Ivermectin: current uses in human medicine

Ivermectin is currently used in humans primarily to treat various parasitic infections. Here are the main uses:

Approved uses

Intestinal strongyloidiasis: Ivermectin is used to treat infections caused by the parasitic worm Strongyloides stercoralis.

Onchocerciasis (River Blindness): It is effective against Onchocerca volvulus, the parasite responsible for river blindness.

Scabies: Ivermectin is used to treat scabies, a skin infestation caused by the mite Sarcoptes scabiei.

Head lice: Topical formulations of ivermectin are used to treat head lice infestations.

Rosacea: Ivermectin cream is used to treat inflammatory lesions of rosacea.

Off-label uses

Other parasitic infections: Ivermectin is sometimes used off-label to treat other parasitic infections, such as certain types of intestinal worms. It’s important to use ivermectin under medical supervision and report any unusual symptoms to a healthcare provider immediately.

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General precautions

Consult your doctor: Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Discuss any existing health conditions, such as liver or kidney problems, which may affect how ivermectin is processed in your body.

Monitor for side effects: Ivermectin, while effective for treating various parasitic infections, can have side effects. Here are some common and serious side effects:

Common side effects

• Headache

• Dizziness

• Muscle pain

• Nausea

• Diarrhea

• Skin rash

• Itching.

Serious side effects

• Neurological Problems: Confusion, sleepiness, or even seizures.

• Eye Problems: Vision changes, eye pain, or redness.

• Severe Skin Reactions: Toxic epidermal necrolysis and Stevens-Johnson syndrome.

• Allergic Reactions: Rash, itching, swelling, severe dizziness, and trouble breathing.

• Liver Damage: Symptoms include dark urine, yellowing of the skin or eyes, and upper right abdominal pain.

Reactions to dying parasites

When treating infections like river blindness, patients may experience reactions to the dying parasites, including:

• Joint pain

• Swollen lymph nodes

• Eye swelling or pain

• Fever.

Overdose symptoms

In case of overdose, symptoms can include:

• Severe sleepiness

• Confusion

• Loss of consciousness.

Be vigilant for any unusual symptoms or side effects when starting a new medication while on ivermectin. Report these to your doctor immediately. When using ivermectin with other medications, it’s important to take certain precautions to ensure safety and effectiveness. Here are some key points to consider: Specific interactions

Warfarin: Ivermectin can enhance the effects of warfarin, a blood thinner, increasing the risk of bleeding. Your doctor may need to adjust your warfarin dose and monitor your blood clotting levels more frequently.

Barbiturates and benzodiazepines: Medications like phenobarbital, butalbital, clonazepam, and lorazepam can interact with ivermectin, potentially leading to increased sedation or other side effects.

Sodium oxybate (GHB): This medication can interact with ivermectin, potentially causing increased sedation.

Valproic acid: Used to treat seizures and bipolar disorder, valproic acid can interact with ivermectin, possibly affecting its metabolism.

Lifestyle considerations

Alcohol: Consuming alcohol while taking ivermectin can increase the risk of side effects like dizziness and drowsiness.

Food interactions: Certain foods may affect how ivermectin is absorbed and processed in your body. Follow your doctor’s advice on whether to take ivermectin with or without food.

Special populations

Pregnancy and breastfeeding: There are no adequate studies in pregnant or breastfeeding women to determine the risks. Using ivermectin during pregnancy carries certain risks, and it is generally recommended to avoid it unless the benefits outweigh the potential risks. Ivermectin is excreted into human milk in low concentrations. Studies have shown that the amounts ingested by breastfed infants are small and are not expected to cause adverse effects. It is generally considered safe to use ivermectin while breastfeeding, especially if the infant is older than 7 days. Weigh the potential benefits against the potential risks before taking ivermectin during these periods. Children and elderly: Appropriate studies have not been performed on the relationship of age to the effects of ivermectin in children weighing less than 15 kilograms (kg). Elderly patients may require dose adjustments due to age-related liver, kidney, or heart problems.

By taking these precautions, you can help ensure the safe and effective use of ivermectin when combined with other medications.

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