Ivermectin Oral Dose for Scabies and Onchocerciasis
Ivermectin guidance for onchocerciasis and scabies, with special caution in regions where loiasis is endemic.
Also searched as
Source reviewed
source date listed on the source page
Guide category
Oral drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Quick clinical summary
| Item | Summary |
|---|---|
| Drug | Ivermectin |
| Class | Anthelminthic and scabicide |
| Common form | 3 mg tablet |
| Key uses | Onchocerciasis and scabies in the source guidance |
| Dose pattern | Weight-based single dose with repeat timing depending on indication |
| Major caution | Loa loa co-infection risk in endemic regions |
| Monitoring | Itching, ocular or systemic reactions, neurologic symptoms, and treatment failure |
Clinical context from Kenza
The sections below add practical explanation around the source-derived monograph. They are educational context and do not replace local protocols or clinician review.
Ivermectin use depends on the parasite
Ivermectin dosing and repeat timing differ between onchocerciasis, ordinary scabies, and crusted scabies. The diagnosis and exposure setting matter as much as the tablet strength.
Why Loa loa screening is highlighted
In areas where loiasis occurs, people with high Loa loa microfilarial loads can have severe reactions after ivermectin. The source guidance therefore emphasizes risk assessment, supervised treatment, hospitalisation, or alternatives when appropriate.
Scabies treatment is more than one tablet
Scabies control also depends on correct diagnosis, treating close contacts when indicated, hygiene measures, and repeat treatment when the regimen requires it.
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 |
Frequently Asked Questions
Ivermectin oral dose and administration questions
What is ivermectin oral used for?
This guide lists ivermectin oral for onchocerciasis and scabies.
What is the ivermectin dose for onchocerciasis?
For children over 15 kg and adults, the listed dose is 150 micrograms/kg as a single dose, with repeat treatment depending on clinical signs and parasite control needs.
What is the ivermectin dose for ordinary scabies?
For children over 15 kg and adults, the listed ordinary scabies dose is 200 micrograms/kg as a single dose; a second dose one week later may reduce treatment failure risk.
What precautions matter with ivermectin in Loa loa areas?
The page says to use caution where loiasis is endemic, evaluate Loa loa microfilaraemia severity where possible, and consider supervised outpatient treatment, hospitalisation, or an alternative such as doxycycline depending on risk.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
Additional medical references
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