• PO: Treatment of:
  • Intestinal strongyloidiasis.
  • Onchocerciasis (nematode form only).
• Topical: Treatment of:
  • Head lice.
  • Inflammatory lesions of rosacea.

Contraindicated in:

• Hypersensitivity.

Use Cautiously in:

• OB: Safety not established in pregnancy
• Lactation: Safety not established in breastfeeding
• Pedi: Safety and effectiveness not established in children <15 kg (oral) or <6 mo (lotion).

Derm: burning sensation (topical), dry skin (topical), pruritus, rash, urticaria.

EENT: conjunctivitis (topical).

GI: abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting.

Neuro: COMA, confusion, disorentation, dizziness, drowsiness, fatigue, stupor, tremor, vertigo, weakness.

Misc: Mazzotti reaction (onchocerciasis only), DEATH.

Drug-Drug:

• May ↑ risk of bleeding with warfarin.

(Generic available)

• Tablets: 3 mg;
• Lotion (Sklice): 0.5%^OTC;
• Cream (Soolantra): 1%;

Strongyloidiasis

• PO (Adults and Children ≥80 kg): 200 mcg/kg as a single dose.
• PO (Adults and Children 66–79 kg): 15 mg (5 tablets) as a single dose.
• PO (Adults and Children 51–65 kg): 12 mg (4 tablets) as a single dose.
• PO (Adults and Children 36–50 kg): 9 mg (3 tablets) as a single dose.
• PO (Adults and Children 25–35 kg): 6 mg (2 tablets) as a single dose.
• PO (Adults and Children 15–24 kg): 3 mg (1 tablet) as a single dose.

Onchocerciasis

• PO (Adults and Children ≥85 kg): 150 mcg/kg as a single dose; course may be repeated at 3–12 mo intervals.
• PO (Adults and Children 65–84 kg): 12 mg (4 tablets) as a single dose; course may be repeated at 3–12 mo intervals.
• PO (Adults and Children 45–64 kg): 9 mg (3 tablets) as a single dose; course may be repeated at 3–12 mo intervals.
• PO (Adults and Children 26–44 kg): 6 mg (2 tablets) as a single dose; course may be repeated at 3–12 mo intervals.
• PO (Adults and Children 15–25 kg): 3 mg (1 tablet) as a single dose; course may be repeated at 3–12 mo intervals.

Head Lice

• Topical (Adults and Children ≥6 mo): Apply lotion (up to 1 tube) to dry hair and rub until scalp is moistened; leave on for up to 10 minutes, and then rinse off with water.

Rosacea

• Topical (Adults): Apply cream to affected areas of face once daily.

Sklice, Soolantra, Stromectol

• Binds selectively and with a high affinity to chloride channels in invertebrate nerve and muscle cells, resulting in parasite paralysis and death.
• Active against Strongyloides stercoralis and the nemotode form of Onchocerca volvulus.
• Mechanism in treating rosacea unknown.

• Death of infecting parasites with resolution of symptoms of infection.
• Reduction in inflammatory lesions of rosacea.

Therapeutic Classification:

Pharmacologic Classification:

Absorption: Some absorption follows oral administration; fat enhances absorption; little systemic absorption with topical administration.

Distribution: Small amounts enter breast milk.

Metabolism/Excretion: Metabolized by the liver by the CYP3A4 isoenzyme; parent drug and metabolites excreted mainly in feces; <1% excreted unchanged in urine.

Half-life: Oral: 18 hr; Cream: 6.5 days.

Rosiver

(blood levels)

• Instruct patient to take the single dose on an empty stomach with water.
• Advise patient that ivermectin does not kill the adult Onchocerca parasites; repeated follow-up and retreatment is usually required.
• Instruct patient to notify health care professional if scalp itching, numbness, redness, or rash occurs.
  • Instruct patient to avoid getting Sklice lotion or Soolantra cream in eyes. If this occurs, eyes should be flushed thoroughly with water. Health care professional should be contacted if eye irritation persists.
  • Advise patient that others residing in the home should also be checked for lice.
  • Instruct patient on methods of preventing reinfestation. All clothes, including outdoor apparel and household linens, should be machine-washed using very hot water and dried for at least 20 min in a hot dryer. Dry-clean nonwashable clothes. Brushes and combs should be soaked in hot (130°F), soapy water for 5–10 min. Remind patient that brushes and combs should not be shared. Wigs and hairpieces should be shampooed. Rugs and upholstered furniture should be vacuumed. Toys should be washed in hot, soapy water. Items that cannot be washed should be sealed in a plastic bag for 2 wk.
  • If patient is a child, instruct parents to notify school nurse or day care center so that classmates and playmates can be checked.
• Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Advise a lactating woman to avoid accidental transfer of topical products to breast area to prevent infant from ingesting the drug.

eye-ver-MEK-tin

NDC Code^*

• 0006- Merck Sharp and Dohme Corp.
  • 0006-0032- STROMECTOL
    • 0006-0032-20- 2 BLISTER PACK in 1 CARTON (0006-0032-20) > 10 TABLET in 1 BLISTER PACK

• 0299- Galderma Laboratories, L.P.
  • 0299-3823- SOOLANTRA
    • 0299-3823-00- 2 g in 1 TUBE (0299-3823-00)

• 0299- Galderma Laboratories, L.P.
  • 0299-3823- SOOLANTRA
    • 0299-3823-02- 1 TUBE in 1 BLISTER PACK (0299-3823-02) > 2 g in 1 TUBE

• 0299- Galderma Laboratories, L.P.
  • 0299-3823- SOOLANTRA
    • 0299-3823-30- 1 TUBE in 1 CARTON (0299-3823-30) > 30 g in 1 TUBE

• 0299- Galderma Laboratories, L.P.
  • 0299-3823- SOOLANTRA
    • 0299-3823-45- 1 TUBE in 1 CARTON (0299-3823-45) > 45 g in 1 TUBE

• 0299- Galderma Laboratories, L.P.
  • 0299-3823- SOOLANTRA
    • 0299-3823-60- 1 TUBE in 1 CARTON (0299-3823-60) > 60 g in 1 TUBE

• 0591- Actavis Pharma, Inc.
  • 0591-4052- Ivermectin
    • 0591-4052-89- 1 TUBE in 1 CARTON (0591-4052-89) > 45 g in 1 TUBE

• 24338- Arbor Pharmaceuticals
  • 24338-183- Sklice
    • 24338-183-04- 1 TUBE in 1 CARTON (24338-183-04) > 117 g in 1 TUBE

• 42799- Edenbridge Pharmaceuticals, LLC
  • 42799-806- Ivermectin
    • 42799-806-01- 2 BLISTER PACK in 1 CARTON (42799-806-01) > 10 TABLET in 1 BLISTER PACK

• 63629- Bryant Ranch Prepack
  • 63629-7275- Ivermectin
    • 63629-7275-1- 2 TABLET in 1 BOTTLE (63629-7275-1)

• 63629- Bryant Ranch Prepack
  • 63629-7275- Ivermectin
    • 63629-7275-2- 30 TABLET in 1 BOTTLE (63629-7275-2)

• 63629- Bryant Ranch Prepack
  • 63629-7275- Ivermectin
    • 63629-7275-3- 4 TABLET in 1 BOTTLE (63629-7275-3)

• 63629- Bryant Ranch Prepack
  • 63629-7275- Ivermectin
    • 63629-7275-4- 10 TABLET in 1 BOTTLE (63629-7275-4)

• 66993- Prasco Laboratories
  • 66993-948- Ivermectin
    • 66993-948-48- 1 TUBE in 1 CARTON (66993-948-48) > 45 g in 1 TUBE

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-02- 2 TABLET in 1 BOTTLE (76413-155-02)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-04- 4 TABLET in 1 BOTTLE (76413-155-04)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-06- 6 TABLET in 1 BOTTLE (76413-155-06)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-08- 8 TABLET in 1 BOTTLE (76413-155-08)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-10- 10 TABLET in 1 BOTTLE (76413-155-10)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-12- 12 TABLET in 1 BOTTLE (76413-155-12)

• 76413- Central Texas Community Health Centers
  • 76413-155- Ivermectin
    • 76413-155-14- 14 TABLET in 1 BOTTLE (76413-155-14)