2020): García CAC+, Gen Hosp Psychiatry Jun, Online ahead of print [REVIEW]
Gastrointestinal disorder / discomfort
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print23%
Hepatic (liver) disorder / hepatobiliary disorder / hepatic (liver) dysfunction
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print14%
Thrombocytopenia
(2020): Nham E+, Infect Chemother Apr, Epub ahead of print
Adverse effects / adverse reactions
(2022): Aguilera C+, Diagnostics (Basel) 12(7), 1612
(2022): Chiu MN+, Eur J Clin Pharmacol Jan, Online ahead of print [REVIEW]
(2022): Diak IL+, Drug Saf Dec, Online ahead of print [REVIEW]
(2021): Bérard A+, PLoS One 16(5), e0251746 [REVIEW] (in pregnancy)
(2021): Cheng Q+, Aging (Albany NY) Sep, Online ahead of print [REVIEW]
(2021): Cruciani F+, Recenti Prog Med 112(3), 195-206 [REVIEW]
(2021): Drożdżal S+, Drug Resist Updat Dec, eCollection [REVIEW]
(2021): Ommati MM+, J Biochem Mol Toxicol May, Online ahead of print [REVIEW]
(2021): Qiu R+, Medicine (Baltimore) 100(16), e25532 [REVIEW]
(2021): Wu SS+, Chin Med J (Engl) Jul, Online ahead of print [REVIEW]
(2020): Favilli A+, J Matern Fetal Neonatal Med Jun, Online ahead of print [REVIEW]
(2020): Griffiths G+, Trials 21(1), 544
(2020): Patil VM+, Life Sci May, Epub ahead of print [REVIEW]
(2020): Rhodes NJ+, medRxiv Jun, Preprint
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print38%
(2020): Svensson M, Lakartidningen (Swedish) Apr, 117
(2020): Wen CY+, Zhonghua Nei Ke Za Zhi (Chinese) May, Epub ahead of print
(2020): Zekarias A+, Drug Saf Sep, Online ahead of print [REVIEW]
(2020): Zhong H+, Pharmacol Res Apr, Epub ahead of print [REVIEW]
Page last updated 08/01/2022
Symbol key
Incidence 
- <1%
- 1-5%
- 5-10%
- 10-15%
- 15-20%
- 20-30%
- >30%
Warnings in other populations 
- Breast feeding
- Geriatric
- Pediatric