Ivermectin

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jun 28, 2024

Warnings

Ivermectin (Stromectol) Risks, Warnings, and Complications

Ivermectin can cause or worsen health problems in certain high-risk individuals. Talk to your doctor or pharmacist about other treatment options for parasitic diseases if you are at an increased risk of complications from this medication.

SEVERE ALLERGIC REACTIONS: Some people who take ivermectin to treat river blindness (onchocerciasis) develop a severe and potentially life-threatening allergic reaction called a Mazzotti reaction. This reaction typically occurs about a week after taking ivermectin for onchocerciasis. It does not occur after taking ivermectin for parasitic worms in the stomach (strongyloidiasis). Symptoms of the reaction may include fever, rash, hives, fast heart rate, and stomach pain. It occurs because the body reacts to the dead larvae (baby worms). Tell your doctor right away or seek emergency medical care if you develop any of these symptoms after taking ivermectin.
NEUROTOXICITY: Although ivermectin does not readily cross the blood-brain barrier, brain damage is a rare complication of ivermectin therapy for river blindness. The risk of this complication is higher in people who also have a concurrent African eye worm (loa loa) infection. Tell your doctor if you have recently spent time in Central or West Africa, where these infectious diseases are endemic. Your healthcare provider will check for African eye worm and treat it before starting ivermectin for river blindness. Symptoms of neurotoxicity may include head and neck pain, blurred vision, difficulty standing or walking, drowsiness, disorientation, confusion, or loss of consciousness. Seek emergency medical care if you develop any of these symptoms.
ADDITIONAL DOSES: People living with HIV or those with a weakened immune system may not respond to one dose of ivermectin tablets for stomach worms. Your healthcare provider will check stool samples to confirm that the infection has cleared and prescribe repeat doses of ivermectin if needed.

Precautions Before Starting Ivermectin (Stromectol)

Tell your doctor if you are allergic to ivermectin, any of the active compounds or inactive ingredients in ivermectin tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions.

Tell your doctor if you have HIV/AIDS or other medical conditions.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding.

Precautions During Use of Ivermectin (Stromectol)

Keep all your medical and laboratory appointments while taking ivermectin. Your healthcare professional will order stool exams to check for parasitic worms and prescribe additional doses if your strongyloidiasis infection has not cleared.

Ivermectin treatment for river blindness (onchocerciasis) can cause postural hypotension (low blood pressure when going from a sitting or lying position to standing), causing dizziness and lightheadedness. Get out of bed slowly by placing your feet on the ground for a few minutes before standing up to prevent falls.

Tell your doctor if you become pregnant while on ivermectin.

Tell all your healthcare providers you are on ivermectin, especially before any surgery, including dental procedures.

Ivermectin (Stromectol) Drug Interactions

Concomitant use of ivermectin with certain other drugs can affect how the medications work. Possible drug interactions between ivermectin and other medicines can increase the risk of severe adverse effects.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your health care professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medicines.

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