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PubMed1992

Coagulation abnormalities and ivermectin.

Prothrombin ratios were measured 13-16 days after treatment in 148 subjects from Sierra Leone taking part in a double-blind placebo-controlled trial of ivermectin. Prolonged prothrombin ratios were observed more frequently in the ivermectin group, although this difference was not significant and no patients suffered bleeding complications. Further investigation of these patients failed to reveal any abnormality of liver function, although factor VII and II levels were reduced in most affected individuals, suggesting interference with vitamin K metabolism. Ivermectin has a minimal effect on coagulation and concern about mass treatment for this reason appears to be unjustified.

Adolescent↗
PubMed1996

Comparison of the reappearance of strongyle eggs on foals, yearlings and adult horses after treatment with ivermectin or pyrantel.

The reappearance of strongyle eggs in faeces after treatment with ivermectin or pyrantel embonate was investigated in 22 foals, 36 yearlings, and 45 adult horses on five Dutch horse farms. The results confirmed earlier studies which showed an egg reappearance period of 9 and 6 weeks after ivermectin and pyrantel treatment, respectively. There were no differences between the egg reappearance periods of foals, yearlings, and adult horses. The mean egg counts of the yearlings were, however, consistently higher than the mean egg counts of the adult horses and foals in both ivermectin- and pyrantel-treated animals. It is concluded that shorter treatment intervals in foals and yearlings are not obligatory. However, longer intervals must be prevented in yearlings because their contribution to pasture contamination is relatively high.

Age Factors↗
PubMed1999

Long-term suppression of Mansonella streptocerca microfilariae after treatment with ivermectin.

The long-term effect of a single oral dose of 150 microg/kg of body weight of ivermectin on Mansonella streptocerca microfilariae was studied in western Uganda. Before treatment, the geometric mean microfilaria density (mf) in 93 infected persons was 2.4 mf/mg of skin (range, 0.1-42.6). One year after treatment, 43 persons (46%) were microfilaria-negative, and the geometric mean in the remaining persons dropped significantly, to 0.7 mf/mg (range, 0.1-6.9). Thus, ivermectin is highly effective against M. streptocerca, and a single dose leads to a sustained suppression of microfilariae in skin. In Africa, ivermectin is used for mass treatment to control Onchocerca volvulus and Wuchereria bancrofti. Because these filarial parasites are often coendemic with M. streptocerca, the treated population may receive the additional benefit of suppression of M. streptocerca microfilariae.

Adolescent↗
PubMed1993

Efficacy of ivermectin in the treatment of strongyloidiasis complicating AIDS.

Nine adult male homosexuals who were infected with the human immunodeficiency virus (five with AIDS-defining conditions) and harbored Strongyloides stercoralis received ivermectin on a compassionate basis for persistent intestinal infection. Hyperinfection was present in all cases. Ivermectin was given either as a single oral dose (200 micrograms/kg) or on a multidose schedule (200 micrograms/kg.d) on days 1, 2, 15, and 16. All seven patients who received multiple doses showed sustained clinical and parasitological cure, whereas one of two patients who received single-dose therapy relapsed promptly and fatally. Remissions have been maintained for at least 7 months and up to 3 years of follow-up. Ivermectin appears promising in the treatment of strongyloidiasis in patients with AIDS. Because of the risk of hyperinfection and/or disseminated disease, multidose courses are warranted. We are not aware of other reports describing the efficacy of antiparasitic drugs for strongyloidiasis in patients with AIDS.

AIDS-Related Opportunistic Infections↗
PubMed1987

Controlled trial and dose-finding study of ivermectin for treatment of onchocerciasis.

Ivermectin, given as a single oral dose, has shown considerable promise as a new treatment for onchocerciasis. We assessed the safety and efficacy of ivermectin and tried to determine the optimal dose. Two hundred Liberians received 100, 150, or 200 micrograms of ivermectin/kg or placebo and were followed up for 12 months. Therapy was associated with only minimal systemic and ocular side effects. A 200-micrograms/kg dose was associated with greater systemic reaction than was a 100-micrograms/kg dose. Each treatment group had significant reduction in skin microfilaria counts by day 3 and a decrease of approximately 95% at three months. At three months the proportion of persons with no microfilariae in a specimen of skin was significantly less in the 100-micrograms/kg group than in the 150-micrograms/kg or 200-micrograms/kg groups. At 12 months, the level of microfilariae in skin was still reduced approximately 80%. Significant reduction in ocular involvement was seen in all groups. These results confirm that single-dose ivermectin is effective and well-tolerated and suggest that 150 micrograms of ivermectin/kg may be the optimal dose for initial therapy.

Clinical Trials as Topic↗
PubMed1991

A comparison of 6-, 12-, and 24-monthly dosing with ivermectin for treatment of onchocerciasis.

This study was designed to examine the optimal dose and interval of administration of ivermectin, the now-accepted drug of choice for onchocerciasis. Two hundred Liberians with Onchocerca volvulus infection received 100, 150, or 200 micrograms/kg ivermectin or placebo and were followed for 36 months. The reaction after the second dose of ivermectin was significantly less than after the initial dose, although it was still significant in the 200-micrograms/kg group. The skin microfilaria counts in the group treated 6-monthly with 150 micrograms/kg was significantly less than in the group treated yearly (12 and 24 months after initial therapy). Prevalence of microfilariae in the anterior chamber and punctate corneal opacities decreased progressively in all groups over 3 years. There appears to be a slight advantage, in terms of antiparasitic effect over the first 2 years, of therapy given 6-monthly compared with yearly.

Adolescent↗
PubMed1992

Kinetics of circulating human IgG4 after diethylcarbamazine and ivermectin treatment of bancroftian filariasis.

Patent filarial infections are associated with elevated levels of parasite-specific IgG4. This study investigated the shifts of filarial-specific human IgG and IgG4 antibodies after diethylcarbamazine and ivermectin treatment of bancroftian filariasis. Thirty adult Haitians were treated first with a 1-mg clearing dose of ivermectin and then with either one or two 200-micrograms/kg doses of ivermectin or with 12 daily 6-mg/kg doses of diethylcarbamazine. Posttreatment levels of antifilarial IgG4 were dependent on both treatment group and time of follow-up. IgG4 increased markedly to a maximum by day 30 in all treatment groups and then began to decrease; the greatest decrease was among diethylcarbamazine-treated patients. Posttreatment microfilaremia was inversely correlated with the decrease in IgG4; thus, shifts in IgG4 were associated with treatment response for all groups. Antifilarial IgG levels were not correlated with drug treatment and did not change to the same degree as did IgG4 responses.

Animals↗
PubMed1994

Ivermectin in human medicine.

Ivermectin is a potent macro-cyclic lactone causing paralysis in many nematodes and arthropods through an influx of chloride ions across cell membranes. It is currently the drug of choice for human onchocerciasis and shows potent microfilaricidal activity against the other major filarial parasites of human (Wuchereria bancrofti, Brugia malayi, Loa loa and Mansonella ozzardi) but not against M. perstans. Whether or not it also kills the adult-stage of these parasites is currently under study. Ivermectin also has excellent efficacy in both human strongyloidiasis and cutaneous larva migrans for which good alternative treatments have not been available; and it is as effective as currently available drugs against the intestinal nematodes Ascaris lumbricoides, Trichuris trichiura and Enterobius vermicularis; against the human hookworms it shows only partial efficacy. Preliminary studies indicate that ivermectin has the potential to become the drug of choice for ectoparasitic infestations (mites, lice) of humans as well.

Animals↗
PubMed1985

Pharmacokinetics of ivermectin in sheep following intravenous, intra-abomasal or intraruminal administration.

The pharmacokinetics of ivermectin in plasma following intravenous, intra-abomasal, and intraruminal administration to sheep was determined. When given intravenously, ivermectin was very slowly eliminated with a terminal half-life of 178 h and a volume of distribution at steady state of 5.3 l/kg indicating sequestration in a temporary depot. Intra-abomasal administration resulted in rapid absorption, a peak plasma concentration of 60.6 ng/ml at 4.4 h, and 100% bioavailability. However, intraruminal administration produced a much lower peak concentration (17.6 ng/ml at 23.5 h) and bioavailability (25.1%). A subsequent in vitro study indicated that ivermectin may be rapidly metabolized in the rumen.

Abomasum↗
PubMed1997

Preliminary investigations of Aphodius species activity in cattle faeces treated with ivermectin.

A.sphacelatus at densities of 0.5 and 1.0 beetle/g faeces caused significantly greater median percentage reductions (65.2% and 87.4% respectively) of Pilobolus sporangia than 0.1 beetle/g faeces (31%) in untreated cattle faeces. The median percentage reduction in sporangia due to beetle activity (48.4%) was significantly lower (P < 0.02) in faeces mixed with ivermectin at 1.0 ppm (wet weight) than in untreated faeces (88.4%). After treating a bullock with ivermectin (IvomecR Pour-On), the median percentage reduction in sporangia caused by beetles was significantly less (P < 0.05) on days 9 (78.9%) and 10 (76.9%) than in pre-dose faeces (86.5% and 93.8% respectively). In microcosms without beetles, sporulation of Pilobolus in cattle faeces from a heifer treated with ivermectin was significantly less on days 5, 10 and 15 after dosing. However, this difference was not apparent for days 5 and 10 after storage of faeces at 4 degrees C for 55 and 50 days respectively.

Animals↗
PubMed1996

Viability and fertility of adult Onchocerca volvulus after 6 years of treatment with ivermectin.

Onchocerca volvulus nodules were removed from 77 fully compliant patients in a longitudinal study of ivermectin treatment in Sierra Leone. The patients had participated in a randomized controlled trial and received either 4 annual doses of ivermectin or 10 6-monthly doses over 6 years. Worms were examined 9 months after the last treatment for evidence of changes in morphology, viability and reproductivity. The findings were compared with results for the 2 groups obtained at earlier surveys of the same study population. Repeated treatment at 6 and 12-month intervals has resulted in a marked ageing of the male worm population profile and a significant reduction in the proportion of live female worms found in the nodules. In addition, there has been a reduction in reproductivity of 90% or more. However, most of the worms found were still alive and potentially fertile, underlining the need for the continuation of regular ivermectin treatment to maintain the benefits achieved.

Adult↗
PubMed2006

Model-based analysis of trial data: microfilaria and worm-productivity loss after diethylcarbamazine-albendazole or ivermectin-albendazole combination therapy against Wuchereria bancrofti.

OBJECTIVES: To determine the efficacies of combinations of ivermectin or diethylcarbamazine and albendazole, which are recommended for use in mass treatment programmes against lymphatic filariasis. METHOD: Review of published trends in microfilarial (mf) intensities after treatment with these combination therapies. By fitting a mathematical model of treatment effects to the trial data, we quantified the efficacy of treatment, distinguishing between the killing of mf (mf loss) and a reduction in mf production by adult worms (worm-productivity loss). After diethylcarbamazine-albendazole treatment mf density dropped immediately, then slowly but steadily decreased further (four trials). After ivermectin-albendazole treatment, mf densities immediately dropped to near-zero levels, followed by a small increase (five trials). For diethylcarbamazine-albendazole treatment the average mf loss was approximately 83% (ranging from 54% to 100% in the different studies) and worm-productivity loss was 100% (in all studies). For ivermectin-albendazole treatment, average mf loss was 100% (ranging from 98% to 100%) and worm productivity loss was 96% (ranging from 83% to 100%). The effects were dose-dependent. Sensitivity analysis showed that the estimates did not depend on assumptions on worm lifespan or premature period and little on assumptions on mf lifespan. CONCLUSION: The two therapies differ with respect to their direct effect on mf, but both are highly effective against adult worms. If mass treatment with these combination therapies achieves high coverage, they can have a large impact on lymphatic filariasis transmission.

Adolescent↗
PubMed2006

Comparison of efficacy of moxidectin and ivermectin in the treatment of Strongyloides fulleborni infection in rhesus macaques.

BACKGROUND: Strongyloides infection may result in clinical disease or confound experimental protocols that utilize non-human primates. There is presently a Strongyloides fulleborni infection rate of approximately 27% in the Tulane National Primate Research Center's breeding colonies despite the routine therapeutic and prophylactic use of ivermectin. METHODS: A study was conducted to determine if moxidectin treatment offers advantages to the intestinal parasite control program. A total of 150 rhesus macaques (Macaca mulatta) that were removed from the breeding colonies due to illness were selected for the study. The animals were randomly assigned to treatment groups with 75 receiving ivermectin and 75 receiving moxidectin. Egg counts were performed on fecal samples collected pre- and post-treatment. RESULTS: Both treatments resulted in decreases in the number of eggs/g in the post-treatment sample as compared with the pre-treatment sample; however, no significant difference was found between treatment groups. CONCLUSIONS: With the data demonstrating a similar efficacy in both ivermectin and moxidectin treated macaques, the benefit of moxidectin treatment relates to biosafety and topical application.

Administration, Topical↗
PubMed1992

Efficacy and safety of ivermectin applied topically to cattle under field conditions in Australia.

Fifteen controlled field trials were conducted to evaluate the efficacy against gastrointestinal nematodes and safety of ivermectin when applied topically to cattle in Australia. Three hundred and fifty-one cattle received ivermectin, and 88 were untreated controls. The trials were conducted in 3 States and included a variety of cattle breeds and environmental conditions. Faecal samples were collected before treatment and 11 to 14 days after treatment for nematode egg counts. Data from these trials show that under Australian conditions, ivermectin applied along the mid line of the back from the withers to the sacral region at a dose rate of 500 mcg/kg body weight, effectively controlled gastrointestinal nematode infections, and did not produce unacceptable adverse reactions in the animals.

Administration, Topical↗
PubMed1993

Treatment with ivermectin of sarcoptic mange in pigs.

Ivermectin injectable solution (1% w/v) was highly effective against Sarcoptes scabiei var suis when administered subcutaneously once to swine at 300 mcg/kg body weight. There were significantly (P < 0.05) fewer Sarcoptes mange mites counted on pigs treated with ivermectin than on untreated pigs at each count up to day 56 after treatment. The results indicate ivermectin should provide an efficient, practical means of control of sarcoptic mange in intensive piggeries.

Animals↗
PubMed1996

Efficacy of an ivermectin and pyrantel pamoate combination against adult hookworm, Ancylostoma braziliense, in dogs.

A chewable tablet incorporating ivermectin and pyrantel was tested in 12 Beagle dogs for efficacy against the adult hookworm, Ancylostoma braziliense. The dogs were administered infective larvae of A braziliense orally. Twenty-one days after infection the dogs were weighed and allocated randomly to receive either an oral treatment with ivermectin and pyrantel in a beef-based chewable tablet or no treatment. The chewable tablet was a commercially available product, which was made to deliver ivermectin at 6 micrograms/kg and pyrantel at 5.0 mg/kg to each dog. Seven days after treatment the dogs were euthanased, necropsied, and examined for adult hookworms. At necropsy, no adult A braziliense was observed in any of the 6 treated dogs and all 6 dogs that had been left untreated were infected with adult A braziliense (range, 48 to 161). It was concluded that this combination product is 100% efficacious against adult A braziliense.

Administration, Oral↗
PubMed1997

Efficacy of ivermectin controlled-release capsules for the control and prevention of nasal bot infestations in sheep.

OBJECTIVE: To investigate the therapeutic and prophylactic efficacy of an ivermectin controlled-release capsule against nasal bots (Oestrus ovis) in sheep. DESIGN: Trial 1--A pen study with controls. Trial 2--A field study with controls. ANIMALS: Trial 1--Forty Merino wethers with natural infestations of nasal bot were used. Trial 2--One hundred nasal bot-free wethers were used. PROCEDURE: Trial 1--Ten randomly selected animals were slaughtered and the heads split and examined to confirm bot infestation. Fifteen animals were allocated to untreated controls and 15 to treatment with a controlled-release capsule delivering ivermectin at > or = 20 micrograms/kg/day for 100 days. Twenty-nine days after treatment the sheep were killed and examined for nasal bots. Trial 2--Nasal bot-free sheep were allocated to two groups of 45 animals. One group was untreated the other sheep were treated with capsules as above. The sheep were grazed as a single group exposed to natural challenge from O ovis. Ninety days after treatment the animals were slaughtered and examined for nasal bot infestation. RESULTS: Trial 1--Live O ovis larvae were recovered from 60% of control sheep. No live larvae were collected from treated sheep. Trial 2--Forty-one percent of untreated sheep harbored nasal bot infestations. No live larvae were collected from any treated animal. CONCLUSION: Treatment with a single ivermectin controlled release capsule was 100% effective against existing infestations of O ovis and as a prophylactic treatment for this parasite.

Animals↗
PubMed1998

Efficacy of ivermectin in a controlled-release capsule for the control of breech strike in sheep.

OBJECTIVE: To investigate the efficacy of ivermectin in an intraruminal controlled-release capsule (CRC) against blowfly strike. DESIGN: Pen and field trials with controls. ANIMALS: Pen studies: Two breech strike trials involving 60 Romney and 60 Merino sheep. One body strike trial using 100 Merino sheep. Field trials: Eight trials in New Zealand used 1000 Romney and Romney-cross sheep. Fifty Merino lambs in one trial in Australia. PROCEDURE: Pen studies: Sheep were allocated to two equal groups. One was not treated, the other sheep received a CRC that delivered ivermectin at > or = 20 micrograms/kg/day for 100 days. In the breech strike trials, each animal was given an oral laxative 2 days before exposure to adult Lucilia cuprina. In the body-strike trial, the sheep sheep were kept wet to increase susceptibility prior to the release of blowflies. Field trials: Fifty or 200 sheep allocated to equal groups of nontreated or treated with the CRC and grazed at pasture exposed to natural blowfly challenge. RESULTS: Pen studies: Breech strikes developed in 24 of 60 controls but in none of 60 CRC-treated sheep. There was a 35% reduction in the number of CRC-treated sheep struck on the body. Field trials: The average number of breech strikes in CRC-treated sheep was reduced by 86% (P < 0.001). The number of body strikes in the treated groups was a reduced by 27% (P < 0.05). CONCLUSION: The ivermectin CRC is a useful aid in controlling breech strike, but provides only moderate reduction in the incidence of body strike.

Animals↗