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Ivermectin (Stromectol)

Antiparasiticprescriptionoral · inferred

Macrocyclic lactone anthelmintic discovered from Streptomyces avermitilis, earning the 2015 Nobel Prize in Physiology or Medicine. Potentiates invertebrate-selective glutamate-gated chloride channels (GluCl), causing flaccid paralysis of parasites. P-gp substrate that is normally excluded from the human CNS, but collies and herding dog breeds carrying MDR1 mutations develop lethal neurotoxicity from BBB penetration. CYP3A4 substrate with long t1/2 (~18h). Used for onchocerciasis (river blindness), strongyloidiasis, scabies, and mass drug administration for lymphatic filariasis elimination programs.

Projected serum levels — 12 mg, once daily

Ivermectin (Stromectol)
Ivermectin (Stromectol) modeled serum levels, 12 mg once daily over 15 days Population-based pharmacokinetic estimate. Steady state reached after approximately 2 days. 0 2.5 5 7.5 10 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule ≈ steady state · day 2
Ivermectin (Stromectol) modeled serum levels with a loading dose of 20.5 mg, then 12 mg once daily The first dose is larger so levels approach steady state faster. 0 2.5 5 7.5 10 Day 0 Day 4 Day 8 Day 11 Day 15 Time on a regular schedule

Maintenance schedule: 12 mg once daily (oral).

Loading schedule: 20.5 mg on day 1, then 12 mg once daily — reaching therapeutic levels sooner.

Modeled steady state after ~2 days: peak ≈ 9.6 mg, trough ≈ 5.1 mg body load. Population-based estimate over 15 days for a 12 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.

Key facts

Category
Antiparasitic
Route modeled
Oral
Model confidence
inferred
Half-life
18 h
Common dose
12 mg
Suggested maximum
12 mg/day
Reference dose range
3–12 mg (single dose)
Suggested cadence
once daily
Validated against
12 mg oral — Cmax 0.040 mg/L at 4.5 h

Documented interactions

  • contraindicated
    Clarithromycin (Biaxin) + Ivermectin (Stromectol) CYP inhibition

    Clarithromycin (Biaxin) mechanism_based of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~5.26x

  • contraindicated
    Diltiazem + Ivermectin (Stromectol) CYP inhibition

    Diltiazem mechanism_based of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~5.26x

  • contraindicated
    Efavirenz (Sustiva) + Ivermectin (Stromectol) CYP induction

    Efavirenz (Sustiva) inducer of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~0.14x

  • contraindicated
    Grapefruit (whole fruit) + Ivermectin (Stromectol) CYP inhibition

    Grapefruit (whole fruit) mechanism_based of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~5.26x

  • contraindicated
    Grapefruit Juice + Ivermectin (Stromectol) CYP inhibition

    Grapefruit Juice mechanism_based of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~5.26x

  • contraindicated
    Paxlovid (Nirmatrelvir/Ritonavir) + Ivermectin (Stromectol) CYP inhibition

    Paxlovid (Nirmatrelvir/Ritonavir) mechanism_based of CYP3A4 predicted to change Ivermectin (Stromectol) AUC by ~5.26x

Serum checks 106 modeled interaction pairings for ivermectin (stromectol) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.

Research behind this entry

  1. Ivermectin: a potent new antiparasitic agent Campbell WC et al. · Science, 1983 DOI

    Seminal paper establishing ivermectin's unprecedented broad-spectrum antiparasitic activity against nematodes and arthropods at microgram-per-kg doses, leading to the 2015 Nobel Prize in Physiology or Medicine. Single…

  2. Mass drug administration of ivermectin for onchocerciasis control in Africa: epidemiological impact Boussinesq M et al. · Parasitology, 2008 DOI

    Comprehensive review of ivermectin Mectizan Donation Program and African Programme for Onchocerciasis Control, documenting >40 million people treated annually with dramatic reductions in blindness and skin disease,…

  3. Ivermectin: a potent new antiparasitic agent. Campbell WC, Fisher MH, Stapley EO, Albers-Schönberg G, Jacob TA · Science (New York, N.Y.), 1983 DOI

    This citation reports a primary research study involving Ivermectin (Stromectol). It does not by itself establish a qualified dose, safety profile, efficacy claim, or pharmacokinetic route for this record.

3 published studies referenced in the app, each with a plain-language summary.