Antiparasitic
Ivermectin
Brand names: Stromectol, Soolantra (topical)
Adult dose
Dose: Scabies: 200 micrograms/kg PO single dose, repeat after 7–14 days. Strongyloidiasis: 200 micrograms/kg PO. Topical (Soolantra 1%) for rosacea: apply OD
Route: PO/Topical
Frequency: single or weekly
Clinical pearls
- Scabies (especially crusted), strongyloidiasis, head lice; topical for rosacea (papulopustular)
- Take on empty stomach for systemic absorption
Contraindications
- Children <15 kg
- Pregnancy/breastfeeding (avoid)
- Loa loa heavy infection (severe encephalopathy)
Side effects
- Mild GI upset
- Pruritus
- Mazzotti reaction with Loa loa
- Hepatotoxicity (rare)
Interactions
- Warfarin
- CNS depressants (may potentiate)
Monitoring
- Clinical response
- LFTs if prolonged
Reference: BNF; NICE CKS; WHO; https://bnf.nice.org.uk/drugs/ivermectin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023