Adult: For treatment of cases due to immature forms of Onchocerca volvulus: 150 mcg/kg as a single dose; may repeat treatment every 3-12 months until symptoms resolved. Child: ≥15 kg: Same as adult dose.
Oral Intestinal strongyloidiasis
Adult: 200 mcg/kg as a single dose. Alternatively, 200 mcg/kg daily may be given for 1-2 days. Child: ≥15 kg: Same as adult dose.
Topical/Cutaneous Head pediculosis
Adult: As 0.5% lotion: Apply sufficient amount (up to 1 tube) to completely coat dry hair and scalp thoroughly, then leave on for 10 minutes. Rinse off the scalp and hair well with warm water; use a fine-toothed comb to remove nits as needed. For single use only. Child: ≥6 months As 0.5% lotion: Same as adult dose.
Topical/Cutaneous Inflammatory lesions of rosacea
Adult: As 1% cream: Apply a thin layer onto the affected area(s) of the face once daily for up to 4 months; may repeat treatment course if needed. If there is no improvement after 3 months, discontinue treatment.
Các sản phẩm có chứa hoạt chất Ivermectin tại Việt Nam?
Intestinal strongyloidiasis:
Immunocompromised (including HIV-infected) patients: Repeated treatment courses may be necessary; control of extraintestinal strongyloidiasis may require once monthly (suppressive) therapy.
Cách dùng
Ivermectin Should be taken on an empty stomach.
Chống chỉ định
Hypersensitivity.
Thận trọng
Patient with loiasis (heavy infection of Loa loa); hyperreactive onchodermatitis (sowda). Immunocompromised (including HIV-infected) patients. No activity against adult Onchocerca volvulus parasites. Severe hepatic impairment (topical cream). Children. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Mazzotti reaction (e.g. lymphadenitis, oedema, arthralgia, synovitis, tachycardia, fever, pruritus, urticaria) and ophthalmic reaction particularly in patients undergoing treatment for onchocerciasis; transient aggravation of rosacea (topical cream). Blood and lymphatic system disorders: Transient eosinophilia, leucopenia, anaemia. Eye disorders: Conjunctival haemorrhage (if treated for onchocerciasis); conjunctivitis, ocular hyperaemia, eye irritation (topical lotion). Ear and labyrinth disorders: Vertigo. Gastrointestinal disorders: Abdominal pain, constipation, diarrhoea, nausea, vomiting. General disorders and administration site conditions: Asthenia, fatigue. Investigations: Increased AST, ALT, and bilirubin. Metabolism and nutrition disorders: Anorexia. Nervous system disorders: Dizziness, tremor, seizures. Psychiatric disorders: Somnolence. Respiratory, thoracic and mediastinal disorders: Worsening of bronchial asthma. Skin and subcutaneous tissue disorders: Rash, Stevens-Johnson syndrome, toxic epidermal necrolysis (oral); dandruff (topical lotion); skin burning sensation, irritation, pruritus, dry skin (topical cream/lotion). Vascular disorders: Orthostatic hypotension. Potentially Fatal: Rarely, encephalopathy (especially if the patient with onchocerciasis is co-infected with Loa loa).
Evaluate pregnancy status before use in patients who may become pregnant. Assess for loiasis before and after therapy (especially in patients with significant exposure to Loa loa endemic areas of West and Central Africa). Obtain skin and eye microfilarial counts; periodic ophthalmologic exams. Perform follow-up stool examination (for intestinal strongyloidiasis).
Tương tác
Rarely, increased INR with warfarin.
Tương tác với thức ăn
Increased bioavailability with a high-fat meal.
Tác dụng
Description: Mechanism of Action: Ivermectin is a semisynthetic anthelmintic derived from the avermectins. It has a strong affinity and binds selectively to glutamate-gated chloride ion channels of invertebrate nerve and muscle cells resulting in increased permeability of cell membrane to chloride ions with hyperpolarisation of the nerve or muscle cell, thereby causing the death of the parasite. The mechanism of action in the treatment of rosacea is still unknown but may be associated with the anti-inflammatory effects of ivermectin and antiparasitic action that causes the death of Demodex mites reported to contribute to skin inflammation. Pharmacokinetics: Absorption: Well absorbed from the gastrointestinal tract (fasted state). Increased bioavailability with a high-fat meal. Time to peak plasma concentration: Approx 4 hours (oral); approx 10 hours (topical cream). Distribution: High concentration in the liver and adipose cell. Enters breast milk (small amounts). Volume of distribution: 3.1-3.5 L/kg. Plasma protein binding: Approx 93% mainly to albumin (oral); >99% (topical). Metabolism: Metabolised in the liver mainly by CYP3A4 isoenzyme. Excretion: Via faeces; urine (<1%). Elimination half-life: Approx 18 hours (oral); approx 6 days (topical cream).
Đặc tính
Ivermectin Source: National Center for Biotechnology Information. PubChem Database. Ivermectin, CID=6321424, https://pubchem.ncbi.nlm.nih.gov/compound/Ivermectin (accessed on Jan. 21, 2020)
Bảo quản
Tab: Store below 30°C. Cream/lotion: Store between 15-30°C. Do not freeze.
D11AX22 - ivermectin ; Belongs to the class of other dermatologicals. P02CF01 - ivermectin ; Belongs to the class of avermectine agents. Used as antinematodal.
Tài liệu tham khảo
Anon. Ivermectin (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 31/03/2021.Anon. Ivermectin (Topical). AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 03/06/2021.Anon. Ivermectin (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 31/03/2021.Buckingham R (ed). Ivermectin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 31/03/2021.Ivermectin Lotion (Taro Pharmaceuticals U.S.A., Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 31/03/2021.Joint Formulary Committee. Ivermectin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 31/03/2021.Merck Sharp & Dohme (NZ) Ltd. Stromectol Tablets data sheet 28 February 2019. Medsafe. http://www.medsafe.govt.nz. Accessed 31/03/2021.Sklice Lotion 0.5% (Sanofi Pasteur Inc.). U.S. FDA. https://www.fda.gov. Accessed 03/06/2021.Soolantra 10 mg/g Cream (Galderma [UK] Limited). MHRA. https://products.mhra.gov.uk. Accessed 31/03/2021.Soolantra Cream (Galderma Laboratories, L.P.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 31/03/2021.Stromectol (MSD Pharma [Singapore] Pte. Ltd.). MIMS Singapore. http://www.mims.com/singapore. Accessed 03/06/2021.Stromectol Tablet (Merck Sharp & Dohme Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 31/03/2021.
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