Ivermectin is a medication used to treat many types of parasite infestations. This includes head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, and lymphatic filariasis. It can be taken by mouth or applied to the skin for external infestations. Use in the eyes should be avoided.
|Trade names||Stromectol, Soolantra cream|
FDA Professional Drug Information (rosacea)
|by mouth, topical|
|Elimination half-life||18 hours|
|Excretion||Feces; <1% urine|
|Chemical and physical data|
14 (22,23-dihydroavermectin B1a)
14 (22,23-dihydroavermectin B1b)
|Molar mass||875.10 g/mol|
|3D model (JSmol)|
|(what is this?)|
Common side effects include red eyes, dry skin, and burning skin. It is unclear if it is safe for use during pregnancy, but is likely acceptable for use during breastfeeding. It belongs to the avermectin family of medications. It works by causing the parasite's cell membrane to increase in permeability, resulting in paralysis and death.
Ivermectin was discovered in 1975 and came into medical use in 1981. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about US$0.12 for a course of treatment. In the United States this costs about US$25–50. In other animals it is used to prevent and treat heartworm among other diseases.
- 1 Medical uses
- 2 Contraindications
- 3 Adverse effects
- 4 Pharmacology
- 5 History
- 6 Society and culture
- 7 Veterinary use
- 8 Research
- 9 See also
- 10 References
- 11 External links
Ivermectin is used for prevention, treatment, and control of river blindness (onchocerciasis) in populations where the disease is common. However, ivermectin is contraindicated in persons with a high burden of loiasis (e.g., >20,000 Loa loa microfilariae per mL), due to risk of ivermectin-associated severe inflammatory events.
A single dose of ivermectin reduces microfilaridermia by 98–99% after 1–2 months. Ivermectin does not kill adult worms. A single oral dose of ivermectin, taken once or twice a year for the 10–15-year lifespan of the adult worms, is required to protect the individual from river blindness.
Moxidectin has been approved by the FDA for use in people with river blindness, has a longer half-life than ivermectin, and may eventually supplant ivermectin, as it is a more potent microfilaricide, but there is a need for additional clinical trials, with long-term follow-up, to assess whether moxidectin is safe and effective for treatment of nematode infection in children and women of childbearing potential.
Loa loa filariasisEdit
A single dose of ivermectin gives a rapid and durable decrease in body burden of eyeworm (Loa loa). The risk of ivermectin-associated severe adverse drug events is very low in persons with less than 20,000 microfilariae per mL of blood.
Ivermectin is more effective than albendazole and equally as effective as thiabendazole for treatment of threadworm (strongyloidiasis). Ivermectin has fewer adverse effects than does thiabendazole and is at least as well tolerated as albendazole. An analysis based on an economic model suggests that it is cost effective for people moving to Europe from areas where threadworm is common to be given a single-dose of ivermectin on arrival so as to cure presumptive infection with threadworm. Persons who are immunocompromised or who will receive immunosuppressive treatment and who have confirmed or presumptive threadworm infestation are likely to benefit from treatment with ivermectin.
Evidence supports its use against parasitic arthropods and insects:
- Mites such as scabies: It is usually limited to cases that prove to be resistant to topical treatments or that present in an advanced state (such as Norwegian scabies). One review found that the efficacy of permethrin is similar to that of systemic or topical ivermectin. A separate review found that although oral ivermectin is usually effective for treatment of scabies, it does have a higher treatment failure rate than topical permethrin. Another review found that oral ivermectin provided a reasonable balance between efficacy and safety. Since ivermectin is more convenient than permethrin, many have turned to veterinary sources of the drug to obtain assurance of a cure at an affordable price.
- Lice: Ivermectin lotion (0.5%) is FDA-approved for patients six months of age and older. After a single, 10-minute application of this formulation on dry hair, 78% of subjects were found to be free of lice after two weeks. This level of effectiveness is equivalent to other pediculicide treatments requiring two applications.
- Bedbugs: There is tentative evidence that ivermectin kills bedbugs, as part of integrated pest management for bedbug infestations. Such use however may required a prolonged course of treatment which is of unclear safety.
- Malaria-bearing mosquitos, such as Anopheles gambiae: Mass drug administration of a population with ivermectin for purposes of treating/preventing nematode infestation is effective for eliminating malaria-bearing mosquitos and thereby reducing infection with residual malaria parasites.
A review found that ivermectin was effective for treatment of rosacea. An ivermectin cream has been approved by the FDA, as well as in Europe, for the treatment of inflammatory lesions of rosacea. The treatment is based upon the hypothesis that parasitic mites of the genus Demodex play a role in rosacea. In a clinical study, ivermectin reduced lesions by 83% over 4 months, as compared to 74% under a metronidazole standard therapy.
Ivermectin is contraindicated in children under the age of five or those who weigh less than 15 kilograms (33 pounds), women who are breastfeeding, and individuals with liver or kidney disease.
The main concern is neurotoxicity, which in most mammalian species may manifest as central nervous system depression, and consequent ataxia, as might be expected from potentiation of inhibitory GABA-ergic synapses.
Dogs with defects in the P-glycoprotein gene (MDR1), often collie-like herding dogs, can be severely poisoned by ivermectin. The mnemonic "white feet, don't treat" refers to Scotch collies that are vulnerable to ivermectin.
Since drugs that inhibit the enzyme CYP3A4 often also inhibit P-glycoprotein transport, the risk of increased absorption past the blood-brain barrier exists when ivermectin is administered along with other CYP3A4 inhibitors. These drugs include statins, HIV protease inhibitors, many calcium channel blockers, lidocaine, the benzodiazepines, and glucocorticoids such as dexamethasone.
Ivermectin and other avermectins (insecticides most frequently used in home-use ant baits) are macrocyclic lactones derived from the bacterium Streptomyces avermitilis. Ivermectin kills by interfering with nervous system and muscle function, in particular by enhancing inhibitory neurotransmission.
The drug binds to glutamate-gated chloride channels (GluCls) in the membranes of invertebrate nerve and muscle cells, causing increased permeability to chloride ions, resulting in cellular hyper-polarization, followed by paralysis and death. GluCls are invertebrate-specific members of the Cys-loop family of ligand-gated ion channels present in neurons and myocytes.
Ivermectin can be given by mouth, topically, or via injection. It does not readily cross the blood–brain barrier of mammals due to the presence of P-glycoprotein, (the MDR1 gene mutation affects function of this protein). Crossing may still become significant if ivermectin is given at high doses (in which case, brain levels peak 2–5 hours after administration). In contrast to mammals, ivermectin can cross the blood–brain barrier in tortoises, often with fatal consequences.
Field studies have demonstrated the dung of animals treated with ivermectin supports a significantly reduced diversity of invertebrates, and the dung persists longer.
The discovery of the avermectin family of compounds, from which ivermectin is chemically derived, was made by Satoshi Ōmura of Kitasato University, Tokyo and William C. Campbell of the Merck Institute for Therapeutic research. Ōmura identified avermectin from the bacterium Streptomyces avermitilis. Campbell purified avermectin from cultures obtained from Ōmura and led efforts leading to the discovery of ivermectin, a derivative of greater potency and lower toxicity. Ivermectin was introduced in 1981. Half of the 2015 Nobel Prize in Physiology or Medicine was awarded jointly to Campbell and Ōmura for discovering avermectin, "the derivatives of which have radically lowered the incidence of river blindness and lymphatic filariasis, as well as showing efficacy against an expanding number of other parasitic diseases".
Society and cultureEdit
Ivermectin is available as a generic prescription drug in the U.S. in a 3 mg tablet formulation. It is also sold under the brand names Heartgard, Sklice and Stromectol in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT in Nepal by Alive Pharmaceutical and Ivexterm in Mexico by Valeant Pharmaceuticals International. In Southeast Asian countries, it is marketed by Delta Pharma Ltd. under the trade name Scabo 6. The formulation for rosacea treatment is sold as Soolantra. While in development, it was assigned the code MK-933 by Merck.
Ivermectin is routinely used to control parasitic worms in the gastrointestinal canal of ruminant animals. These parasites normally enter the animal when it is grazing, pass the bowel and set and mature in the intestines, after which they produce eggs which leave the animal via its droppings and can infest new pastures. Ivermectin is effective in killing some, but not all, of these parasites.
Some dog breeds (especially the Rough Collie, the Smooth Collie, the Shetland Sheepdog, and the Australian Shepherd), though, have a high incidence of a certain mutation within the MDR1 gene (coding for P-glycoprotein); affected animals are particularly sensitive to the toxic effects of ivermectin. Clinical evidence suggests kittens are susceptible to ivermectin toxicity. A 0.01% ivermectin topical preparation for treating ear mites in cats (Acarexx) is available.
Ivermectin is sometimes used as an acaricide in reptiles, both by injection and as a diluted spray. While this works well in some cases, care must be taken, as several species of reptiles are very sensitive to ivermectin. Use in turtles is particularly contraindicated.
- "Ivermectin". The American Society of Health-System Pharmacists. Archived from the original on January 3, 2016. Retrieved January 16, 2016.
- Sneader, Walter (2005). Drug Discovery a History. Chichester: John Wiley & Sons. p. 333. ISBN 978-0-470-01552-0.
- Saunders Handbook of Veterinary Drugs: Small and Large Animal (4 ed.). Elsevier Health Sciences. 2015. p. 420. ISBN 978-0-323-24486-2. Archived from the original on January 31, 2016.
- Panahi Y, Poursaleh Z, Goldust M (2015). "The efficacy of topical and oral ivermectin in the treatment of human scabies". Annals of Parasitology. 61 (1): 11–6. PMID 25911032.
- "Ivermectin Levels and Effects while Breastfeeding". Archived from the original on January 1, 2016. Retrieved January 16, 2016.
- Mehlhorn, Heinz (2008). Encyclopedia of parasitology (3rd ed.). Berlin: Springer. p. 646. ISBN 978-3-540-48994-8. Archived from the original on January 31, 2016.
- Vercruysse J, Rew RS, eds. (2002). Macrocyclic lactones in antiparasitic therapy. Oxon, UK: CABI Pub. p. Preface. ISBN 978-0-85199-840-4. Archived from the original on January 31, 2016.
- "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on December 13, 2016. Retrieved December 8, 2016.
- "Ivermectin". International Drug Price Indicator Guide. Retrieved January 16, 2016.
- Hamilton, Richard J. (2014). Tarascon pocket pharmacopoeia : 2014 deluxe lab-pocket edition (15th ed.). Sudbury: Jones & Bartlett Learning. p. 40. ISBN 978-1-284-05399-9. Archived from the original on January 31, 2016.
- Ottesen EA, Campbell WC (August 1994). "Ivermectin in human medicine". The Journal of Antimicrobial Chemotherapy. 34 (2): 195–203. doi:10.1093/jac/34.2.195. PMID 7814280.
- Keating J, Yukich JO, Mollenkopf S, Tediosi F (July 2014). "Lymphatic filariasis and onchocerciasis prevention, treatment, and control costs across diverse settings: a systematic review". Acta Tropica. 135: 86–95. doi:10.1016/j.actatropica.2014.03.017. PMID 24699086.
- Basáñez MG, Pion SD, Boakes E, Filipe JA, Churcher TS, Boussinesq M (May 2008). "Effect of single-dose ivermectin on Onchocerca volvulus: a systematic review and meta-analysis". The Lancet. Infectious Diseases. 8 (5): 310–22. doi:10.1016/S1473-3099(08)70099-9. PMID 18471776.
- United Front Against Riverblindness. "Control of Riverblindness". Archived from the original on August 27, 2007.
- Maheu-Giroux M, Joseph SA (August 2018). "Moxidectin for deworming: from trials to implementation". The Lancet. Infectious Diseases. 18 (8): 817–819. doi:10.1016/S1473-3099(18)30270-6. PMID 29858152.
- Boussinesq M (October 2018). "A new powerful drug to combat river blindness". Lancet. 392 (10154): 1170–1172. doi:10.1016/S0140-6736(18)30101-6. PMID 29361336.
- Pion, Sébastien D; Tchatchueng-Mbougua, Jules Brice; Chesnais, Cédric B; Kamgno, Joseph; Gardon, Jacques; Chippaux, Jean-Philippe; Ranque, Stéphane; Ernould, Jean-Christophe; Garcia, André; Boussinesq, Michel (January 11, 2019). "Effect of a single standard dose (150–200 μg/kg) of ivermectin on microfilaremia: systematic review and meta-analysis". Open Forum Infectious Diseases. doi:10.1093/ofid/ofz019. PMC 6449757.
- Henriquez-Camacho C, Gotuzzo E, Echevarria J, White AC, Terashima A, Samalvides F, Pérez-Molina JA, Plana MN (January 2016). "Ivermectin versus albendazole or thiabendazole for Strongyloides stercoralis infection". The Cochrane Database of Systematic Reviews (1): CD007745. doi:10.1002/14651858.CD007745.pub3. PMC 4916931. PMID 26778150.
- Agbata EN, Morton RL, Bisoffi Z, Bottieau E, Greenaway C, Biggs BA, Montero N, Tran A, Rowbotham N, Arevalo-Rodriguez I, Myran DT, Noori T, Alonso-Coello P, Pottie K, Requena-Méndez A (December 2018). "Effectiveness of Screening and Treatment Approaches for Schistosomiasis and Strongyloidiasis in Newly-Arrived Migrants from Endemic Countries in the EU/EEA: A Systematic Review". Int J Environ Res Public Health. 16 (1). doi:10.3390/ijerph16010011. PMC 6339107. PMID 30577567.
- Kotton, Camille; Mileno, Maria; Keystone, J. (2019). "The Immunocompromised Traveler". Travel medicine. Edinburgh: Elsevier. pp. 269–277. ISBN 978-0-323-54696-6.
- Palmeirim MS, Hürlimann E, Knopp S, Speich B, Belizario V, Joseph SA, Vaillant M, Olliaro P, Keiser J (April 2018). "Efficacy and safety of co-administered ivermectin plus albendazole for treating soil-transmitted helminths: A systematic review, meta-analysis and individual patient data analysis". PLoS Neglected Tropical Diseases. 12 (4): e0006458. doi:10.1371/journal.pntd.0006458. PMC 5942849. PMID 29702653.
- de Kraker ME, Stolk WA, van Oortmarssen GJ, Habbema JD (May 2006). "Model-based analysis of trial data: microfilaria and worm-productivity loss after diethylcarbamazine-albendazole or ivermectin-albendazole combination therapy against Wuchereria bancrofti". Tropical Medicine & International Health. 11 (5): 718–28. doi:10.1111/j.1365-3156.2006.01606.x. PMID 16640625.
- Taylor MJ, Hoerauf A, Bockarie M (October 2010). "Lymphatic filariasis and onchocerciasis". Lancet. 376 (9747): 1175–85. doi:10.1016/S0140-6736(10)60586-7. PMID 20739055.
- Brooks PA, Grace RF (August 2002). "Ivermectin is better than benzyl benzoate for childhood scabies in developing countries". Journal of Paediatrics and Child Health. 38 (4): 401–4. doi:10.1046/j.1440-1754.2002.00015.x. PMID 12174005.
- Victoria J, Trujillo R (2001). "Topical ivermectin: a new successful treatment for scabies". Pediatric Dermatology. 18 (1): 63–5. doi:10.1046/j.1525-1470.2001.018001063.x. PMID 11207977.
- Strong M, Johnstone P (July 2007). Strong M (ed.). "Interventions for treating scabies". The Cochrane Database of Systematic Reviews (3): CD000320. doi:10.1002/14651858.CD000320.pub2. PMC 6532717. PMID 17636630.
- Rosumeck S, Nast A, Dressler C (April 2018). "Ivermectin and permethrin for treating scabies". Cochrane Database Syst Rev. 4: CD012994. doi:10.1002/14651858.CD012994. PMID 29608022.
- Dhana A, Yen H, Okhovat JP, Cho E, Keum N, Khumalo NP (January 2018). "Ivermectin versus permethrin in the treatment of scabies: A systematic review and meta-analysis of randomized controlled trials". Journal of the American Academy of Dermatology. 78 (1): 194–198. doi:10.1016/j.jaad.2017.09.006. PMID 29241784.
- Thadanipon K, Anothaisintawee T, Rattanasiri S, Thakkinstian A, Attia J (2019). "Efficacy and safety of antiscabietic agents: A systematic review and network meta-analysis of randomized controlled trials". J Am Acad Dermatol. doi:10.1016/j.jaad.2019.01.004. PMID 30654070.
- Crump A, Ōmura S (February 10, 2011). "Ivermectin, 'wonder drug' from Japan: the human use perspective". Proceedings of the Japan Academy. Series B, Physical and Biological Sciences. 87 (2): 13–28. doi:10.2183/pjab.87.13. PMC 3043740. PMID 21321478.
- Laing R, Gillan V, Devaney E (June 2017). "Ivermectin - Old Drug, New Tricks?". Trends in Parasitology. 33 (6): 463–472. doi:10.1016/j.pt.2017.02.004. PMID 28285851.
- Dourmishev AL, Dourmishev LA, Schwartz RA (December 2005). "Ivermectin: pharmacology and application in dermatology". International Journal of Dermatology. 44 (12): 981–8. doi:10.1111/j.1365-4632.2004.02253.x. PMID 16409259.
- Strycharz JP, Yoon KS, Clark JM (January 2008). "A new ivermectin formulation topically kills permethrin-resistant human head lice (Anoplura: Pediculidae)". Journal of Medical Entomology. 45 (1): 75–81. doi:10.1603/0022-2585(2008)45[75:ANIFTK]2.0.CO;2. PMID 18283945.
- "Sklice lotion". Archived from the original on May 12, 2012.
- Pariser DM, Meinking TL, Bell M, Ryan WG (November 2012). "Topical 0.5% ivermectin lotion for treatment of head lice". The New England Journal of Medicine. 367 (18): 1687–93. doi:10.1056/NEJMoa1200107. PMID 23113480.
- Study shows ivermectin ending lice problem in one treatment, Los Angeles Times, November 5, 2012
- Crump A (May 2017). "Ivermectin: enigmatic multifaceted 'wonder' drug continues to surprise and exceed expectations". J. Antibiot. 70 (5): 495–505. doi:10.1038/ja.2017.11. PMID 28196978.
- Ōmura S (August 2016). "A Splendid Gift from the Earth: The Origins and Impact of the Avermectins (Nobel Lecture)". Angew. Chem. Int. Ed. Engl. 55 (35): 10190–209. doi:10.1002/anie.201602164. PMID 27435664.
- James, William D.; Elston, Dirk; Berger, Timothy; Neuhaus, Isaac (2015). Andrews' Diseases of the Skin: Clinical Dermatology. Elsevier Health Sciences. p. 439. ISBN 9780323319690.
Ivermectin treatment is emerging as a potential ancillary measure.
- Lebwohl, Mark G.; Heymann, Warren R.; Berth-Jones, John; Coulson, Ian (2017). Treatment of Skin Disease: Comprehensive Therapeutic Strategies. Elsevier Health Sciences. p. 89. ISBN 9780702069130.
- Tizifa TA, Kabaghe AN, McCann RS, van den Berg H, Van Vugt M, Phiri KS (2018). "Prevention Efforts for Malaria". Curr Trop Med Rep. 5 (1): 41–50. doi:10.1007/s40475-018-0133-y. PMC 5879044. PMID 29629252.
- Siddiqui K, Stein Gold L, Gill J (2016). "The efficacy, safety, and tolerability of ivermectin compared with current topical treatments for the inflammatory lesions of rosacea: a network meta-analysis". SpringerPlus. 5 (1): 1151. doi:10.1186/s40064-016-2819-8. PMC 4956638. PMID 27504249.
- Moran EM, Foley R, Powell FC (2017). "Demodex and rosacea revisited". Clin. Dermatol. 35 (2): 195–200. doi:10.1016/j.clindermatol.2016.10.014. PMID 28274359.
- Galderma Receives FDA Approval of Soolantra (Ivermectin) Cream for Rosacea Archived January 22, 2015, at the Wayback Machine"
- "SOOLANTRA- ivermectin cream (NDC Code(s): 0299-3823-30, 0299-3823-45, 0299-3823-60)". DailyMed. December 2014. Archived from the original on February 24, 2016. Retrieved September 9, 2015.
- Heukelbach J, Winter B, Wilcke T, Muehlen M, Albrecht S, de Oliveira FA, Kerr-Pontes LR, Liesenfeld O, Feldmeier H (August 2004). "Selective mass treatment with ivermectin to control intestinal helminthiases and parasitic skin diseases in a severely affected population". Bulletin of the World Health Organization. 82 (8): 563–71. PMC 2622929. PMID 15375445.
- Dowling P (December 2006). "Pharmacogenetics: it's not just about ivermectin in collies". Can. Vet. J. 47 (12): 1165–8. PMC 1636591. PMID 17217086.
- Goodman and Gilman's Pharmacological Basis of Therapeutics, 11th edition, pages 122, 1084–1087.
- "COMFORTIS® and ivermectin interaction Safety Warning Notification". U.S. Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM). Archived from the original on August 29, 2009.
- Yates DM, Wolstenholme AJ (August 2004). "An ivermectin-sensitive glutamate-gated chloride channel subunit from Dirofilaria immitis". International Journal for Parasitology. 34 (9): 1075–81. doi:10.1016/j.ijpara.2004.04.010. PMID 15313134.
- Borst P, Schinkel AH (June 1996). "What have we learnt thus far from mice with disrupted P-glycoprotein genes?". European Journal of Cancer. 32A (6): 985–90. doi:10.1016/0959-8049(96)00063-9. PMID 8763339.
- Iglesias LE, Saumell CA, Fernández AS, Fusé LA, Lifschitz AL, Rodríguez EM, Steffan PE, Fiel CA (December 2006). "Environmental impact of ivermectin excreted by cattle treated in autumn on dung fauna and degradation of faeces on pasture". Parasitology Research. 100 (1): 93–102. doi:10.1007/s00436-006-0240-x. PMID 16821034.
- Fisher MH, Mrozik H (1992). "The chemistry and pharmacology of avermectins". Annual Review of Pharmacology and Toxicology. 32: 537–53. doi:10.1146/annurev.pa.32.040192.002541. PMID 1605577.
- Campbell WC, Burg RW, Fisher MH, Dybas RA (June 26, 1984). "Chapter 1: The discovery of ivermectin and other avermectins". Pesticide Synthesis Through Rational Approaches. ACS Symposium Series. 255. American Chemical Society. pp. 5–20. doi:10.1021/bk-1984-0255.ch001. ISBN 978-0-8412-1083-7.
- "The Nobel Prize in Physiology or Medicine 2015" (PDF). Nobel Foundation. Archived (PDF) from the original on October 6, 2015. Retrieved October 7, 2015.
- U.S. FDA. "Abbreviated New Drug Application (ANDA): 204154". Drugs@FDA: FDA Approved Drug Products. U.S. Food and Drug Administration. Retrieved August 18, 2018.
- "SKLICE- ivermectin lotion (NDC Code(s): 49281-183-71)". DailyMed. February 2012. Archived from the original on March 6, 2016. Retrieved September 9, 2015.
- "STROMECTOL- ivermectin tablet (NDC Code(s): 0006-0032-20)". DailyMed. May 2010. Archived from the original on March 6, 2016. Retrieved September 9, 2015.
- Adhikari, Santosh (May 27, 2014). "ALIVE PHARMACEUTICAL (P) LTD.: Iver-DT". ALIVE PHARMACEUTICAL (P) LTD. Archived from the original on March 4, 2016. Retrieved October 7, 2015.
- Pampiglione S, Majori G, Petrangeli G, Romi R (1985). "Avermectins, MK-933 and MK-936, for mosquito control". Transactions of the Royal Society of Tropical Medicine and Hygiene. 79 (6): 797–9. doi:10.1016/0035-9203(85)90121-X. PMID 3832491.
- "MDR1 FAQs" Archived December 13, 2007, at the Wayback Machine, Australian Shepherd Health & Genetics Institute, Inc.
- "Multidrug Sensitivity in Dogs" Archived June 23, 2015, at the Wayback Machine, Washington State University's College of Veterinary Medicine
- Frischke H, Hunt L (April 1991). "Alberta. Suspected ivermectin toxicity in kittens". The Canadian Veterinary Journal. 32 (4): 245. PMC 1481314. PMID 17423775.
- Klingenberg, Roger (2007). Understanding reptile parasites : from the experts at Advanced Vivarium Systems. Irvine, Calif: Advanced Vivarium Systems. ISBN 978-1882770908.
- Varghese FS, Kaukinen P, Gläsker S, Bespalov M, Hanski L, Wennerberg K, Kümmerer BM, Ahola T (February 2016). "Discovery of berberine, abamectin and ivermectin as antivirals against chikungunya and other alphaviruses". Antiviral Research. 126: 117–24. doi:10.1016/j.antiviral.2015.12.012. PMID 26752081.
- Ejere HO, Schwartz E, Wormald R, Evans JR (August 2012). "Ivermectin for onchocercal eye disease (river blindness)". The Cochrane Database of Systematic Reviews. 8 (8): CD002219. doi:10.1002/14651858.CD002219.pub2. PMC 4425412. PMID 22895928.
- Carotti A, Marinozzi M, Custodi C, Cerra B, Pellicciari R, Gioiello A, Macchiarulo A (2014). "Beyond bile acids: targeting Farnesoid X Receptor (FXR) with natural and synthetic ligands". Current Topics in Medicinal Chemistry. 14 (19): 2129–42. doi:10.2174/1568026614666141112094058. PMID 25388537.
- Jin L, Feng X, Rong H, Pan Z, Inaba Y, Qiu L, Zheng W, Lin S, Wang R, Wang Z, Wang S, Liu H, Li S, Xie W, Li Y (2013). "The antiparasitic drug ivermectin is a novel FXR ligand that regulates metabolism". Nature Communications. 4: 1937. doi:10.1038/ncomms2924. PMID 23728580.
- Kim SG, Kim BK, Kim K, Fang S (December 2016). "Bile Acid Nuclear Receptor Farnesoid X Receptor: Therapeutic Target for Nonalcoholic Fatty Liver Disease". Endocrinology and Metabolism. 31 (4): 500–504. doi:10.3803/EnM.2016.31.4.500. PMC 5195824. PMID 28029021.
- Chaccour, Carlos; Hammann, Felix; Rabinovich, N. Regina (April 24, 2017). "Ivermectin to reduce malaria transmission I. Pharmacokinetic and pharmacodynamic considerations regarding efficacy and safety". Malaria Journal. 16 (1). doi:10.1186/s12936-017-1801-4. PMID 28434401.
- Siewe Fodjo, JN; Kugler, M; Hotterbeekx, A; Hendy, A; Van Geertruyden, JP; Colebunders, R (August 23, 2019). "Would ivermectin for malaria control be beneficial in onchocerciasis-endemic regions?". Infectious diseases of poverty. 8 (1): 77. doi:10.1186/s40249-019-0588-7. PMID 31439040.
- The Carter Center River Blindness (Onchocerciasis) Control Program
- American NGDO Treating River Blindness
- Trinity College Dublin. Prof William Campbell – The Story of Ivermectin
- "IVERMECTIN- ivermectin tablet (NDC Code(s): 42799-806-01)". DailyMed. November 2014. Retrieved September 9, 2015.
- "ivermectin (Rx) Stromectol". Medscape. WebMD. Retrieved November 1, 2015.