ivermectin at a glance
Medicine class
Anthelmintic and avermectin antiparasitic agent.
Available forms
Oral tablets for systemic parasite infections and facial cream for adult papulopustular rosacea.
Tablet administration
Swallow with water on an empty stomach.
Cream administration
Use only on facial skin, avoiding the eyes, lips and other mucosal surfaces; wash hands afterwards.
What is ivermectin used for?
Selected UK products are licensed for:
Intestinal strongyloidiasis.
Suspected or confirmed microfilaraemia caused by Wuchereria bancrofti lymphatic filariasis.
Human sarcoptic scabies after clinical or parasitological diagnosis; itching alone is not sufficient reason for oral treatment.
Inflammatory papules and pustules of rosacea in adults, using the facial cream.
How does ivermectin work?
Ivermectin acts on chloride channels in invertebrate nerve and muscle cells, causing paralysis and death of susceptible parasites. Its effect in rosacea is not fully established; anti-inflammatory activity and effects on Demodex mites may contribute.
ivermectin preparations and strengths
Cream
Route: Cutaneous
Strengths: 10 mg/g
Tablet
Route: Oral
Strengths: 3 mg
How to take ivermectin
Follow the product-specific prescription. Swallow tablets with water on an empty stomach. Apply the cream as a thin layer to the face, avoiding the eyelids, eyes, lips, mouth and inside the nose. Wash your hands afterwards and allow the cream to dry before applying cosmetics.
Do not use veterinary ivermectin products.
For scabies, follow advice about close contacts, clothing and bedding to reduce reinfestation.
If cream enters an eye or another sensitive surface, rinse thoroughly with water.
ivermectin side effects
Common or expected effects
- Cream: burning, irritation, itching or dryness of facial skin; rosacea may temporarily worsen.
- Tablets: nausea, abdominal discomfort, diarrhoea, weakness, dizziness or sleepiness. Reactions vary with the infection and parasite burden.
- Filarial infection treatment may cause fever, headache, sweating, muscle or joint pain and other inflammatory symptoms as microfilariae die.
Get urgent medical advice
- Severe allergic reaction with breathing difficulty or swelling.
- Blistering, peeling or target-like rash, especially with fever or sores affecting the mouth, eyes or genitals.
- Reduced consciousness, confusion or major difficulty walking or standing.
- Signs of significant liver injury, such as jaundice or dark urine.
- Severe skin reaction or facial swelling after using the cream.
ivermectin in pregnancy
Oral ivermectin should be used during pregnancy only when clearly necessary after specialist assessment because human evidence is too limited to establish safety. The facial cream is not recommended during pregnancy because clinical experience is limited, despite low systemic absorption.
ivermectin while breastfeeding
Small amounts of oral ivermectin enter breast milk, but safety in newborn infants is not established. For facial cream, a prescriber should help decide whether to avoid treatment or interrupt breastfeeding because risk to the infant cannot be excluded.
ivermectin interactions
Interaction evidence is limited. The prescriber should review all medicines and supplements.
Potent CYP3A4 inhibitors
These may increase systemic exposure to ivermectin from the cream; caution is required.
Diethylcarbamazine citrate
Combined systemic use in people with certain filarial coinfections may provoke serious inflammatory or neurological reactions and is not recommended in relevant mass-treatment settings.
Common questions about ivermectin
Answers are fully visible for fast scanning and source review.
Is ivermectin licensed for scabies in the UK?
Yes. Selected oral tablets are licensed for human sarcoptic scabies when the diagnosis has been established clinically or by parasitological examination.
Does itching after ivermectin mean scabies treatment has failed?
Not necessarily. Itching may continue after successful treatment because the skin remains reactive. Persistent or worsening symptoms should be clinically reviewed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.