Assess for loiasis prior to therapy. Monitor for presence of larvae in stool, 3-4 wk post-therapy; skin and eye microfilarial counts; ophthalmological conditions.
Increased serum concentration w/ P-glycoprotein inhibitors. Decreased serum concentration w/ P-glycoprotein inducers. Enhanced anticoagulant effect of vit K antagonists (e.g. warfarin). Diminished therapeutic effect of lactobacillus and estriol.
Increased absorption w/ high-fat meal.
Description: Ivermectin is a semisynthetic anthelmintic. It has strong affinity and selectively binds to glutamate gated Cl ion channels which results to increased permeability of cell membranes to Cl ions leading to hyperpolarisation of the nerve or muscle cell causing death of the parasite. Its mode of action in rosacea is still unknown but thought to act as an antiparasitic agent against Dermodex folliculorum mites which can trigger rosacea and has anti-inflammatory effect. Pharmacokinetics: Absorption: Well absorbed from the GI tract. Increased absorption w/ high-fat meal. Time to peak plasma concentration: Approx 4 hr (oral); approx 10 hr (topical). Distribution: High concentration in the liver and adipose cell. Enters breast milk. Volume of distribution: 3.1-3.5 L/kg. Plasma protein binding: Approx 93%, mainly albumin (oral); >99% (topical). Metabolism: Metabolised in the liver by CYP3A4 enzyme. Excretion: Via faeces; urine (<1 %). Elimination half-life: 18 hr (oral); approx 6 days (topical).
D11AX22 - ivermectin ; Belongs to the class of other dermatologicals. P02CF01 - ivermectin ; Belongs to the class of avermectine agents. Used as antinematodal.
Anon. Ivermectin (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/08/2017.Anon. Ivermectin (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 15/08/2017.Buckingham R (ed). Ivermectin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/08/2017.Joint Formulary Committee. Ivermectin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 15/08/2017.McEvoy GK, Snow EK, Miller J et al (eds). Ivermectin. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 15/08/2017.Sklice Lotion (Sanofi Pasteur, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/08/2017.Stromectol Tab (Merck Sharp & Dohme Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 15/08/2017.