What is Ivermectin: Uses, Dosage, Side Effects and More

Ivermectin is an antiparasitic medication that helps your body fight off certain types of worms and parasites. It's been used safely for decades to treat conditions like river blindness, strongyloidiasis, and other parasitic infections that can affect millions of people worldwide.

This medication works by targeting the nervous system of parasites, which makes it highly effective against specific types of infections. While you might have heard about ivermectin in recent news, it's important to understand what it actually does and when doctors prescribe it.

What is Ivermectin?

Ivermectin is a prescription medication that belongs to a class of drugs called antiparasitics. It was originally developed in the 1970s and has become one of the most important tools in fighting parasitic diseases around the world.

The medication comes from a naturally occurring compound found in soil bacteria. Scientists modified this compound to create a medicine that's safe for humans while being highly effective against parasites. It's available in both oral tablets and topical creams, though we'll focus on the oral form here.

When you take ivermectin, it travels through your bloodstream to reach areas where parasites might be living. The medication has saved countless lives, particularly in developing countries where parasitic infections are more common.

What is Ivermectin Used For?

Doctors prescribe oral ivermectin to treat several specific parasitic infections. The most common uses include treating strongyloidiasis (a type of roundworm infection) and onchocerciasis (also known as river blindness).

Strongyloidiasis happens when tiny roundworms enter your body, usually through your skin when you walk barefoot on contaminated soil. These worms can live in your intestines and cause symptoms like stomach pain, diarrhea, and skin rashes. Ivermectin helps eliminate these worms from your system.

River blindness occurs when you're bitten by infected black flies, typically in certain parts of Africa and Latin America. The parasites can cause severe itching, skin changes, and in serious cases, vision problems. Ivermectin effectively kills the young parasites before they can cause more damage.

Sometimes doctors may prescribe ivermectin for other parasitic conditions, but this happens less frequently. Your healthcare provider will determine if ivermectin is right for your specific situation based on your symptoms and test results.

How Does Ivermectin Work?

Ivermectin works by interfering with the nervous system of parasites, which paralyzes and eventually kills them. It binds to specific channels in the parasite's nerve cells, causing them to become overactive and then shut down completely.

This mechanism is quite selective, meaning it affects parasites much more than human cells. Your body's nervous system works differently from parasite nervous systems, which is why the medication can target the parasites while leaving your own cells largely unaffected.

The medication is considered moderately strong against the parasites it targets. It's not the strongest antiparasitic available, but it's highly effective for the specific conditions it treats. Most people see improvement within a few days to weeks of starting treatment.

Once the parasites are eliminated, your body's natural healing processes can begin to repair any damage they may have caused. This is why you might continue to see improvements even after you finish taking the medication.

How Should I Take Ivermectin?

Take ivermectin exactly as your doctor prescribes, usually on an empty stomach with water. This means taking it at least one hour before eating or two hours after eating, as food can reduce how well your body absorbs the medication.

Swallow the tablets whole with a full glass of water. Don't crush, chew, or break the tablets, as this can affect how the medication works. If you have trouble swallowing pills, talk to your doctor about other options.

The timing of your dose matters for getting the best results. Many doctors recommend taking ivermectin first thing in the morning, then waiting at least an hour before breakfast. This gives your body the best chance to absorb the medication properly.

If you're taking multiple doses, try to space them evenly throughout your treatment period. Setting a reminder on your phone can help you remember to take your medication at the right times.

How Long Should I Take Ivermectin For?

The length of ivermectin treatment depends on the type of infection you have and how your body responds to the medication. Most people take it for just one to two days, though some conditions may require longer treatment.

For strongyloidiasis, you'll typically take ivermectin for one to two days. Your doctor might want to repeat the treatment after a few weeks to make sure all the parasites are eliminated. This approach helps catch any parasites that might have been in early stages during your first treatment.

River blindness treatment usually involves taking ivermectin every six to twelve months. This ongoing treatment helps prevent new infections and manages any existing parasites. Your doctor will create a schedule that works best for your specific situation.

Never stop taking ivermectin early, even if you start feeling better. Parasites can survive partial treatment and may become harder to eliminate if you don't complete the full course your doctor prescribed.

What Are the Side Effects of Ivermectin?

Most people tolerate ivermectin well, but like all medications, it can cause side effects in some individuals. The good news is that serious side effects are relatively uncommon when the medication is used as prescribed.

Here are the most common side effects you might experience, and it's helpful to know that these usually resolve on their own within a few days:

• Nausea and stomach discomfort
• Diarrhea or loose stools
• Dizziness or lightheadedness
• Muscle aches or joint pain
• Skin rash or itching
• Headache
• Fatigue or weakness

These common side effects are usually mild and temporary. Your body is often responding to the dying parasites as much as to the medication itself.

Some people experience what's called a Mazzotti reaction, especially when treating river blindness. This happens when large numbers of parasites die at once, and your immune system responds strongly. You might notice increased itching, skin rashes, swollen lymph nodes, or fever. While uncomfortable, this reaction actually indicates that the treatment is working.

Rarely, more serious side effects can occur, and you should contact your doctor right away if you experience any of these:

• Severe dizziness or problems with balance
• Difficulty breathing or chest tightness
• Severe skin reactions or widespread rash
• Vision changes or eye pain
• Confusion or difficulty thinking clearly
• Seizures or loss of consciousness
• Severe abdominal pain

These serious reactions are uncommon, but they require immediate medical attention. Don't hesitate to seek help if you're concerned about any symptoms you're experiencing.

Who Should Not Take Ivermectin?

Ivermectin isn't safe for everyone, and there are certain situations where your doctor will likely recommend a different treatment. Being honest about your health history helps your doctor make the best decision for your care.

You should not take ivermectin if you're allergic to it or any of its ingredients. Signs of an allergic reaction include hives, difficulty breathing, or swelling of your face, lips, tongue, or throat. If you've had any allergic reactions to medications in the past, make sure to tell your doctor.

Pregnancy and breastfeeding require special consideration. While ivermectin may be used during pregnancy in certain situations, your doctor needs to weigh the benefits against potential risks. The medication does pass into breast milk, so nursing mothers should discuss alternatives with their healthcare provider.

Children under 15 kilograms (about 33 pounds) typically shouldn't take ivermectin, as there isn't enough safety data for very young children. Your pediatrician will know the best treatment options for younger kids.

Certain medical conditions may affect whether ivermectin is right for you. Let your doctor know if you have any of these conditions:

• Liver disease or liver function problems
• Kidney disease or reduced kidney function
• A weakened immune system
• Central nervous system disorders
• A history of seizures
• Asthma or other breathing problems

Having one of these conditions doesn't automatically mean you can't take ivermectin, but your doctor may need to adjust your dose or monitor you more closely during treatment.

Ivermectin Brand Names

Ivermectin is available under several brand names, though it's also commonly prescribed as a generic medication. The most well-known brand name is Stromectol, which is the oral tablet form used for treating parasitic infections.

Generic ivermectin contains the same active ingredient as brand-name versions and works just as effectively. Many pharmacies carry generic versions, which can be more affordable while providing the same therapeutic benefits.

Your doctor might write your prescription for either the brand name or generic version, depending on your insurance coverage and the pharmacy you use. Both options are equally safe and effective when used as prescribed.

Ivermectin Alternatives

If ivermectin isn't suitable for you, there are other medications that can treat parasitic infections. The best alternative depends on the specific type of parasite you're dealing with and your individual health situation.

For strongyloidiasis, albendazole is sometimes used as an alternative, especially in cases where ivermectin isn't available or isn't tolerated well. Thiabendazole is another option, though it's used less frequently due to more side effects.

For river blindness, doxycycline is sometimes used in combination with other treatments. This antibiotic targets bacteria that live inside the parasites, which can help weaken them and make treatment more effective.

Your doctor will consider factors like your age, other medications you're taking, and any health conditions you have when choosing the best treatment option for you. Don't switch medications on your own, as different parasites respond to different treatments.

Is Ivermectin Better Than Albendazole?

Both ivermectin and albendazole are effective antiparasitic medications, but they work better for different types of infections. Comparing them directly depends on what condition you're treating and your specific circumstances.

For strongyloidiasis, ivermectin is generally considered the first-choice treatment because it's more effective at eliminating this particular type of worm. Studies show that ivermectin clears strongyloidiasis infections in about 95% of cases, while albendazole has a lower success rate for this condition.

For other types of worm infections, like roundworms or hookworms, albendazole might be equally effective or sometimes preferred. Albendazole tends to work better for certain intestinal worms, while ivermectin excels at treating strongyloidiasis and river blindness.

The side effect profiles are somewhat different too. Ivermectin generally causes fewer stomach problems, while albendazole might cause more nausea but fewer neurological effects. Your doctor will choose based on which medication is most likely to work for your specific infection while causing the fewest problems for you.