This medication is used to treat certain parasitic roundworm infections. Curing parasitic infections helps to improve your quality of life. In people with weakened defense (immune) systems, curing roundworm infections can reduce the risk of developing a severe or life-threatening infection. Ivermectin belongs to a class of drugs known as antihelmintics. It works by paralyzing and killing parasites.

Ivermectin is not recommended for coronavirus disease, also known as COVID-19, unless you are enrolled in a study. Talk to your doctor about the risks and benefits.

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This drug may also be used for other parasitic infections, including lice and scabies.

Take this medication by mouth with a full glass of water (8 ounces or 240 milliliters) on an empty stomach (at least 1 hour before a meal). Take ivermectin as directed by your doctor, usually as a single dose or a series of doses. The dosage is based on your weight, medical condition, and response to treatment.

Tell your doctor if your condition lasts or gets worse.

Headache, dizziness, muscle pain, nausea, or diarrhea may occur. If you are being treated for "river blindness" (onchocerciasis), you may experience reactions to the dying parasites during the first 4 days of treatment, including joint pain, tender/swollen lymph nodes, eye swelling/redness/pain, weakness, vision changes, itching, rash, and fever. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce dizziness upon standing, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• neck/back pain
• swelling face/arms/hands/feet
• chest pain
• fast heartbeat
• drowsiness
• confusion
• seizures

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking ivermectin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• liver problems

If you have traveled or lived in West or Central Africa, you may be infected with certain parasites (such as Loa loa, African trypanosomiasis) that could cause problems with ivermectin treatment. These effects could rarely result in serious (possibly fatal) effects on the brain (such as encephalopathy). Consult your doctor for more information.

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you have a weakened immune system (such as due to HIV infection), you may need repeat treatments with this medicine. Talk to your doctor for more details.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Ivermectin passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some of the products that may interact with this drug include:

• barbiturates (such as phenobarbital, butalbital)
• benzodiazepines (such as clonazepam, lorazepam)
• sodium oxybate (GHB)
• valproic acid

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: numbness, tingling, trouble breathing, loss of coordination, seizures.

Do not share this medication with others.

Lab and/or medical tests (such as stool exams for intestinal parasites) should be done while you are taking this medication. If you are being treated for "river blindness," you may need more medical examinations and repeated treatment because ivermectin does not kill adult Onchocerca worms. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.