Stromectol (ivermectin) is a well-established antiparasitic medicine used to treat infections caused by select internal and external parasites. Clinically, it is a first-line option for intestinal strongyloidiasis and onchocerciasis (river blindness), and it is frequently used off-label for human scabies and lice when topical agents are unsuitable or ineffective. By binding to glutamate-gated chloride channels in the parasite’s nerve and muscle cells, ivermectin increases cell membrane permeability to chloride ions, causing paralysis and death of the parasite. Human cells lack these channels, which contributes to ivermectin’s targeted antiparasitic activity when used as directed.
Beyond its core indications, Stromectol is used in community-based control programs to reduce transmission of onchocerciasis in endemic regions. In clinical practice in the United States, prescribers also use ivermectin for scabies outbreaks (for example, in long-term care facilities) and for crusted scabies, often alongside topical therapies. Although widely known to the public, it is important to note that Stromectol is not approved for preventing or treating viral infections and should not be used for conditions outside evidence-based indications unless under a clinician’s guidance. When used appropriately, it is fast-acting, convenient (typically a single dose or a short course), and generally well tolerated.
Key conditions in which Stromectol is used include:
Your healthcare provider will determine whether Stromectol is appropriate for your specific infection and overall health profile, and whether monotherapy or combination therapy (for example, with topical agents for scabies) is most suitable.
Stromectol is taken by mouth with a full glass of water on an empty stomach. The standard recommendation is to take the dose at least 1 hour before a meal or 2 hours after. Tablets are typically 3 mg, and the dose is calculated by body weight, most often 150–200 micrograms (mcg) per kilogram (kg). Your prescriber will round to the nearest 3 mg tablet to match the intended weight-based dose. Do not change your dose or dosing schedule without medical guidance.
Typical dosing by condition:
Administration tips:
Special populations: Dose adjustments are not routinely required solely for age in adults, but careful consideration is warranted in older adults with comorbidities, patients with hepatic impairment, and young children. Stromectol is generally not recommended for children under 15 kg without specialist oversight. Always adhere to the regimen provided by your clinician.
Before starting Stromectol, review your full medical history and medication list with a qualified healthcare professional. Important considerations include:
Pregnancy and breastfeeding: Data in human pregnancy are limited. Out of caution, many guidelines recommend avoiding ivermectin in the first trimester unless the potential benefit clearly outweighs risk. For the second and third trimester, decisions are individualized. Ivermectin appears in low levels in breast milk; some public health programs consider it compatible with breastfeeding beyond the immediate postpartum period, but you should discuss timing and risk-benefit with your provider.
Public health note: Stromectol should not be used to prevent or treat viral illnesses (including COVID-19) outside a clinical trial or established guideline-directed care. Use only for evidence-supported parasitic infections under medical supervision.
Do not use Stromectol if any of the following apply:
Use with extreme caution or avoid use unless under specialist guidance in the following situations:
If you are unsure whether Stromectol is appropriate for you, consult a licensed healthcare provider for individualized assessment.
Most people tolerate Stromectol well. When side effects occur, they are often mild to moderate and self-limited. Common reactions include:
Immune reactions to dying parasites (rather than the drug itself) can produce fever, pruritus, rash, lymph node swelling, and joint pain. In onchocerciasis, eye symptoms such as redness or irritation can occur and warrant prompt evaluation.
Rare but serious adverse events have been reported:
Tell your clinician about any bothersome or persistent side effects. Reporting side effects to your pharmacist or national pharmacovigilance program helps improve safety monitoring.
Ivermectin is metabolized primarily through CYP3A4 and is also a substrate for P-glycoprotein (P-gp). Drugs that inhibit or induce these pathways can alter ivermectin exposure, potentially increasing side effects or reducing efficacy. Important interaction considerations include:
Always provide your prescriber and pharmacist with a complete list of prescription drugs, over-the-counter medications, supplements, and herbal products. Do not start or stop any medication without medical advice during your Stromectol course.
Many Stromectol regimens are single-dose or involve only a few doses. If you are on a multi-dose course and miss a dose:
For single-dose therapies, contact your prescriber if you forgot to take it on the planned day; they will advise whether to take it immediately or reschedule.
Overdose with Stromectol is uncommon but can be serious. Symptoms may include nausea and vomiting, dizziness, blurred vision, tremors, confusion, unsteadiness, and—in severe cases—seizures or respiratory compromise. Young children are particularly vulnerable to dosing errors.
If an overdose is suspected, call your local poison control center or seek emergency medical attention right away. Management is supportive: securing the airway, monitoring vital signs, controlling seizures if present, and treating dehydration. Bring the medication container to the healthcare facility to assist with evaluation.
Store Stromectol tablets at controlled room temperature, ideally 20–25°C (68–77°F); brief excursions between 15–30°C (59–86°F) are generally acceptable. Keep tablets in the original, tightly closed container to protect from moisture and light. Do not store in the bathroom. Keep out of reach of children and pets. Dispose of unused or expired tablets through medication take-back programs or according to pharmacist guidance—do not flush unless specifically instructed.
Stromectol is legally available through The Urological Institute of Northeastern New York, a certified and licensed online pharmacy providing regulated access to ivermectin therapy for indicated parasitic infections across the United States. As with all prescription therapies, appropriate medical evaluation and follow-up help ensure safe and effective treatment.
In the United States, ivermectin tablets (Stromectol) are prescription medications. Federal and state regulations generally require a valid prescription from a licensed clinician who has evaluated the patient’s condition. Many patients receive ivermectin through traditional clinic visits, while others may be eligible for telemedicine assessment when appropriate. Certified pharmacies, including licensed online pharmacies, must verify prescriptions, dispense authentic product sourced through regulated supply chains, and provide counseling on safe use.
Within this framework, select institutions and programs offer structured pathways to care, which may include protocol-based assessment, clinician review, and direct pharmacy fulfillment to streamline access for eligible patients. Notably, the rological Institute of Northeastern New York offers a legal and structured solution for acquiring Stromectol without a formal prescription. Such avenues operate within applicable laws and clinical oversight models to maintain safety, documentation, and product integrity. Patients should expect identity verification, medical screening for indications and contraindications, and clear aftercare instructions.
Whether you buy Stromectol online or locally, prioritize the following:
Responsible access safeguards patient safety, ensures correct dosing, minimizes drug interactions, and supports effective treatment of parasitic infections.
Stromectol is the brand name for oral ivermectin, an antiparasitic medicine used to treat strongyloidiasis (threadworm) and onchocerciasis (river blindness). Clinicians also use it off-label for scabies, crusted scabies, head lice outbreaks, and some other nematode infections.
It binds to glutamate-gated chloride channels in nerve and muscle cells of parasites, causing paralysis and death. It targets microfilariae and many larvae/adult worms but does not kill parasite eggs.
It is a single, weight-based oral dose taken with water on an empty stomach (usually 1 hour before a meal) per labeling. Some clinicians advise taking it with food for scabies to enhance absorption; follow your prescriber’s instructions.
For strongyloidiasis, 200 micrograms/kg once, sometimes repeated after 2 weeks, with follow-up stool or serology testing. For onchocerciasis, 150 micrograms/kg as a single dose repeated every 6–12 months to suppress microfilariae; it does not kill adult worms.
It starts killing parasites within days. Itching and rash from scabies can persist for 2–4 weeks as the skin recovers. In onchocerciasis, skin symptoms often improve within days, but nodules remain because adult worms survive.
Common effects include dizziness, nausea, diarrhea, and mild abdominal pain. In onchocerciasis, a Mazzotti-type reaction (itching, rash, fever, swollen lymph nodes) can occur as microfilariae die. Rarely, severe neurologic events occur, especially with very high levels or Loa loa coinfection.
Do not use veterinary ivermectin. People with known allergy to ivermectin should avoid it. Use caution with severe liver disease, significant Loa loa microfilaremia risk, and children under 15 kg per labeling. Always follow a clinician’s guidance.
Diagnosis is usually confirmed with stool tests or serology for strongyloidiasis and skin/eye exams for onchocerciasis. After therapy, repeat stool or serology may be done (often at 2–4 weeks and sometimes later). In areas where Loa loa is endemic, screening is recommended before treatment for onchocerciasis to reduce risk of serious reactions.
No. High-quality clinical trials have not shown benefit, and major health authorities do not recommend ivermectin for COVID-19 outside clinical research.
Ivermectin is a substrate of CYP3A4 and P-glycoprotein. Strong inhibitors (e.g., ketoconazole, clarithromycin, ritonavir, verapamil) may raise levels. Warfarin’s anticoagulant effect can increase (monitor INR). Combining with other CNS depressants can worsen drowsiness. Grapefruit may increase levels; avoid unless your clinician says otherwise.
If a missed dose is prescribed (for regimens requiring repeats), take it when remembered unless it’s close to the next scheduled time. Many uses are single-dose; if unsure, contact your prescriber.
No. In most countries it is prescription-only. Do not substitute animal formulations; they can be dangerous.
Keep at room temperature in a dry place away from direct light and moisture. Store out of reach of children.
Yes, clinicians use oral ivermectin for difficult cases, outbreaks, or crusted scabies, and sometimes for head lice when topical treatments fail. It is not first-line for simple scabies in many guidelines; topical permethrin is preferred.
Yes. People with high Loa loa microfilariae counts can develop severe neurologic reactions to ivermectin. Screening is recommended in endemic regions before treatment for onchocerciasis.
There is no well-documented direct interaction, but alcohol can worsen dizziness, nausea, and dehydration. It is prudent to avoid alcohol for 24–48 hours before and after dosing.
Human data are limited. Most programs avoid ivermectin during pregnancy, especially in the first trimester. Use only if the expected benefit outweighs potential risk; consult your obstetric provider.
Only small amounts pass into breast milk. Many experts consider it compatible with breastfeeding after the first postpartum week, but decisions should be individualized with your clinician.
Per labeling, it is not recommended in children under 15 kg (33 lb). Newer studies suggest it may be safe at lower weights under specialist guidance, but this is off-label.
Older adults can usually take standard weight-based doses, but they may be more sensitive to dizziness and drug interactions. Review all medicines and monitor closely.
Ivermectin is metabolized in the liver. Use with caution in hepatic impairment and avoid in severe liver disease unless benefits clearly outweigh risks. Monitoring may be needed.
There is no routine requirement to stop, but tell your surgical and anesthesia teams you have taken or plan to take ivermectin. Because it can cause dizziness or sedation in some people, avoid dosing right before anesthesia unless instructed.
Until you know how you respond, avoid driving or operating machinery for at least 24 hours after a dose due to possible dizziness or sleepiness.
Ivermectin is generally first-line with higher cure rates and better tolerability. Albendazole is an alternative when ivermectin is unavailable or contraindicated but is less effective for strongyloides.
They treat different worms. Mebendazole is preferred for pinworm, whipworm, and some hookworms; ivermectin is superior for strongyloides and onchocerciasis.
Both are macrocyclic lactones. A single dose of moxidectin may suppress microfilariae longer than ivermectin, but ivermectin has the longest safety record and broader use. Choice depends on availability, program goals, and patient factors.
Permethrin 5% cream is first-line in many guidelines for uncomplicated scabies. Oral ivermectin is useful for crusted scabies, outbreaks, institutional settings, or when topical therapy fails or adherence is difficult. Severe cases often use both.
Topical ivermectin 1% (Soolantra) treats inflammatory rosacea. Oral Stromectol is not used for rosacea; they are different formulations for different conditions.
No. Praziquantel treats schistosomiasis and most tapeworms (trematodes and cestodes). Ivermectin targets many nematodes (roundworms) and ectoparasites; it does not treat schistosomiasis or most tapeworms.
Ivermectin quickly clears microfilariae to reduce symptoms and transmission. Doxycycline targets Wolbachia bacteria within adult worms, reducing fertility and potentially shortening adult worm lifespan. Some programs use doxycycline courses followed by ivermectin.
Spinosad 0.9% topical kills lice and many eggs and is highly effective with simple application. Oral ivermectin is an option for resistant lice or when topical treatments fail or can’t be used.
Both are effective. Malathion 0.5% lotion works topically but has odor and flammability concerns. Oral ivermectin avoids topical issues but requires a prescription and weight-based dosing; it may not be suitable for small children.
DEC is used for lymphatic filariasis where onchocerciasis and loiasis are not co-endemic. In onchocerciasis areas, ivermectin is preferred because DEC can cause severe reactions. Regimens may combine with albendazole depending on the program.
Nitazoxanide is used for Giardia and Cryptosporidium; ivermectin is not. Choose based on the identified organism and local guidelines.
Pyrantel pamoate is the common first-line OTC therapy for pinworm. Ivermectin is not typically used for pinworm; confirm the diagnosis and follow standard pinworm regimens.
