Stromectol

Introduction

Written by Alex Brewer, PharmD, MBA
Medically reviewed by Purva Singla, PharmD 
Updated on October 16, 2023

Ivermectin (eye ver MEK tin) is a generic medication prescribed to treat certain infections caused by parasites and to treat rosacea. Ivermectin belongs to a group of drugs called anthelmintics.

The Food and Drug Administration (FDA) has approved ivermectin to:

• treat onchocerciasis and strongyloidiasis, which are infections caused by parasites (worms)
• treat rosacea in adults

These approved uses differ based on the form of ivermectin your doctor prescribes.

This article doesn’t provide coupons for all forms of ivermectin. To find coupons for ivermectin topical cream, see this article. 

Uses of ivermectin

The Food and Drug Administration (FDA) approves prescription drugs such as ivermectin for certain conditions. Approved uses for ivermectin are described below. These uses differ based on the form of ivermectin prescribed.

Use for rosacea

Doctors may prescribe ivermectin topical cream for treating skin lesions caused by rosacea. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

Rosacea is a skin condition that causes the appearance of raised, red, or discolored bumps on the face. Specifically, these bumps can appear on the forehead, eyelids, nose, cheeks, or chin. Other symptoms can include blushing easily and a gritty or burning feeling in the eyes.

Use for infections caused by parasites

Doctors may prescribe ivermectin oral tablet for treating infections caused by parasitic nematodes (worms). It’s used for this purpose in adults and in children who weigh at least 15 kilograms (about 33 pounds). It’s usually prescribed as a short-term treatment.

Infections caused by parasitic nematodes are also called parasitic infections. Specifically, ivermectin may be used to treat the following parasitic infections:

• intestinal strongyloidiasis caused by the parasite Strongyloides stercoralis. With this infection, you may experience abdominal pain, cycles of diarrhea and constipation, and bloating.
• onchocerciasis (also called river blindness) caused by the parasite Onchocerca volvulus. With this infection, you may experience an itchy skin rash, vision changes, and bumps under the skin.

Side effects of ivermectin

Ivermectin may cause mild or serious side effects. More common mild side effects of ivermectin and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about ivermectin’s side effects, see this article or ask your doctor or pharmacist. You can also refer to the prescribing information for ivermectin listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of ivermectin are listed below. These side effects may differ based on the form of ivermectin you use. 

This article doesn’t include all possible mild side effects of the drug. To learn more about ivermectin’s side effects based on the form, refer to the prescribing information for ivermectin listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Ivermectin oral tablet’s mild side effects include:

• dizziness
• itchiness
• nausea
• diarrhea
• mild allergic reaction*

Ivermectin topical cream’s mild side effects include:

• burning skin sensation at sites where ivermectin cream is applied
• irritated skin at sites where ivermectin cream is applied
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for ivermectin” section.

Serious side effects

Serious side effects of ivermectin are listed below. These side effects may differ based on the form of ivermectin you take or use. 

This article doesn’t include all possible serious side effects of the drug. To learn more about ivermectin’s side effects based on the form, refer to the prescribing information for ivermectin listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number. 

In general, ivermectin’s serious side effects include:

• low blood pressure and dizziness or fainting when standing or sitting up
• fast heart rate
• severe and possibly life threatening skin reactions, including Stevens-Johnson syndrome†
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for ivermectin” section.

† This side effect wasn’t reported in studies of the drug. But it has occurred in people after the drug was approved for use.

Interactions and warnings for ivermectin

Below, you’ll find information about ivermectin’s possible interactions and warnings. 

Interactions of ivermectin

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Some forms of ivermectin have interactions, so ask your doctor to check for possible interactions before you take or use ivermectin. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs 
• vitamins, herbs, or supplements

Other forms of ivermectin don’t have any known interactions. But this doesn’t mean drug interactions with ivermectin won’t happen or be reported sometime. For instance, medications created at a later time could interact with these forms of ivermectin.

To learn about drug-condition interactions, see the “Warnings for ivermectin” section below.

Warnings for ivermectin

Some people should not take or use ivermectin, and others should take or use it cautiously.

Ivermectin could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether ivermectin is a safe option for you. These warnings may differ based on the form of ivermectin you use.

Ask your doctor about specific warnings for ivermectin, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Ivermectin can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to ivermectin or any of its ingredients, your doctor will likely not prescribe ivermectin. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems 

If you have an allergic reaction to ivermectin, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of ivermectin

You should not take or use more ivermectin than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken or used too much ivermectin, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and ivermectin

Information about ivermectin and pregnancy and breastfeeding is described below.

Ivermectin and pregnancy

It’s not known whether ivermectin should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. 

Ivermectin and breastfeeding

It’s not known whether ivermectin should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. 

Common questions about ivermectin

Below you’ll find answers to a few commonly asked questions about ivermectin.

Is ivermectin available over the counter?

Yes, an ivermectin lotion is available over the counter (OTC). But ivermectin tablets and topical cream are only available with a prescription from a healthcare professional.

These forms of ivermectin are used for treating different conditions:

• Ivermectin OTC lotion is used to treat lice. It’s available as the brand-name product Sklice and as generic ivermectin 0.5% lotion.
• Ivermectin tablets are approved to treat onchocerciasis and strongyloidiasis, which are infections caused by parasitic nematodes (worms).
• Ivermectin cream is approved to treat rosacea.

Talk with your doctor or pharmacist to learn more about different forms of ivermectin.

How does ivermectin work? And how long does it take to start working?

Ivermectin tablets are used to treat certain parasitic infections. It does this by affecting certain nerve and muscle cells that are present in parasites, but not people. By affecting these cells, ivermectin causes paralysis and death in the parasites.

It’s not known how ivermectin cream works to treat rosacea. One theory is that ivermectin may reduce inflammation, but more research is needed.

Usually, a one-time dose of ivermectin tablets will treat parasitic infections. In studies, ivermectin tablets started working within 2 days of taking the dose. Ivermectin tablets usually take between 3 weeks and 3 months to fully treat parasitic infections, depending on what type of infection is being treated.

Ivermectin cream starts to become effective in your body 2 weeks after you start using it. Around this time, your rosacea may start to clear up. In studies, rosacea cleared up in 40–80% of people after using ivermectin cream for 3 months.

If you’d like to know more about this, talk with your doctor or pharmacist. 

What to ask your doctor

Let your doctor know if you have questions about ivermectin or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Are there other treatment options for my infection, and how do they compare with ivermectin?
• If my symptoms continue after my ivermectin treatment course, what should I do?
• If I only need to take one ivermectin dose to treat my infection, am I still at risk of drug interactions?
• Does ivermectin interact with my health history? If so, would prescribing a lower dosage for me help lower the risk of interaction?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Gazewood JD, et al. (2016). Ivermectin 1% cream (Soolantra) for inflammatory lesions of rosacea. https://www.aafp.org/pubs/afp/issues/2016/0915/p512.html
• Ivermectin- ivermectin cream. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/6b4a7400-d34c-4947-90e6-340f7087a702/spl-doc
• Ivermectin – ivermectin tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/104a5045-94b1-4022-bc49-719521f30f0d/spl-doc
• Raedler LA. (2015). Soolantra (ivermectin) 1% cream: A novel, antibiotic-free agent approved for the treatment of patients with rosacea. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665052/

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.