Infectious Disease Book

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Ivermectin

Aka: Ivermectin, Mectizan, Stromectol
  1. Indication
    1. Scabies (refractory to Permethrin 5%)
    2. Head Lice
    3. Strongyloidiasis
    4. Onchocerciasis
  2. Mechanism
    1. Related to Macrolide antibiotics
    2. Developed initially as veterinary anti-parasitic agent
  3. Preparations
    1. Ivermectin 6 mg tablet
  4. Dosing
    1. Scabies or Head Lice
      1. Ivermectin 200 mcg/kg PO x1 dose, repeat in 10 days
    2. Strongyloidiasis
      1. Ivermectin 200 mcg/kg PO for 1 dose
    3. Onchocerciasis
      1. Ivermectin 150 mcg/kg PO for 1 dose
  5. Efficacy: Scabies
    1. Studies show efficacy over Lindane for Scabies
      1. Madan (2001) J Dermatol 28:481-4
    2. Permethrin 5% appears to be more effective for Scabies
      1. Usha (2000) J Am Acad Dermatol 42:236-40
  6. Precautions
    1. Safe in children >15 kg (33 pounds)
    2. Avoid in Lactation
    3. Pregnancy Category: C
  7. Adverse Effects (due to allergy to parasite death)
    1. Nausea
    2. Fever
    3. Headache
    4. Arthralgia
    5. Rash
  8. Reference
    1. Meinking (1995) N Engl J Med 333:26
    2. Fawcett (2003) Am Fam Physician 68(6):1089-92

Ivermectin (C0022322)

Definition (NCI) A macrocyclic lactone derived from Streptomyces avermitilis with antiparasitic activity. Ivermectin exerts its anthelmintic effect via activating glutamate-gated chloride channels expressed on nematode neurons and pharyngeal muscle cells. Distinct from the channel opening induced by endogenous glutamate transmitter, ivermectin-activated channels open very slowly but essentially irreversibly. As a result, neurons or muscle cells remain at either hyperpolarisation or depolarization state, thereby resulting in paralysis and death of the parasites. Ivermectin does not readily pass the mammal blood-brain barrier to the central nervous system where glutamate-gated chloride channels locate, hence the hosts are relatively resistant to the effects of this agent.
Definition (MSH) A mixture of mostly avermectin H2B1a (RN 71827-03-7) with some avermectin H2B1b (RN 70209-81-3), which are macrolides from STREPTOMYCES avermitilis. It binds glutamate-gated chloride channel to cause increased permeability and hyperpolarization of nerve and muscle cells. It also interacts with other CHLORIDE CHANNELS. It is a broad spectrum antiparasitic that is active against microfilariae of ONCHOCERCA VOLVULUS but not the adult form.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D007559
SnomedCT 387559003, 96138006
English Ivermectin, ivermectin, ivermectin (medication), IVERMECTIN, Ivermectin [Chemical/Ingredient], Ivermectin (product), Ivermectin (substance)
Swedish Ivermektin
Czech ivermektin
Finnish Ivermektiini
Russian IVERMEKTIN, ИВЕРМЕКТИН
Japanese イベルメクチン
Polish Iwermektyna, Ivermectin
Spanish ivermectina (producto), ivermectina (sustancia), ivermectina, Ivermectina
French Ivermectine
German Ivermectin
Italian Ivermectina
Portuguese Ivermectina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Stromectol (C0723477)

Definition (MSH) Oral preparation of ivermectin.
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D007559
English Stromectol, Ivermectin Merck Brand, Merck Brand of Ivermectin
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Mectizan (C0751253)

Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D007559
English Mectizan
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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