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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Rid One And Done
Generic Name
Ivermectin
Active Ingredient
IvermectinCategory
Antiparasitic [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 5 mg/g | LOTION | TOPICAL | 82392-200 |
Detailed information about Rid One And Done
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Rid One And Done, you must consult a qualified healthcare professional.
Ivermectin is a potent broad-spectrum antiparasitic agent belonging to the avermectin class, primarily used to treat infections caused by certain internal and external parasites, including Strongyloidiasis and Onchocerciasis.
Dosage for ivermectin is highly dependent on the specific condition being treated and the patient's body weight. According to the FDA-approved dosing for Stromectol:
The recommended dosage is a single oral dose of approximately 200 mcg (micrograms) per kilogram of body weight. For a typical adult weighing 70 kg, this equates to approximately 14 mg (usually five 3 mg tablets). Healthcare providers may require follow-up stool examinations to ensure the infection is cleared.
The recommended dosage is a single oral dose of 150 mcg per kilogram of body weight. In many cases, retreatment is necessary at intervals of 3 to 12 months until the adult worms die off. For a 70 kg adult, this is approximately 10.5 mg.
When used for scabies, a common regimen is 200 mcg/kg as a single dose, often repeated 7 to 14 days later to ensure that any newly hatched mites are killed.
Ivermectin's safety in pediatric patients weighing less than 15 kg (approximately 33 lbs) has not been established for oral use. For children weighing more than 15 kg, dosing is generally based on the same weight-based calculations used for adults (150–200 mcg/kg).
For topical use (head lice), the 0.5% lotion is approved for children as young as 6 months of age. It is applied once to dry hair and scalp and rinsed off after 10 minutes.
Because less than 1% of ivermectin is excreted in the urine, dosage adjustments are typically not required for patients with kidney disease. However, clinical monitoring is always advised.
Ivermectin is heavily metabolized by the liver. While there are no specific quantitative dosing adjustments provided in the manufacturer's labeling for patients with liver disease, the drug should be used with extreme caution in these individuals due to the risk of reduced clearance and increased toxicity.
Clinical studies did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently than younger subjects. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function.
To ensure the medication works effectively and safely, follow these instructions:
Since ivermectin is often prescribed as a single dose or infrequent doses, missing a dose is uncommon. However, if you are on a multi-dose schedule and miss a dose:
Symptoms of ivermectin overdose can be severe and include:
In the event of an overdose, contact your local poison control center or seek emergency medical attention immediately. Treatment typically involves supportive care, including intravenous fluids and respiratory support if necessary.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance.
Side effects of ivermectin can vary significantly depending on the condition being treated. When treating onchocerciasis, many side effects are actually an immune response to the dying parasites rather than a direct reaction to the drug itself. Common symptoms include:
For intestinal strongyloidiasis, common side effects include:
> Warning: Stop taking Ivermectin and call your doctor immediately if you experience any of these.
This is a severe systemic reaction seen primarily in patients treated for onchocerciasis. It is caused by the sudden death of vast numbers of microfilariae. Symptoms include severe hypotension (low blood pressure), tachycardia, edema (swelling), and respiratory distress. It can be life-threatening if not managed with corticosteroids and intravenous fluids.
Though rare at standard doses, ivermectin can cause central nervous system (CNS) depression. Seek help for:
In patients with river blindness, the death of parasites in the eye can cause:
Ivermectin is typically used for short-term or intermittent therapy. There is limited data on the effects of chronic, daily long-term use in humans, as this is not an approved dosing regimen. Prolonged use without medical supervision could theoretically lead to cumulative neurological effects or liver enzyme elevations. Long-term topical use for rosacea is generally well-tolerated, with some patients reporting localized skin dryness or irritation over several months of use.
No FDA black box warnings currently exist for ivermectin. However, there are significant warnings regarding its use in patients co-infected with Loa loa (African eye worm), as this can lead to fatal encephalopathy (brain dysfunction).
Report any unusual symptoms to your healthcare provider.
Ivermectin is a potent medication that must be used only under the direct supervision of a healthcare professional. It is critical to distinguish between human-grade ivermectin and animal-grade ivermectin. Animal products are often highly concentrated and contain ingredients that have not been tested for safety in humans. Using animal-grade products can lead to severe toxicity, permanent organ damage, or death.
No FDA black box warnings for Ivermectin. However, the FDA and WHO emphasize the risk of severe adverse events in specific geographical regions where Loa loa is endemic.
Patients who are co-infected with Loa loa (a parasite found primarily in West and Central Africa) and are treated with ivermectin may develop a serious or even fatal encephalopathy. This is due to the rapid killing of high loads of Loa loa microfilariae, which then clog small blood vessels in the brain. Symptoms include neck pain, red eyes, urinary/fecal incontinence, difficulty walking, and mental status changes. Before starting ivermectin, patients who have traveled to or lived in areas where Loa loa is prevalent must be screened.
Because ivermectin acts on chloride channels, there is a theoretical risk of CNS depression. This risk is significantly increased in patients with conditions that compromise the blood-brain barrier, such as meningitis or African trypanosomiasis (sleeping sickness). Patients should be monitored for signs of ataxia, lethargy, or confusion.
While rare, hypersensitivity reactions can occur. Patients should be aware of the signs of anaphylaxis, including hives, swelling of the face or throat, and difficulty breathing. If these occur, immediate emergency care is required.
Although ivermectin is not commonly associated with severe liver injury at standard doses, there have been rare reports of liver enzyme elevations and hepatitis. Patients with pre-existing liver disease require closer monitoring.
Depending on the condition being treated, your doctor may require the following:
Ivermectin can cause dizziness, drowsiness, and vertigo in some patients. You should not drive, operate heavy machinery, or engage in hazardous activities until you know how the medication affects you. These effects are most common in the first 24 to 48 hours after a dose.
Alcohol should be avoided while taking ivermectin. Alcohol can increase the sedative effects of the medication and may potentially increase the permeability of the blood-brain barrier, increasing the risk of neurological side effects. Furthermore, both alcohol and ivermectin are processed by the liver, and combining them may increase the risk of hepatic stress.
For most parasitic infections, ivermectin is given as a single dose. There is no withdrawal syndrome associated with stopping ivermectin. However, if you are using topical ivermectin for rosacea, stopping the medication suddenly may cause a flare-up of inflammatory lesions. Always consult your doctor before stopping a prescribed course of treatment.
> Important: Discuss all your medical conditions with your healthcare provider before starting Ivermectin.
While there are few absolute contraindications based on drug interactions, ivermectin should never be used with other medications that significantly increase blood-brain barrier permeability unless specifically directed by a specialist.
Ivermectin may enhance the anticoagulant (blood-thinning) effect of warfarin. There have been post-marketing reports of increased International Normalized Ratio (INR) in patients taking both medications. If you are on warfarin, your healthcare provider will likely monitor your INR more frequently after you take a dose of ivermectin to prevent bleeding complications.
Ivermectin is a substrate for P-glycoprotein (P-gp), an efflux pump that keeps the drug out of the brain. Drugs that inhibit P-gp can increase the concentration of ivermectin in the central nervous system, potentially leading to toxicity. Examples include:
Ivermectin is primarily metabolized by the CYP3A4 enzyme.
As noted in the pharmacokinetic profile, a high-fat meal can increase the bioavailability of ivermectin by 2.5 times. While this might seem beneficial, it can lead to unpredictable drug levels and increased risk of toxicity. Therefore, it is strictly recommended to take oral ivermectin on an empty stomach with water.
Grapefruit juice is a known inhibitor of the CYP3A4 enzyme in the gut. Consuming grapefruit or grapefruit juice while taking ivermectin could lead to higher-than-intended levels of the drug in your system. It is best to avoid grapefruit products for at least 48 hours before and after your dose.
This common herbal supplement is a potent inducer of CYP3A4. Taking St. John's Wort may significantly reduce the concentration of ivermectin in the blood, which could lead to treatment failure when treating serious parasitic infections.
Herbs that affect GABA receptors, such as Valerian root, Kava, or Lemon Balm, should be used with caution, as they may theoretically potentiate the CNS-depressant effects of ivermectin.
Ivermectin is not known to interfere significantly with most common laboratory tests. However, it may cause transient elevations in liver function tests (ALT, AST) and bilirubin. It may also cause a temporary decrease in white blood cell counts (leukopenia), which should be considered when interpreting blood work results shortly after treatment.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking.
Ivermectin is absolutely contraindicated in patients who have a known hypersensitivity (allergy) to ivermectin or any of the inactive ingredients in the formulation. An allergic reaction may manifest as skin rash, hives, swelling, or anaphylaxis. If you have had a previous reaction to any avermectin-class drug, you must inform your doctor.
In regions where Loa loa is endemic, patients with high microfilarial loads (typically >30,000 microfilariae per mL of blood) should not be treated with ivermectin due to the high risk of fatal encephalopathy. This is considered an absolute contraindication in the absence of intensive care monitoring facilities.
Conditions that increase the permeability of the blood-brain barrier, such as active meningitis, cerebral malaria, or African sleeping sickness, require extreme caution. In these cases, ivermectin may enter the central nervous system and cause life-threatening neurotoxicity.
Because the liver is the primary organ for ivermectin metabolism, patients with end-stage liver disease or severe cirrhosis may not be able to clear the drug effectively. A risk-benefit analysis is required, and lower doses or alternative treatments may be considered.
While not an absolute contraindication, ivermectin is generally avoided during the first trimester of pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus, as safety data in early pregnancy is limited.
There is a potential for cross-sensitivity between ivermectin and other avermectins (often used in veterinary medicine, such as selamectin or doramectin). If you have had an adverse reaction to a veterinary avermectin product, you should exercise caution with human-grade ivermectin.
> Important: Your healthcare provider will evaluate your complete medical history before prescribing Ivermectin.
Ivermectin is classified as Pregnancy Category C by the FDA. This means that animal reproduction studies have shown an adverse effect on the fetus (such as cleft palate in mice and rats at high doses), but there are no adequate and well-controlled studies in humans.
Ivermectin is excreted in human milk in low concentrations (less than 2% of the maternal dose). While no adverse effects have been reported in nursing infants, the safety of the drug in newborns and infants weighing less than 15 kg is not fully established. The WHO suggests that breastfeeding mothers can be treated with ivermectin if the clinical need is clear, but some clinicians prefer to wait until the infant is older or use alternative treatments if available.
Safety and effectiveness in pediatric patients weighing less than 15 kg have not been established. In children above this weight, the drug is used similarly to adults. There are no known long-term effects on growth or development when used as a single dose.
Topical ivermectin (0.5% lotion) is approved for children 6 months of age and older for head lice. It has been shown to be safe and effective in this population with minimal systemic absorption.
Elderly patients (65 and older) are at a higher risk for adverse drug reactions due to age-related declines in hepatic and renal function. They are also more likely to be taking multiple medications (polypharmacy), increasing the risk of drug-drug interactions. Clinical monitoring for dizziness and orthostatic hypotension is particularly important in this group to prevent falls.
As less than 1% of the drug is eliminated through the kidneys, ivermectin is generally considered safe for patients with renal impairment, including those on dialysis. No specific dose adjustments are typically required based on Glomerular Filtration Rate (GFR).
Hepatic impairment is a significant concern for ivermectin therapy. The drug undergoes extensive oxidative metabolism in the liver. In patients with Child-Pugh Class B or C cirrhosis, the half-life of ivermectin may be significantly prolonged. Healthcare providers should monitor these patients closely for signs of toxicity, particularly neurological symptoms.
> Important: Special populations require individualized medical assessment.
Ivermectin is a member of the avermectin class of endectocides. Its primary molecular mechanism involves binding to glutamate-gated chloride channels (GluCls) which are specific to invertebrates. These channels are located on the nerve and muscle cells of nematodes (roundworms) and arthropods (insects/mites).
Upon binding, ivermectin acts as an agonist, keeping the chloride channels open. This leads to a continuous influx of chloride ions into the cell, resulting in hyperpolarization of the postsynaptic membrane. This state of hyperpolarization prevents the transmission of nerve impulses, leading to flaccid paralysis of the parasite's pharyngeal muscles and body wall. Unable to eat or move, the parasite eventually dies or is flushed out of the host's system.
Ivermectin is highly effective against the larval stages (microfilariae) of Onchocerca volvulus but is not macrofilaricidal (it does not kill adult worms). The microfilaricidal effect is rapid, with significant reductions in skin microfilariae seen within days. The duration of this effect is long-lasting, often suppressing microfilarial production for 6 to 12 months. In strongyloidiasis, the drug acts on the adult intestinal stages to clear the infection.
| Parameter | Value |
|---|---|
| Bioavailability | ~40% (increased by food) |
| Protein Binding | 93% (primarily albumin) |
| Half-life | 18 hours (range 12-26) |
| Tmax | 4 hours |
| Metabolism | Hepatic (primarily CYP3A4) |
| Excretion | Fecal (>99%), Renal (<1%) |
Ivermectin is classified as an anthelmintic and an avermectin. It is part of the broader group of macrocyclic lactones. Other related medications in the veterinary field include moxidectin and doramectin, though ivermectin remains the primary agent for human use in this class.
Common questions about Rid One And Done
Ivermectin is an FDA-approved antiparasitic medication used primarily to treat infections caused by specific parasites. Its main oral uses include treating intestinal strongyloidiasis and onchocerciasis, also known as river blindness. Topically, it is used to treat head lice infestations and the inflammatory bumps associated with rosacea. It works by paralyzing and killing the parasites or their larvae. It is important to use this medication only for the specific conditions prescribed by your healthcare provider. Always use human-grade formulations, as animal versions are dangerous for human consumption.
The most common side effects of oral ivermectin include dizziness, nausea, diarrhea, and a temporary loss of appetite. When treating certain parasitic infections like river blindness, patients may experience a 'Mazzotti reaction,' which includes itching, fever, joint pain, and tender lymph nodes as the parasites die. Topical ivermectin may cause mild skin irritation, redness, or a burning sensation at the application site. Most of these side effects are mild and resolve on their own, but you should report persistent symptoms to your doctor. Serious neurological side effects are rare but require immediate medical attention.
It is generally recommended to avoid alcohol while taking ivermectin. Alcohol can increase the sedative effects of the medication, potentially leading to increased dizziness, drowsiness, or confusion. There is also a theoretical concern that alcohol could increase the permeability of the blood-brain barrier, allowing ivermectin to enter the central nervous system and cause toxicity. Since both substances are processed by the liver, avoiding alcohol reduces the metabolic strain on the organ. Always consult your healthcare provider for specific guidance based on your medical history.
Ivermectin is classified as Pregnancy Category C, meaning its safety in pregnant women has not been fully established through controlled clinical trials. Animal studies have shown some risks to the fetus at high doses, such as birth defects. Consequently, it is usually avoided during the first trimester when the baby's organs are forming. Healthcare providers only prescribe ivermectin during pregnancy if the benefits of treating a severe parasitic infection outweigh the potential risks to the fetus. If you are pregnant or planning to become pregnant, discuss alternative treatments with your doctor.
The time it takes for ivermectin to work depends on the type of infection being treated. For intestinal parasites like Strongyloides, a single dose may begin killing parasites within hours, though it may take several days for symptoms to fully improve. In the case of onchocerciasis, the drug kills the larvae quickly, but the full clinical benefit in reducing skin itching or eye symptoms may take weeks. For topical head lice treatment, the medication works during the 10-minute application, though a second treatment is sometimes needed. Your doctor will often perform follow-up tests to ensure the infection is completely cleared.
For most parasitic infections, ivermectin is prescribed as a single dose or a very short course, so 'stopping' the medication is not usually an issue. If you are using topical ivermectin for rosacea, stopping the cream suddenly may cause your skin symptoms to return or worsen. There is no risk of a 'withdrawal' syndrome like those seen with some other medications. However, you should always complete the full course of treatment as directed by your doctor to ensure the parasites are fully eradicated. If you experience bothersome side effects, contact your healthcare provider before deciding to stop the medication.
If you miss a dose of ivermectin, take it as soon as you remember, unless it is almost time for your next scheduled dose. If you are close to the next dose, skip the missed one and continue with your regular schedule. Do not take two doses at once to make up for a missed one, as this can increase the risk of side effects. Since ivermectin is often a single-dose treatment, missing a dose usually means you haven't started the treatment yet. Contact your doctor or pharmacist if you are unsure how to proceed after missing a dose.
Weight gain is not a known or reported side effect of ivermectin. Clinical studies and post-marketing surveillance have not identified any link between ivermectin use and changes in body weight. In fact, some patients may experience a temporary loss of appetite (anorexia) or nausea, which could lead to minor, short-term weight loss. If you notice significant or unexplained weight changes while taking this medication, it is likely due to another cause or the underlying infection itself. Discuss any concerns about weight or metabolism with your healthcare provider.
Ivermectin can interact with several other medications, so it is vital to provide your doctor with a full list of what you are taking. It may increase the effects of the blood-thinner warfarin, increasing the risk of bleeding. Medications that inhibit the P-glycoprotein pump or the CYP3A4 enzyme, such as certain antibiotics, antifungals, or heart medications, can increase ivermectin levels in your body. This can lead to a higher risk of side effects, particularly neurological ones. Your doctor will check for these interactions and may adjust your doses or monitor you more closely.
Yes, ivermectin is available as a generic medication in both oral tablet and topical forms. The generic versions are bioequivalent to the brand-name drugs like Stromectol (tablets), Soolantra (cream), and Sklice (lotion). Generic medications are required by the FDA to have the same active ingredient, strength, dosage form, and route of administration as the brand-name product. Choosing the generic version can often significantly reduce the cost of treatment. Check with your pharmacist to see if a generic version is appropriate for your prescription and covered by your insurance.
Other drugs with the same active ingredient (Ivermectin)