Ivermectin

BreastfeedingPediatric
  • 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
CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:

Alprazolam, Barbiturates, Benzodiazepines, Diazepam, Midazolam, Valproic Acid

PREGNANCY CATEGORY: C

Under investigation for treating COVID-19

See adverse reactions attributed to class:

Covid-19 putative drug

Angioedema 

(2006): Olson BG+, Pediatr Infect Dis J 25(5), 466 (with praziquantel and albendazole)

Bullous dermatosis 

(1993): Burnham GM, Trans R Soc Trop Med Hyg 87, 313

Dermatitis 

(1999): Editorial, Arch Dermatol 135, 705

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)

Erythema 

(2012): Pariser DM+, N Engl J Med 367(18), 16871%

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%

Excoriations 

(2012): Pariser DM+, N Engl J Med 367(18), 1687<1%

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%

Fixed eruption 

(2018): Ngwasiri CA+, J Med Case Rep 12(1) (1 case)Geriatric

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%

Stevens-Johnson syndrome 

(2017): Aroke D+, BMC Res Notes 10(1), 179

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)

Dandruff <1%

(package insert)

Postural hypotension 

(2012): Ejere HO+, Cochrane Database Syst Rev 8, CD002219 [REVIEW]

Tachycardia 4%

(package insert)

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%Pediatric

(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)

Somnolence (drowsiness) 

(2011): Bisoffi Z+, PLoS Negl Trop Dis 5(7), e1254 (daytime)

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%Pediatric

(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)

Diarrhea 

(2016): Abegunde AT+, Cochrane Database Syst Rev 1, CD011146 [REVIEW] (with doxycycline)

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)

Eosinophilia 

(2013): Ito T, J Dermatol 40(9), 776

Application-site burning <1%

(2015): Deeks ED, Am J Clin Dermatol 16(5), 447 [REVIEW]<2%

Application-site irritation <1%

(2015): Deeks ED, Am J Clin Dermatol 16(5), 447 [REVIEW]<2%

Application-site pruritus 

(2015): Deeks ED, Am J Clin Dermatol 16(5), 447 [REVIEW]<2%

Application-site xerosis <1%

(2015): Deeks ED, Am J Clin Dermatol 16(5), 447 [REVIEW]<2%

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

Ocular hyperemia <1%

(package insert)

Ocular stinging <1%

(package insert)

Adverse effects / adverse reactions 

(2019): Levy M+, Br J Dermatol Jul, Epub ahead of print4%Pediatric

(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]Pediatric

(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), 181Pediatric

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

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%

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

Drug Eruption Mobile Site

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Incidence info

  • <1%
  • 1-5%
  • 5-10%
  • 10-15%
  • 15-20%
  • 20-30%
  • >30%

Seriousness info

  • Hospitalization possible
  • Life threatening
  • Fatal

Warnings in other populations info

  • Breast feeding
  • Geriatric
  • Pediatric
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