In these patients, pain (including neck and back pain), red eye, conjunctival hemorrhage, dyspnea, urinary and/or fecal incontinence, difficulty in standing/walking, mental status changes, confusion, lethargy, stupor, seizures, or coma have been reported. Serious or fatal encephalopathy has been reported rarely in patients with onchocerciasis, and heavily infected with Loa loa, either spontaneously or after treatment with ivermectin.
Oral or intravenous rehydration, corticosteroids, antihistamines, acetaminophen and/or aspirin have been used for treatment.Īfter treatment with microfilaricidal medications, patients with hyperreactive onchodermatitis (sowda) may be more likely than others to experience severe adverse reactions, especially edema and aggravation of onchodermatitis.
The treatment of severe Mazzotti reactions has not been subjected to controlled clinical studies. Patients treated with ivermectin therapy for onchocerciasis may experience these reactions in addition to clinical adverse reactions possibly, probably, or definitely related to the therapy itself. Allergic and inflammatory reactions (the Mazzotti reaction) may occur with ivermectin, probably due to the death of the microfilariae. PrecautionsĬutaneous, systemic and/or ophthalmological reactions have been reported with other microfilaricidal drugs. Patients with crusted scabies may require two or more doses of ivermectin spaced at one to two week intervals. Surgical excision of these nodules may be considered to eliminate the adult reproduction of microfilariae. Retreatment is required because ivermectin has no activity against adult onchocerca volvulus parasites which tend to reside in subcutaneous nodules. Usual Pediatric Dose for Filariasisĥ years or older: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years Renal Dose Adjustmentsĭata not available Liver Dose Adjustments Ivermectin therapy may be combined with a topical scabicide. Cure may not be achievable in these patients.Ĩ0 kg or more: 0.2 mg/kg orally one time Usual Adult Dose for AscariasisĠ.2 mg/kg orally once Usual Adult Dose for Cutaneous Larva MigransĠ.2 mg/kg orally once Usual Adult Dose for Filariasisīancroftian filariasis: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years Usual Adult Dose for ScabiesĠ.2 mg/kg orally once, and repeated in 2 weeks In immunocompromised (including HIV) patients, the treatment of strongyloidiasis may be refractory requiring repeated treatment (i.e., every 2 weeks) and suppressive therapy (i.e., once a month), although well-controlled studies are not available. Retreatment may be considered at intervals as short as 3 months.Ĩ5 kg or more: 0.15 mg/kg orally one time Usual Adult Dose for Strongyloidiasis Patients with heavy ocular infection may require retreatment every 6 months.