Ivermectin

Ivermectin is a antiparasitic (avermectin) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Scabies, including crusted scabies and household outbreaks
• Strongyloidiasis (threadworm of the gut)
• Lymphatic filariasis (as part of programme treatment)
• Onchocerciasis (river blindness)
• Head lice resistant to topical treatment
• Cutaneous larva migrans (as advised by a doctor)

The dose of Ivermectin is calculated by body weight, commonly around 200 micrograms per kg as a single dose — your doctor will work out the exact number of tablets. Take Ivermectin on an empty stomach with a glass of water, at least 1 hour before or 2 hours after food, unless your doctor advises otherwise. For scabies, a second dose is usually repeated after 7–14 days to kill newly hatched mites, and all close contacts should be treated at the same time. Children's use depends on weight (generally above 15 kg) and must be decided by a doctor. Do not self-medicate with Ivermectin.

Ivermectin is usually well tolerated as a single dose. Possible side effects include dizziness, nausea, diarrhoea, stomach pain, headache, and drowsiness. In scabies, itching may temporarily worsen for a few days as mites die — this is expected and not treatment failure. When many parasites die at once (especially in filariasis), fever, rash, joint pain, and swollen glands can occur. Seek urgent care for severe rash, swelling of face or throat, confusion, or vision problems.

For scabies, treat all household members and close contacts on the same day, wash bedding and clothes in hot water, and dry them in the sun to prevent reinfestation. Itching may continue for 2–4 weeks after successful treatment; do not keep repeating doses without a doctor's advice. Use caution in liver disease, in severe debility, and in patients from areas where Loa loa infection occurs. The safety of ivermectin in children under 15 kg is not established. Avoid driving if you feel dizzy or drowsy after the dose.

Ivermectin may increase the effect of warfarin, so blood clotting (INR) may need closer monitoring. Drugs that affect the P-glycoprotein transporter or liver enzyme CYP3A4 — such as ketoconazole, itraconazole, ritonavir, and verapamil — can raise ivermectin levels and side effects. Alcohol may increase absorption and adverse effects, so avoid it around the time of dosing. Tell your doctor about all medicines, including herbal products, before taking ivermectin.

Ivermectin must not be taken by people with known hypersensitivity to it. It is not recommended in children weighing under 15 kg, in pregnancy, or during the first week of breastfeeding unless a doctor decides the benefit outweighs the risk. Special caution applies in patients with conditions that weaken the blood–brain barrier, such as severe meningitis or trypanosomiasis.

Pregnancy: Ivermectin is generally avoided in pregnancy because safety has not been established; treatment for scabies in pregnant women is usually with permethrin cream instead. Lactation: Small amounts pass into breast milk. Many guidelines allow use during established breastfeeding when clearly needed, but it is best avoided in the first week after birth. Always consult your doctor before use if pregnant or breastfeeding.

Store below 30°C in a dry place away from light and moisture. Keep tablets in the original blister pack until use and out of the reach of children. Do not use after the expiry date printed on the pack.