IVERMECTIN

IVERMECTIN
(i-ver-mec'tin)
Stromectol
Classifications: anthelmintic;
Therapeutic: anthelmintic; antiparasitic
Prototype: Mebendazole
Pregnancy Category: C

Availability

3 mg tablets

Action

A semisynthetic anthelmintic agent which is a broad-spectrum antiparasitic agent with a unique mode of action. It leads to an increase in permeability to chloride ions of the cell membrane of the parasites, resulting in hyperpolarization of nerve or muscle cells of parasites. Hyperpolarization of nerve and muscle cells of parasites results in their paralysis and cell death.

Therapeutic Effect

Causes cell death of parasites.

Uses

Treatment of strongyloidiasis of the intestinal tract, onchocerciasis.

Contraindications

Hypersensitivity to ivermectin; pregnancy (category C). Safety and efficacy in children weighing ≤15 kg are not established.

Cautious Use

Asthma; older adults; moderate or severe hepatic disease.

Route & Dosage

Strongyloides
Adult/Child (≥15 kg): PO 200 mcg/kg x 1 dose

Onchocerciasis
Adult/Child (≥15 kg): PO 150 mcg/kg x 1 dose, may repeat q3–12 mo prn

Administration

Oral

Give tablets with water rather than any other type of liquid.
Store below 30° C (86° F).

Adverse Effects (≥1%)

Body as a Whole: Fever, peripheral edema. CNS: Dizziness. CV: Tachycardia. GI: Diarrhea, nausea. Skin: Pruritus, rash. Other: Arthralgia/synovitis, lymphadenopathy.

Pharmacokinetics

Peak: 4 h. Distribution: Distributed into breast milk. Metabolism: In the liver. Elimination: In feces over 12 d. Half-Life: 16 h.

Nursing Implications

Assessment & Drug Effects

Monitor for therapeutic effectiveness: Indicated by negative stool samples.
Monitor for cardiovascular effects such as orthostatic hypotension and tachycardia.
Monitor for and report inflammatory conditions of the eyes.

Patient & Family Education

Get a follow-up stool examination to determine effectiveness of treatment. Treatment for worms does not kill adult parasites; repeated follow-up and retreatment are usually needed.
Notify physician if eye discomfort develops.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

(109)