Last update July 15, 2022

Ivermectin

Compatible

Safe substance and/or breastfeeding is the best option.

Used as systemic treatment of onchocercosis, strongyloidiasis, filariasis and scabies (Pérez 2009, Prescrire 2002). Oral administration. Topically it is used in the treatment of pediculosis capitis. Used experimentally in the treatment of the COVID-19 coronavirus. (Vallejos 2020)

Its pharmacokinetic data (high molecular weight and high protein binding) explain the small excretion in breast milk, without clinical relevance for the infant. (Rodari 2020, Ogbuokiri 1993)

No problems have been observed in infants whose mothers were taking it. (Porto 2003, Ogbuokiri 1994 y 1993)

Expert authors consider the use of this medication safe during breastfeeding. (Anderson 2020)

American Academy of Pediatrics: Maternal Medication Usually Compatible With Breastfeeding. (Butler 2014, AAP 2001)

Alternatives

We do not have alternatives for Ivermectin since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Ivermectin in other languages or writings:

Groups

Ivermectin belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Ivermectin in its composition:

List of 20 tradenames

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 %
Molecular weight 875 daltons
Protein Binding 93 - 99 %
VD 3 - 3.5 l/Kg
pKa 12.4 -
Tmax 4 hours
T½ 12 - 18 hours
M/P ratio 0.4 - 0.6 -
Theoretical Dose 0.0002 - 0.003 mg/Kg/d
Relative Dose 0. 55 - 1.5 %
Ped.Relat.Dose 1 %

References

  1. Vallejos J, Zoni R, Bangher M, Villamandos S, Bobadilla A, Plano F, Campias C, Chaparro Campias E, Achinelli F, Guglielmone HA, Ojeda J, Medina F, Farizano Salazar D, Andino G, Ruiz Diaz NE, Kawerin P, Meza E, Dellamea S, Aquino A, Flores V, Martemucci CN, Vernengo MM, et al. Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19): a structured summary of a study protocol for a randomized controlled trial. Trials. 2020 Nov 24;21(1):965. Consulted on Nov. 30, 2020 Abstract
  2. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187. Abstract Full text (link to original source)
  3. Rodari P, Buonfrate D, Pomari E, Lunardi G, Bon I, Bisoffi Z, Angheben A. Ivermectin concentration in breastmilk of a woman with Strongyloides stercoralis and human T-lymphotropic virus-I co-infection. Acta Trop. 2020 Feb;202:105249. Abstract
  4. Anderson PO. Antivirals for COVID-19 and Breastfeeding. Breastfeed Med. 2020 Oct;15(10):605-607. Abstract
  5. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  6. Pérez JL, Carranza C, Mateos F. Antiparasitarios. Revisión de los fármacos útiles en el tratamiento de parasitosis clásicas y emergentes. \ [Antiparasitic drugs. Review of the useful drugs in the treatment of classic and emergent parasitic diseases]. Rev Esp Quimioter. 2009 Jun;22(2):93-105. Review. Spanish. Abstract Full text (link to original source) Full text (in our servers)
  7. Porto I. Antiparasitic drugs and lactation: focus on anthelmintics, scabicides, and pediculicides. J Hum Lact. 2003 Abstract
  8. [No authors listed] Ivermectin: new indication. Oral treatment of scabies: simple and effective. Prescrire Int. 2002 Oct;11(61):137-40. Abstract
  9. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  10. Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breast milk. Eur J Clin Pharmacol. 1994 Abstract
  11. Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breastmilk. Eur J Clin Pharmacol. 1993;45(4):389-90. Abstract

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