I’m getting ready to take ivermectin against strongyloides and want to share my research so it may help others. It seems that ivermectin is a broad-spectrum antiparasitic that became the cornerstone of one of the most successful public health programs of the past century. It’s also one of the most successful veterinarian medications widely used on dogs and horses.
It’s a systemic agent that acts against parasitic worms including strongyloidiasis, ascariasis, trichuriasis, filariasis, river blindness worms and enterobiasis, epidermal parasitic skin diseases, including scabies and head lice.
Ivermectin acts by inhibiting neurotransmission and by stimulating the release of gamma-aminobutyric acid-dependent neurotransmission. This causes paralysis of the somatic muscles and consequently the pharyngeal pump, resulting in the death of the parasite.
Although Ivermectin has been shown to be superior to albendazole it is used by many in conjunction with albendazole. Used by itself, Ivermectin is becoming the drug of choice in many countries due to its more favorable side effects compared with albendazole.
Against Strongyloides, it seems Ivermectin is combined with Fenbendazole in difficult disseminated cases. I started with Fenben instead of ivermectin because of Fenben’s very broad spectrum nature (it’s also antifungal). Now I’m guessing that was a mistake because I reacted so strongly to Fenben, it gives me intense migraines when it’s killing fungal slime.
So that scared me and made me think that ivermectin would be even more difficult. Now I see that Ivermectin doesn’t have any antifungal activity and I’m relieved. Maybe it’s narrower targeting will make it easier than Fenben.
One Curezone user (sharkman) who fought disseminated strongyloides successfully with the help of his veterinarian mom, has written extensively about his long battle and wrote this:
My mom had me split my ivermectin into 2 half doses per day , which seemed to help in my treatment with less side effects . In all I been thru ivermectin was my best med in the beginning with treatment, wasn’t a fan of albendazole and I haven’t used anymore since November 2014.
Disseminated Strongyloides is often fatal so, this is a guy to pay attention to I think.
From the curezone protocol page (who knows why instructions say take it on an empty stomach when bioavailability is increased 2.5-fold when administered following a high-fat meal):
Ivermectin (Stromectol): 1 dose*, based on .2mg/kg, 1 hr before bedtime, on empty stomach, with 8oz water or beverage. Take dose for 4 days on, 3 days off. Repeat dosage every week (even during off-days of Albendazole) for 5 or more weeks, as needed, to cure infection.
Alternate Dosage Schedule: For severe hyperinfection cases, follow this schedule instead of the above: Take dose for 7 days on, 2 days off, 2 days on. Continue the “pulse method” of 2 days off, 2 days on, etc, even during off-days of Albendazole, until infection is cured.
Post-Treatment for Strongyloides, Filariasis, & Morgellons: Take a maintenance dose of Ivermectin every 7 days (once a week). This suppressive therapy keeps any remaining encysted parasites sterile & prevents reinfection.
Ivermectin Side Effects: When there is a heavy parasite burden, the first dose of Ivermectin might cause shortness of breath or abdominal discomfort. This is caused by parasitic die-off & the toxins they release. If extreme, stop dosage for 1-2 days & then resume. These effects subside with subsequent doses as the parasite burden decreases. See info below on the Herxheimer reaction.
Ivermectin (Stromectol) comes in 3mg, 6mg, & 12mg tablets.
I’m going to take a few days off Fenben to regain some strength before starting Ivermectin…
From the data sheet:
(eye ver MEK tin)
U.S. Brand Names
Treatment of the following infections: Strongyloidiasis of the intestinal tract due to the nematode parasite Strongyloides stercoralis. Onchocerciasis due to the nematode parasite Onchocerca volvulus. Ivermectin is only active against the immature form of Onchocerca volvulus, and the intestinal forms of Strongyloides stercoralis.
Use – Unlabeled/Investigational
Has been used for other parasitic infections including Ascaris lumbricoides, Bancroftian filariasis, Brugia malayi, scabies, Enterobius vermicularis, Mansonella ozzardi, Trichuris trichiura.
Safety and efficacy have not been established in pregnant women. The WHO considers use after the first trimester as “probably acceptable.”
Enters breast milk/not recommended
Hypersensitivity to ivermectin or any component of the formulation
Data have shown that antihelmintic drugs like ivermectin may cause cutaneous and/or systemic reactions (Mazzoti reaction) of varying severity including ophthalmological reactions in patients with onchocerciasis. These reactions are probably due to allergic and inflammatory responses to the death of microfilariae. Patients with hyper-reactive onchodermatitis may be more likely than others to experience severe adverse reactions, especially edema and aggravation of the onchodermatitis. Repeated treatment may be required in immunocompromised patients (eg, HIV); control of extraintestinal strongyloidiasis may necessitate suppressive (once monthly) therapy. Pretreatment assessment for Loa loa infection is recommended in any patient with significant exposure to endemic areas (West and Central Africa); serious and/or fatal encephalopathy has been reported during treatment in patients with loiasis. Safety and efficacy in children <15 kg have not be established.
Frequency not defined.
- Cardiovascular: Hypotension, mild ECG changes, orthostasis, peripheral and facial edema, transient tachycardia
- Central nervous system: Dizziness, headache, hyperthermia, insomnia, somnolence, vertigo
- Dermatologic: Pruritus, rash, urticaria, toxic epidermal necrolysis, Stevens-Johnson syndrome
- Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, nausea, vomiting
- Hematologic: Anemia, eosinophilia, leukopenia
- Hepatic: ALT/AST increased
- Neuromuscular & skeletal: Limbitis, myalgia, tremor, weakness
- Ocular: Blurred vision, mild conjunctivitis, punctate opacity
- Respiratory: Asthma exacerbation
- Mazzotti reaction (with onchocerciasis): Arthralgia, edema, fever, lymphadenopathy, ocular damage, pruritus, rash, synovitis
Accidental intoxication with, or significant exposure to unknown quantities of veterinary formulations of ivermectin in humans, either by ingestion, inhalation, injection, or exposure to body surfaces, has resulted in the following adverse effects: rash, edema, headache, dizziness, asthenia, nausea, vomiting, and diarrhea; other adverse effects that have been reported include seizure and ataxia
Treatment is supportive; usual methods for decontamination are recommended
Substrate of CYP3A4 (minor)
Food: Bioavailability is increased 2.5-fold when administered following a high-fat meal.
Mechanism of Action
Ivermectin is a semisynthetic antihelminthic agent; it binds selectively and with strong affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to increased permeability of cell membranes to chloride ions then hyperpolarization of the nerve or muscle cell, and death of the parasite.
Onset of action: Peak effect: 3-6 months
Absorption: Well absorbed
Distribution: Does not cross blood-brain barrier
Half-life elimination: 16-35 hours
Metabolism: Hepatic (>97%)
Excretion: Urine (<1%); feces
15 kg and Adults:
Strongyloidiasis: 200 mcg/kg as a single dose; follow-up stool examinations
Onchocerciasis: 150 mcg/kg as a single dose; retreatment may be required every 3-12 months until the adult worms die
Administer on an empty stomach with water.
Skin and eye microfilarial counts, periodic ophthalmologic exams
Take on an empty stomach with water.
Medication should be taken with water. If infected with strongyloidiasis, repeated stool examinations are required to document clearance of the organisms. Repeated follow-up and retreatment is usually required in the treatment of onchocerciasis.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness, drowsiness, or insomnia
Mental Health: Effects on Psychiatric Treatment
May cause leukopenia; use caution with clozapine and carbamazepine
Tablet [scored]: 3 mg
de Silva N, Guyatt H, and Bundy D, “Anthelmintics. A Comparative Review of Their Clinical Pharmacology,”Drugs, 1997, 53(5):769-88.
“Drugs for Parasitic Infections,”Med Lett Drugs Ther, 1993, 35(911):111-22.
Ottesen EA and Campbell WC, “Ivermectin in Human Medicine,”J Antimicrob Chemother, 1994, 34(2):195-203.
International Brand Names
Baymec® (AU); Bimectin® (SE); Dairymec® (AU); Ecomectin® (AU); Equell® (DE); Equimec® (AU); Eqvalan® (BE, CH, FR, IE, NZ); Eraquall® (AT); Eraquell® (AU, CH, SE); Flurexel® (DE); Furexel® (BE, FR, GB, IE); Genesis® (AU); Heartgard® (AU); Heart Gold Chewable® (AU); Ivomec® (AT, AU, BE, CH, DE, GB, IE, NO, NZ, SE); Ivomec-P® (AT, DE); Ivomec Pour on® (AT, DE, GB, IE, NO, NZ, SE); Ivomec Premix® (DE, GB, IE, NZ); Ivomec S® (DE); Ivomec SR® (GB, IE, NO, NZ, SE); Mectizan® (EG, FR, ZA); Noromectin® (AU, GB, SE); Numectin® (AU); Optimectin® (CH); Oramec® (BE, FR, GB, IE); Panomec® (GB, IE); Paramax® (AU); Popantel Heartworm Tablets for Dogs® (AU); Revectina® (BR); Rycomec® (GB); Securo® (AR); Stockman® (NZ); Stromectol® (AU, FR); Totectin® (AU); Virbamax® (AU); Virbamec® (CH, DE, GB, SE); Virbamec S® (DE)