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Head Lice (Pediculosis capitis; Off-label) 200 mcg/kg PO once; may require 1-2 additional doses repeated after 7 days Blepharitis (Demodex folliculorum; Off-label) 200 mcg/kg PO once as a single dose, THEN repeat dose once in 7 days Filariasis Due to Mansonella Ozzardi (Off-label) 6 mg PO as single dose Filariasis Due to Mansonella Streptocera (Off-label) 150 mcg/kg as single dose Scabies Due to Sarcoptes Scabiel Immunocompromised patients: 200 mcg/kg as single dose; may repeat in 14 days if necessary Gnathostoma Spinigerum Gnathostomiasis: 200 mcg/kg as single dose Administration Take on empty stomach


image here Strongyloidiasis: The patient should be reminded of the need for repeated stool examinations to document clearance of infection with Strongyloides stercoralis; not active against disseminated Strongyloides, only intestinal Onchocerciasis: The patient should be reminded that treatment does not kill the adult Onchocerca volvulus parasite, and therefore repeated follow-up and retreatment is usually required Long-term studies in animals have not been performed to evaluate carcinogenic potential of ivermectin Therapy had no adverse effects on fertility in rats in studies at repeated doses of up to 3 times maximum recommended human dose of 200 mcg/kg (on mg/m2/day basis) Immunocompromised patients may require repeated treatment; control of extraintestinal strongyloidiasis may require suppressive therapy (eg, once monthly) Mazzotti reactions Microfilaricidal drugs, such as diethylcarbamazine citrate (DEC-C), might cause cutaneous and/or systemic reactions of varying severity (the Mazzotti reaction) and ophthalmological reactions in patients with onchocerciasis These reactions are probably due to allergic and inflammatory responses to the death of microfilariae; onchocerciasis treated patients may experience these reactions in addition to clinical adverse reactions possibly related to the drug itself The treatment of severe Mazzotti reactions has not been subjected to controlled clinical trials; oral hydration, recumbency, intravenous normal saline, and/or parenteral corticosteroids have been used to treat postural hypotension; antihistamines and/or aspirin have been used for most mild to moderate cases Neurotoxicity with use of ivermectin, including alteration of consciousness of variable severity (eg, somnolence/drowsiness, stupor, and coma), confusion, disorientation, and death, reported in patients without onchocerciasis or in patients with onchocerciasis in absence of Loa loa infection; these reactions have generally resolved with supportive care and discontinuation of therapy

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