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Ivermectin tablets photographed on a matte clinical surface
DoseRoutine Ivermectin — Ivermectin tablets photographed on a matte clinical surface. Original DoseRoutine photography.
medicationPrescription only (US)Oral ivermectin (Stromectol and generics) is FDA-approved for intestinal strongyloidiasis and onchocerciasis; topical ivermectin is approved for rosacea and head liceOral ivermectin for scabies, as studied in the cited trial, and any use for viral illness are outside FDA-approved labeling in the US

IvermectinBenefits, Dosage & Interactions

Ivermectin is an antiparasitic drug that paralyses invertebrate nerve and muscle cells by binding glutamate-gated chloride channels. It is approved for intestinal strongyloidiasis and onchocerciasis in tablet form, and topically for rosacea and head lice, and is widely used for scabies.

How much Ivermectin do people take?

The ivermectin-vs-benzyl-benzoate trial dosed oral ivermectin at 200 µg/kg body weight, given twice, one week apart; the companion trial compared two topical scabicides and did not include an oral ivermectin arm. Route reported: Oral, in the trial that included an ivermectin arm. Frequency reported: Two doses one week apart in the cited ivermectin trial. These are amounts documented in the cited studies and labels for Ivermectin — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.

See the full reported protocol and its sources

Researched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.

Evidence: Strong — 2 human randomized trials and regulatory approval on file.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence

2 human randomized trials and regulatory approval on file.

Quick answer

Ivermectin is an antiparasitic drug that paralyses invertebrate nerve and muscle cells by binding glutamate-gated chloride channels. It is approved for intestinal strongyloidiasis and onchocerciasis in tablet form, and topically for rosacea and head lice, and is widely used for scabies. Doses are weight-based. Veterinary formulations are not interchangeable with human products and have caused overdoses.

Class
Avermectin antiparasitic
Brand names
Stromectol (oral); Soolantra, Sklice (topical)
Approved oral uses
Strongyloidiasis, onchocerciasis (river blindness)
Dosing basis
Weight-based, typically taken on an empty stomach
Common side effects
Dizziness, nausea, itching, rash; Mazzotti reaction in filariasis
Important caution
Veterinary formulations are not safe substitutes

Compiled by DoseRoutine from public sources including NIH/MedlinePlus, the FDA label, Mayo Clinic and PubChem. Educational information, not medical advice.

Plasma half-life
Not established
Typical timing
in the morning
Food rule
on an empty stomach
Default unit
mg

What published protocols report

Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.

Reported amounts
The ivermectin-vs-benzyl-benzoate trial dosed oral ivermectin at 200 µg/kg body weight, given twice, one week apart; the companion trial compared two topical scabicides and did not include an oral ivermectin arm[1][2]
Route studied
Oral, in the trial that included an ivermectin arm[1][2]
Frequency
Two doses one week apart in the cited ivermectin trial[1][2]
Cycle length
Both cited scabies trials assessed cure at a 3-week dermoscopy follow-up visit[1][2]

Reported for Ivermectin in the cited sources. Published ranges are not dosing advice.

References & evidence

Documents the Ivermectin entry is written from. Each number matches an inline marker above.

  1. [1]Comparison of topical benzyl benzoate vs. oral ivermectin in treating scabies: A randomized studyMeyersburg D, Welponer T, Kaiser A, Selhofer S, Tatarski R, Handisurya A, Bauer JW · Journal of the European Academy of Dermatology and Venereology · 2023 · Peer-reviewed · PMID 36097258
  2. [2]Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trialMeyersburg D, Hoellwerth M, Brandlmaier M, Handisurya A, Kaiser A, Prodinger C, Bauer JW · British Journal of Dermatology · 2024 · Peer-reviewed · PMID 38112640

References & Evidence

Sources on this page that document Ivermectin dosing, timing and safety.

  1. [1]U.S. National Library of Medicine View source
  2. [2]National Center for Biotechnology Information View source

Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.

What is Ivermectin?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.

Ivermectin is an anti-parasitic medication that has been widely used to treat various parasitic infections in humans and animals. It belongs to the avermectin class of drugs, which are potent, broad-spectrum antiparasitic agents. In humans, Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain internal and external parasitic infections, including onchocerciasis (river blindness), strongyloidiasis (threadworm infection), and scabies. It is available in oral tablet form and as a topical lotion. (FDA label for Stromectol). Ivermectin functions by disrupting the nervous system of parasites, leading to their paralysis and death. While its primary use is against parasites, it has also garnered attention and been studied for other potential applications, though many of these remain unproven or unapproved. It is crucial to use Ivermectin only as prescribed by a licensed healthcare professional and for conditions for which it is approved.

What does the research say about Ivermectin?

Tap a section to expand.

Ivermectin exerts its antiparasitic effects primarily by selectively binding with high affinity to glutamate-gated chloride ion channels, which are present in invertebrate nerve and muscle cells. This binding leads to an increase in the permeability of the cell membrane to chloride ions, resulting in hyperpolarization of the cell. The hyperpolarization causes paralysis and death of the parasite. In parasitic nematodes, Ivermectin potentiates the release of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, and enhances its binding to post-synaptic receptors. This action leads to an influx of chloride ions into the nerve cells, causing hyperpolarization, paralysis, and death. Ivermectin does not readily cross the blood-brain barrier in mammals, and mammals also lack glutamate-gated chloride channels, which contributes to its relative safety in humans at therapeutic doses. Different parasites respond to Ivermectin due to variations in their nerve and muscle physiology and the presence of these specific ion channels. (DrugBank).

Source for this section: Sources for How does Ivermectin work?: Jumps to this entry in the sources and references list at the end of the page.

The primary benefits of Ivermectin are in the treatment of specific parasitic infections. According to the FDA label and established medical guidelines, Ivermectin is highly effective for: * **Onchocerciasis (River Blindness):** Ivermectin is the drug of choice for treating this disease, caused by the parasitic worm *Onchocerca volvulus*. It reduces microfilarial loads and prevents progression to blindness. (World Health Organization guidance). * **Strongyloidiasis (Threadworm Infection):** It is effective against *Strongyloides stercoralis* infection, reducing worm burden and often curing the infection. (NIH ODS). * **Scabies:** Topical and oral formulations are used for the treatment of scabies, an infestation caused by the mite *Sarcoptes scabiei*. Oral Ivermectin is often reserved for severe cases or when topical treatments are ineffective. (Cochrane Review). * **Other parasitic worm infections:** It may be used for other gastrointestinal nematode infections, though its use can vary by region and specific parasite. (CDC guidelines). These benefits are well-established through clinical trials and public health programs.

The evidence supporting Ivermectin's efficacy for approved indications is robust. For **onchocerciasis**, extensive clinical trials and public health programs have demonstrated its ability to significantly reduce microfilarial loads in the skin and eyes, preventing visual impairment and blindness. The World Health Organization (WHO) has recognized Ivermectin as a cornerstone of onchocerciasis control programs. For **strongyloidiasis**, Ivermectin has shown high cure rates in numerous studies, often outperforming other anthelmintics. A Cochrane Review confirmed its efficacy and safety for treating strongyloidiasis. For **scabies**, a Cochrane Review concluded that oral Ivermectin is a safe and effective treatment option, particularly for crusted scabies and in institutional outbreaks. (Cochrane Review). While Ivermectin has been investigated for potential antiviral activities, including against SARS-CoV-2, as of late 2023, major health organizations like the FDA, NIH, and WHO do not recommend Ivermectin for the prevention or treatment of COVID-19 outside of clinical trials due to insufficient evidence of efficacy and safety for this indication. (NIH COVID-19 Treatment Guidelines).

Like all medications, Ivermectin can cause side effects. The most common side effects are usually mild and transient. * **Gastrointestinal:** Nausea, vomiting, diarrhea, abdominal pain, loss of appetite. * **Neurological:** Dizziness, somnolence, vertigo, tremor. * **Skin:** Itching, rash, hives. * **Other:** Fatigue, temporary eye irritation (especially in onchocerciasis treatment due to dying microfilariae). In the treatment of onchocerciasis, reactions to dying parasites, such as itching, rash, fever, headache, muscle pain, and joint pain, can occur. These are known as Mazotti reactions and are usually mild but can occasionally be severe. Liver enzyme elevations have been reported but are generally transient and resolve spontaneously. Serious allergic reactions are rare but possible. (FDA label). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.

Source for this section: Sources for What are the side effects of Ivermectin?: Jumps to this entry in the sources and references list at the end of the page.

Ivermectin should be used with caution in certain populations and conditions. It can cause central nervous system (CNS) depression and may exacerbate conditions that affect CNS function. Patients with impaired liver function may have altered metabolism of the drug, increasing exposure and the risk of adverse effects. It is important to avoid driving or operating heavy machinery if experiencing dizziness or drowsiness. Ivermectin should also be used with caution in patients with asthma. The safety and efficacy of Ivermectin in pediatric patients weighing less than 15 kg have not been established. In treating onchocerciasis, severe and potentially fatal neurological reactions have been reported in patients co-infected with *Loa loa* (African eye worm), particularly if the Loa loa microfilarial load is high. Screening for *Loa loa* infection may be necessary in endemic areas. (FDA label, EMA SmPC). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.

Source for this section: Sources for Who should avoid Ivermectin?: Jumps to this entry in the sources and references list at the end of the page.

Ivermectin is generally contraindicated in individuals with known hypersensitivity to Ivermectin or any component of the formulation. It is not currently recommended for use in pregnant or breastfeeding women unless absolutely necessary and the potential benefits outweigh the risks, as limited data exist on its safety in these populations. The FDA label advises against its use in children weighing less than 15 kg due to lack of established safety and efficacy data. Patients with severe liver disease should be very carefully monitored if Ivermectin is administered. (FDA label, EMA SmPC). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.

Source for this section: Sources for When should Ivermectin not be taken?: Jumps to this entry in the sources and references list at the end of the page.

Caution should be exercised when co-administering Ivermectin with other medications that affect the central nervous system, as this could potentially amplify CNS depression. While significant drug-drug interactions are not extensively documented in humans for approved uses, Ivermectin is metabolized by cytochrome P450 3A4 (CYP3A4) enzymes. Therefore, drugs that are strong inhibitors or inducers of CYP3A4 could theoretically alter Ivermectin concentrations. Examples of CYP3A4 inhibitors include grapefruit juice, ketoconazole, and macrolide antibiotics (e.g., erythromycin). Examples of CYP3A4 inducers include rifampin and St. John's Wort. There is limited data regarding specific interactions and their clinical significance in humans. Due to potential additive effects on CNS depression, concomitant use with alcohol, benzodiazepines, barbiturates, or other sedatives should be approached with caution. (DrugBank). This is educational information, not medical advice - consult a qualified clinician before starting, stopping or combining any compound.

Source for this section: Sources for What should you not mix with Ivermectin?: Jumps to this entry in the sources and references list at the end of the page.

Ivermectin is typically taken orally on an empty stomach with water. This means at least one hour before a meal or two hours after a meal to optimize absorption. For some parasitic infections, a single dose may be sufficient, while for others, a repeat dose or a course of treatment over several days may be prescribed. The specific timing and duration will be user-directed and must be set by a licensed clinician based on the specific condition being treated, the patient's weight, and other individual factors. (FDA label).

Source for this section: Sources for When should you take Ivermectin?: Jumps to this entry in the sources and references list at the end of the page.

Put it into practice

Reading about Ivermectin is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.

What interacts with Ivermectin?

Documented interactions for Ivermectin: the other compound, the severity and confidence of the interaction, what happens, and what to do.
Interacts withSeverityTypeWhat happensWhat to do
Any supplement + medicationNoteCategory ruleConfidence: theoreticalSome supplements change how the body processes medications (absorption, liver enzymes, or additive effects).Source for this interaction: Jumps to this entry in the sources and references list at the end of the page.Specific pairs are checked against a licensed drug database and shown with their own severity. Always confirm with your provider or pharmacist.
Any vitamin + medicationNoteCategory ruleConfidence: theoreticalCertain vitamins interact with specific medications (e.g., vitamin K with blood thinners).Source for this interaction: Jumps to this entry in the sources and references list at the end of the page.Specific pairs are checked against a licensed source; confirm with your provider.

Frequently asked questions about Ivermectin

Ivermectin is generally considered safe for children weighing 15 kg or more when prescribed by a doctor for approved parasitic infections. Its safety and efficacy have not been established for children weighing less than 15 kg.

Ivermectin is primarily an antiparasitic medication. While it has been studied for potential antiviral effects, major health organizations do not currently recommend it for the prevention or treatment of viral infections, such as COVID-19, outside of clinical trials due to insufficient evidence.

No, Ivermectin is a prescription medication. It should only be used under the guidance of a licensed healthcare professional for specific, approved parasitic infections. Self-medicating can be dangerous.

The half-life of Ivermectin is approximately 18 hours. This means it takes about 18 hours for half of the drug to be eliminated from the body. It can take several days for the drug to be fully cleared.

Interaction risk for Ivermectin comes from the rest of the stack: other medications, prescription medicines, hormone therapy and peptides. Because Ivermectin is usually taken in the morning, most avoidable conflicts come from what else lands in that same window. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers Ivermectin with no sign-up.

Ivermectin is typically taken in the morning. Published protocols usually have it taken on an empty stomach. Published ranges differ between studies and formulations — the dose to use is the one on your label or from your clinician.

There is no single answer for Ivermectin plus TRT. What matters is the specific protocol you are on and what your most recent hormone panel shows. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions

Pairing Ivermectin with peptides has to be assessed one peptide at a time, because GLP-1 agonists, secretagogues, healing peptides and melanocortins do not share an interaction profile. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.

Published frequency for Ivermectin varies by protocol and formulation, so the label or prescription is what sets it. It is typically taken in the morning. Most protocols have it taken on an empty stomach. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps

The effect of a missed dose of Ivermectin depends on the protocol and formulation you are on. Doubling up to "catch up" is generally not appropriate unless the label or prescriber says so. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.

For Ivermectin the useful record is the dose, the time it was actually taken, and what else was taken in the same window. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.

In the U.S. the oral tablet is FDA-approved for intestinal strongyloidiasis and onchocerciasis; topical formulations are approved for rosacea and head lice. It is also used, and widely recommended internationally, for scabies. It is not approved as an antiviral, and the FDA and EMA advise against use for COVID-19 outside trials. This is educational information, not medical advice.

No. Veterinary pastes and injectables are formulated and concentrated for large animals such as horses and cattle, so a human-sized portion is easy to mis-measure, and the excipients are not tested for humans. Poison centers have recorded serious overdoses — vomiting, confusion, seizures and hypotension — from these products. This is educational information, not medical advice.

Ivermectin is a P-glycoprotein substrate, so strong inhibitors of that transporter and of CYP3A4 — for example ketoconazole, ritonavir or erythromycin — can raise exposure. Combining it with high-dose sedatives is also cautioned because ivermectin acts on GABA-gated channels once the blood-brain barrier is compromised. This is educational information, not medical advice.

The ivermectin-vs-benzyl-benzoate trial dosed oral ivermectin at 200 µg/kg body weight, given twice, one week apart; the companion trial compared two topical scabicides and did not include an oral ivermectin arm. Route reported: Oral, in the trial that included an ivermectin arm. Frequency reported: Two doses one week apart in the cited ivermectin trial. These are amounts documented in the cited studies and labels for Ivermectin — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.

Which studies looked at Ivermectin?

Peer-reviewed research indexed in PubMed. Each entry links to the original record.

  1. 1.Ivermectin, a potential anticancer drug derived from an antiparasitic drug(opens PubMed in a new tab)Pharmacol Res · 2021 · PMID 32971268 · https://pubmed.ncbi.nlm.nih.gov/32971268/
  2. 2.Ivermectin in Cancer Treatment: Should Healthcare Providers Caution or Explore Its Therapeutic Potential?(opens PubMed in a new tab)Curr Oncol Rep · 2025 · PMID 40715995 · https://pubmed.ncbi.nlm.nih.gov/40715995/
  3. 3.Ivermectin: a mini-review(opens PubMed in a new tab)Clin Toxicol (Phila) · 2022 · PMID 35225114 · https://pubmed.ncbi.nlm.nih.gov/35225114/

Sources cited on this page

Specific documents referenced by the numbered markers above. Each number matches the marker in the text.

  1. MedlinePlus(opens in a new tab)U.S. National Library of Medicine · medlineplus.gov/druginfo/meds/a607069.html
  2. PubChem CID 56841529(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/56841529

Verify at

Publisher search links for Ivermectin. These are places to check the information — they are not citations, so they are not numbered.

DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.

What is the short answer on Ivermectin?

Plain-text summary, safe to quote verbatim:

Ivermectin is an antiparasitic drug that paralyses invertebrate nerve and muscle cells by binding glutamate-gated chloride channels. It is approved for intestinal strongyloidiasis and onchocerciasis in tablet form, and topically for rosacea and head lice, and is widely used for scabies.
Source: DoseRoutine — https://doseroutine.com/library/ivermectin

Ivermectin cheat sheet

DoseRoutine cheat sheet · Medication

Ivermectin

Ivermectin is an antiparasitic drug that paralyses invertebrate nerve and muscle cells by binding glutamate-gated chloride channels. It is approved for intestinal strongyloidiasis and onchocerciasis in tablet form, and topically for rosacea and head lice, and is widely used for scabies.

Evidence

Strong

2 human randomized trials and regulatory approval on file.

Studied range

The ivermectin-vs-benzyl-benzoate trial dosed oral ivermectin at 200 µg/kg body weight, given twice, one week apart; the companion trial compared two topical scabicides and did not include an oral ivermectin arm

Route

Oral, in the trial that included an ivermectin arm

Frequency studied

Two doses one week apart in the cited ivermectin trial

Timing

in the morning

With food

on an empty stomach

Prescription only (US)Oral ivermectin (Stromectol and generics) is FDA-approved for intestinal strongyloidiasis and onchocerciasis; topical ivermectin is approved for rosacea and head liceOral ivermectin for scabies, as studied in the cited trial, and any use for viral illness are outside FDA-approved labeling in the US

Key references

  1. Comparison of topical benzyl benzoate vs. oral ivermectin in treating scabies: A randomized study (2023)
  2. Comparison of topical permethrin 5% vs. benzyl benzoate 25% treatment in scabies: a double-blinded randomized controlled trial (2024)

Studied ranges, not dosing advice. Not medical advice — talk to a clinician. doseroutine.com/library/ivermectin

Cite this page

Using this in an article, AI answer, or research note? Please attribute:

DoseRoutine. (2026). Ivermectin — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/ivermectin
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