Ivermectin oral
Ivermectin guidance for onchocerciasis and scabies, with special caution in regions where loiasis is endemic.
Therapeutic action
Anthelminthic, scabicide.
Indications
- Onchocerciasis.
- Scabies.
Forms and strengths
- 3 mg tablet.
Dose and duration
Onchocerciasis
- Child over 15 kg and adult: 150 micrograms/kg single dose.
- A 2nd dose should be administered after 3 months if clinical signs persist.
- Repeat treatment every 6 or 12 months to maintain parasite load below the threshold at which clinical signs appear.
Ordinary scabies
- Child over 15 kg and adult: 200 micrograms/kg single dose.
- A single dose may be sufficient; a 2nd dose one week later reduces the risk of treatment failure.
Crusted scabies
- Child over 15 kg and adult: 2 doses of 200 micrograms/kg one week apart, in combination with a topical keratolytic and topical scabicide; additional doses may be necessary.
Contra-indications, adverse effects, precautions
Administer with caution in regions where loiasis is endemic.
Evaluate the severity of Loa loa microfilaraemia and manage accordingly: either treat as an outpatient under supervision, or hospitalise, or choose an alternative treatment such as doxycycline.
If thick film examination is not possible, ivermectin may be administered if the patient has no history of loiasis or severe adverse reactions after previous ivermectin treatment.
For ordinary scabies, review the patient's history and if in doubt, topical scabicidal treatment is preferred.
- May cause increased itching.
- May cause moderate reactions in patients with onchocerciasis such as ocular irritation, headache, arthralgia, myalgia, lymphadenopathy, fever, and oedema.
- May cause severe reactions in patients co-infected with Loa loa, including marked functional impairment and encephalopathy at high microfilarial loads.
- Pregnancy: avoid.
- Breast-feeding: no contra-indication.
Dosage and duration
| Height Weight | 0 to < 90 cm < 15 kg | 90 to < 120 cm 15 to < 25 kg | 120 to < 140 cm 25 to < 45 kg | 140 to < 160 cm 45 to < 65 kg | ≥ 160 cm ≥ 65 kg |
|---|---|---|---|---|---|
| 3 mg tablet | Do not administer | 1 tab | 2 tab | 3 tab | 4 tab |
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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