Adult Dosing

Strongyloidiasis

• 0.2 mg/kg PO given as a single dose

• Dose should be taken on an empty stomach with water
• Follow-up stool examination should be done to verify eradication of infection

Onchocerciasis

• 0.15 mg/kg PO given as a single dose

• Dose should be taken on an empty stomach with water
• Follow-up examinations and repetition of treatment may be done in 3-12 months

Pediatric Dosing

• Safety and effectiveness in pediatric patients <15 kg have not been established

Strongyloidiasis

• 15-24 kg: 3 mg PO as a single dose
• 25-35 kg: 6 mg PO as a single dose
• 36-50 kg: 9 mg PO as a single dose
• 51-65 kg: 12 mg PO as a single dose
• 66-79 kg: 15 mg PO as a single dose
• >80 kg: 0.2 mg/kg PO given as a single dose

• Dose should be taken on an empty stomach with water
• Follow-up stool examination should be done to verify eradication of infection

Onchocerciasis

• 15-25 kg: 3 mg PO as a single dose
• 26-44 kg: 6 mg PO as a single dose
• 45-64 kg: 9 mg PO as a single dose
• 65-84 kg: 12 mg PO as a single dose
• >85 kg: 0.15mg/kg PO given as a single dose

• Dose should be taken on an empty stomach with water
• Follow-up examinations and repetition of treatment may be done in 3-12 months

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of intestinal (i.e., nondisseminated) strongyloidiasis due to the nematode parasite, Strongyloides stercoralis
• Treatment of onchocerciasis due to the nematode parasite, Onchocerca volvulus

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

See Supplemental Patient Information

• Patients with onchocerciasis may have cutaneous and/or systemic reactions of varying severity (the Mazzotti reaction) and ophthalmological reactions on taking microfilaricidal drugs, such as diethylcarbamazine citrate (DEC-C) probably due to allergic and inflammatory responses to the death of microfilariae; patients treated with ivermectin may also show such reactions
• For the treatment of postural hypotension associated with Mazzotti reaction, oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids can be given, while antihistamines and aspirin can be used to treat mild to moderate cases of reaction
• Hyperreactive onchodermatitis (sowda) patients treated with microfilaricidal drugs may be more prone to have severe adverse reactions such as edema and aggravation of onchodermatitis
• Onchocerciasis patients infected heavily with Loa loa may develop a serious or fatal encephalopathy either spontaneously or following treatment with an effective microfilaricide. Consider pretreatment assessment for loiasis and careful post-treatment follow-up in these patients

Caution: Use cautiously in

• Asthma

Supplemental Patient Information

• Advise patients to take the drug on an empty stomach with water
• Follow-up stool examination should be repeatedly done to verify eradication of infection
• Inform patients with onchocerciasis about the need for follow-up examinations and repetition of treatment

Pregnancy Category:C

Breastfeeding: Limited data indicate that ivermectin is poorly excreted in breast milk and does not adversely affect the breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 February 2011). As per the manufacturer's data, treatment of mothers who intend to breast-feed should only be undertaken when the risk of delayed treatment to the mother outweighs the possible risk to the newborn.

• GI: Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting, hepatitis
• CNS: Dizziness, somnolence, vertigo, tremor, seizures, headache
• CV: Orthostatic hypotension, tachycardia
• RESP: Exacerbation of asthma
• EENT: Loss of vision, abnormal sensation in the eyes, eyelid edema, anterior uveitis, conjunctivitis, conjunctival hemorrhage, limbitis, keratitis, punctate opacity, chorioretinitis or choroiditis
• DERM: Pruritus, rash, urticaria, Stevens-Johnson syndrome, toxic epidermal necrolysis
• MUSC: Arthralgia, myalgia, synovitis
• LYMPH: Enlargement and tenderness of axillary, cervical, inguinal and other lymph nodes
• HEMA: Leukopenia, anemia, eosinophilia, increase in hemoglobin
• LABTESTS: Elevated ALT, AST and bilirubin
• MISC: Asthenia, fatigue, fever, edema

• Anthelmintics; binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, which causes an increase in the permeability of the cell membrane to chloride ions and hyperpolarization of the cell leading to paralysis and death of the parasite
• Metabolized by liver
• Metabolites excreted primarily in feces over 12 days; <1% in urine
• Half-life: 18 hrs

US Trade Name(s)

• Stromectol

US Availability

Stromectol

• TABS: 3 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Stromectol

Australian Availability

Stromectol

• TABS: 3 mg

[Outline]

Antimicrobials

Antiparasitics

Antihelmintics

Infectious Disease

Antiparasitics

Antihelmintics

Pricing data from www.DrugStore.com in U.S.A.

• Stromectol 3 MG TABS [Box] (MERCK SHARP & DOHME)
  20 mg = $111.17
  60 mg = $320.68

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Drug Name: Stromectol 3 MG Oral Tablet

Ingredient(s): Ivermectin

Imprint: MSD;32

Color(s): White

Shape: Round

Size (mm): 6.00

Score: 1

Inactive Ingredient(s): cellulose, microcrystalline / starch, corn / magnesium stearate / butylated hydroxyanisole / anhydrous citric acid

Drug Label Author:
Merck & Co., Inc.

DEA Schedule:
Non-Scheduled