Ivermectin for Scabies
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In the United States, treating scabies with ivermectin is considered an unlabeled use of the medicine.
How It Works
Ivermectin is a prescription medicine taken as a pill to kill scabies mites and their eggs.
Why It Is Used
Doctors may prescribe ivermectin to treat a scabies infestation in certain situations.
- People who have a severe or resistant form of scabies infestation, such as crusted (Norwegian) scabies, may be prescribed ivermectin in combination with medicine applied to the skin, such as permethrin. It can be especially helpful for treating HIV-infected people who have scabies.
- A pill form of medicine may be preferred for some people who are unlikely to use topical medicated creams or lotions properly.
- Ivermectin may help get rid of or prevent scabies for people in group living situations, such as those who live in nursing homes.
Ivermectin is usually not used for children younger than 5 or for pregnant women, because its safety in these children is not known.1
How Well It Works
Ivermectin is effective for treating scabies.2 One dose may be all that is needed, although sometimes a second dose is given a week or two later.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
Common side effects of this medicine include:
- Stomach upset.
- Increase in rash and itching during the first 3 days of treatment.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Take this medicine on an empty stomach with a glass of water.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Burkhart CN, Burkhart CG (2012). Scabies, other mites, and pediculosis. In LA Goldman et al., eds., Fitzpatrick's Dermatology in General Medicine, 8th ed., vol. 2, pp. 2569–2578. New York: McGraw-Hill.
- Johnstone P, Strong M (2008). Scabies, search date October 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Last Revised: January 23, 2013
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