Brands, Medical Use, Clinical Data
Drug Category
- Anthelmintics
- Antinematodal Agents
- Antiprotozoal Agents
Dosage Forms
- Bolus
- Liquid
- Solution
- Tablet
Brands / Synonyms
22,23-Dihydroxy-avermectin B; 22,23-Dihyroavermectin B1; 5-O-demethyl-22,23-dihydro-avermectin A1a; Ivermectin B1; Ivermectin-luminol; Mectizan; Stromectol; Stromectol
Indications
For the treatment of intestinal (i.e., nondisseminated) strongyloidiasis due to the nematode parasite Strongyloides stercoralis. Also for the treatment of onchocerciasis (river blindness) due to the nematode parasite Onchocerca volvulus. Can be used to treat scabies caused by Sarcoptes scabiei.
Pharmacology
Ivermectin is a semisynthetic, anthelminitic agent. It is an avermectin which a group of pentacyclic sixteen-membered lactone (i.e. a macrocyclic lactone disaccharide) derived from the soil bacterium Streptomyces avermitilis. Avermectins are potent anti-parasitic agents. Ivermectin is the most common avermectin. It is a broad spectrum antiparasitic drug for oral administration. It is sometimes used to treat human onchocerciasis (river blindness). It is the mixture of 22,23-dihydro-avermectin B1a (at least 90%) and 22,23-dihydro-avermectin B1b (less than 10%).
Mechanism of Action
Ivermectin binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate muscle and nerve cells of the microfilaria. This binding causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell, leading to paralysis and death of the parasite. Ivermectin also is believed to act as an agonist of the neurotransmitter gamma-aminobutyric acid (GABA), thereby disrupting GABA-mediated central nervous system (CNS) neurosynaptic transmission. Ivermectin may also impair normal intrauterine development of O. volvulus microfilariae and may inhibit their release from the uteri of gravid female worms.
Absorption
Moderately well absorbed. Improved absorption with high fat meal.
Toxicity
LD50 29.5 mg/kg (Mouse, oral). LD50 10 mg/kg (Rat, oral). Adverse effects include muscle or joint pain, dizziness, fever, headache, skin rash, fast heartbeat.
Biotrnasformation / Drug Metabolism
Primarily hepatic. Ivermectin and/or its metabolites are excreted almost exclusively in the feces over an estimated 12 days, with less than 1 % of the administered dose excreted in the urine.
Contraindications
STROMECTOL is contraindicated in patients who are hypersensitive to any component of this product.
Drug Interactions
No information provided.
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