Ivermectin Orifarm

What Is Ivermectin Orifarm and What Is It Used For?

Ivermectin Orifarm contains the active substance ivermectin, a broad-spectrum antiparasitic agent that belongs to the avermectin class of compounds. Originally derived from the bacterium Streptomyces avermitilis, ivermectin was discovered in the 1970s and has since become one of the most important antiparasitic drugs in the world. Its discoverers, Satoshi Omura and William C. Campbell, were awarded the Nobel Prize in Physiology or Medicine in 2015 for their contributions to parasitic disease therapy.

Ivermectin works through a unique mechanism of action. It binds selectively and with high affinity to glutamate-gated chloride ion channels found in invertebrate nerve and muscle cells. This binding causes an increase in the permeability of the cell membrane to chloride ions, leading to hyperpolarization of the nerve or muscle cell. The result is paralysis and death of the parasite. Importantly, these glutamate-gated chloride channels are not present in mammals, which provides the drug with a high degree of selectivity and a favorable safety profile in humans.

The primary approved indications for Ivermectin Orifarm include:

• Sarcoptic scabies – Caused by the mite Sarcoptes scabiei var. hominis, scabies is a highly contagious skin condition characterized by intense itching and a pimple-like rash. Ivermectin is particularly useful for treating crusted (Norwegian) scabies, institutional outbreaks, and cases that are refractory to topical treatments such as permethrin.
• Intestinal strongyloidiasis – Caused by the nematode Strongyloides stercoralis, this infection can range from asymptomatic carriage to life-threatening hyperinfection syndrome, particularly in immunocompromised patients. Ivermectin is the first-line treatment recommended by the World Health Organization (WHO).
• Microfilaraemia due to lymphatic filariasis – Caused by Wuchereria bancrofti, ivermectin is used as part of mass drug administration programs to reduce microfilarial levels, often in combination with albendazole or diethylcarbamazine (DEC).

In global health programs, ivermectin has been instrumental in the fight against river blindness (onchocerciasis) and lymphatic filariasis. The WHO includes ivermectin on its Model List of Essential Medicines, recognizing it as one of the most efficacious, safe, and cost-effective medicines needed in a health system. More than 3.7 billion doses of ivermectin have been distributed worldwide through donation programs such as the Mectizan Donation Program, making it one of the most widely used drugs in history.

What Should You Know Before Taking Ivermectin Orifarm?

Contraindications

You must not take Ivermectin Orifarm if you have a known hypersensitivity (allergy) to ivermectin or any of the other ingredients in the tablets. Allergic reactions, although rare, can manifest as skin rash, urticaria (hives), angioedema (swelling of the face, lips, or throat), or in severe cases, anaphylaxis. If you have experienced any allergic reaction to ivermectin in the past, inform your doctor immediately.

Ivermectin Orifarm is not recommended for children weighing less than 15 kg (approximately 33 lbs), as there is insufficient safety and efficacy data in this population. The drug's pharmacokinetics in very young children have not been adequately studied, and the blood-brain barrier may not be fully developed in neonates and young infants, potentially increasing the risk of central nervous system effects.

Warnings and Precautions

Several important precautions should be considered before starting treatment with Ivermectin Orifarm:

• Mazzotti-type reaction: In patients with onchocerciasis or other filarial infections, the death of microfilariae following ivermectin treatment can provoke a systemic inflammatory response known as the Mazzotti reaction. Symptoms may include fever, headache, dizziness, drowsiness, weakness, rash, increased itching, diarrhea, joint and muscle pain, hypotension, tachycardia, lymphadenopathy, and peripheral edema. This reaction is usually self-limiting but can be severe in patients with high microfilarial loads. Close medical supervision is recommended when treating filarial infections.
• Hepatic impairment: Ivermectin is extensively metabolized in the liver by the cytochrome P450 enzyme system, primarily CYP3A4. Patients with significant liver disease may have reduced clearance of the drug, leading to higher plasma levels and potentially increased side effects. Liver function should be assessed before treatment, and dose adjustments may be necessary.
• Immunocompromised patients: Patients with weakened immune systems, including those with HIV/AIDS, organ transplant recipients on immunosuppressive therapy, or patients receiving high-dose corticosteroids, are at increased risk for Strongyloides hyperinfection syndrome. While ivermectin is the treatment of choice for this condition, these patients may require repeated courses of treatment and close monitoring to ensure complete eradication of the parasite.
• Co-infection with Loa loa: In patients from regions endemic for Loa loa (African eye worm), treatment with ivermectin can trigger severe and potentially fatal encephalopathy when there is a high Loa loa microfilarial load. Before treating with ivermectin in patients from Central and West Africa, assessment for Loa loa co-infection should be considered.
• Central nervous system disorders: Although ivermectin does not readily cross an intact blood-brain barrier, caution is advised in patients with conditions that may compromise the blood-brain barrier, such as meningitis or African trypanosomiasis, as this could allow higher drug concentrations in the CNS.

Pregnancy and Breastfeeding

Pregnancy: Ivermectin should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. Animal reproduction studies have shown that ivermectin can be teratogenic (causing birth defects) at high doses – approximately 3 times the maximum recommended human dose in mice, and 6 times in rats. There are limited data on the use of ivermectin in pregnant women. If you are pregnant, think you might be pregnant, or are planning to become pregnant, consult your doctor before taking this medicine.

Breastfeeding: Ivermectin is excreted in human breast milk in low concentrations. The estimated infant dose through breast milk is less than 1% of the maternal dose, which is generally considered to be clinically insignificant. However, because ivermectin is not recommended for children weighing less than 15 kg, a risk-benefit assessment should be made. Your doctor will advise you on whether to discontinue breastfeeding or delay treatment. In mass drug administration programs, the WHO advises that breastfeeding women can be treated with ivermectin if breastfeeding is well established and the infant is older than one week.

How Does Ivermectin Orifarm Interact with Other Drugs?

Drug interactions with ivermectin primarily occur through two mechanisms: effects on hepatic metabolism via the cytochrome P450 system, and pharmacodynamic interactions at the level of neurotransmitter receptors. It is essential to inform your doctor about all medications you are currently taking, including over-the-counter drugs and herbal supplements, before starting treatment with Ivermectin Orifarm.

Ivermectin is metabolized predominantly by cytochrome P450 3A4 (CYP3A4) in the liver. Drugs that inhibit this enzyme can decrease the metabolic clearance of ivermectin, leading to higher plasma concentrations and potentially increased risk of adverse effects. Conversely, CYP3A4 inducers may decrease ivermectin blood levels and reduce its efficacy. Additionally, ivermectin is a substrate for P-glycoprotein (P-gp), a drug efflux transporter that plays a role in limiting its entry into the central nervous system. Inhibitors of P-gp may increase CNS penetration of ivermectin.

Major Interactions

Minor Interactions

This list is not exhaustive. Herbal supplements such as St. John's Wort (Hypericum perforatum) are potent CYP3A4 inducers and may reduce ivermectin efficacy. Grapefruit juice is a CYP3A4 inhibitor and could potentially increase ivermectin levels, although the clinical significance of this interaction has not been specifically studied. Always consult your doctor or pharmacist before combining ivermectin with any other medication or supplement.

What Is the Correct Dosage of Ivermectin Orifarm?

Ivermectin Orifarm should always be taken exactly as prescribed by your doctor. The dose is calculated based on your body weight, using a standard dose of 200 micrograms (0.2 mg) per kilogram of body weight. Tablets should be swallowed whole with water on an empty stomach, at least 2 hours before or after a meal, as food (especially a high-fat meal) can significantly increase the bioavailability of ivermectin and alter its pharmacokinetics.

Adults

For scabies: Take a single dose as shown above. A second dose is generally recommended 8 to 15 days after the first dose. This is because ivermectin kills adult mites and larvae but may not kill all eggs. The second dose ensures that any newly hatched mites are eliminated before they can reproduce and re-establish the infestation.

For intestinal strongyloidiasis: Take a single dose as shown above. Your doctor may recommend a follow-up stool examination 2 to 4 weeks after treatment to confirm that the infection has been eradicated. In some cases, particularly in immunocompromised patients, repeated courses may be necessary.

For lymphatic filariasis: Take a single dose of 200 mcg/kg. This is typically administered as part of a mass drug administration program, often in combination with albendazole. Treatment may be repeated annually.

Children

Ivermectin Orifarm is not recommended for children weighing less than 15 kg. For children weighing 15 kg or more, the dosage is the same as for adults: 200 micrograms per kilogram of body weight. The safety and efficacy of ivermectin in children for the treatment of scabies have been demonstrated in clinical trials, and the WHO recommends ivermectin for the treatment of scabies in children weighing at least 15 kg when topical treatment has failed or is impractical.

Elderly

No specific dose adjustment is required for elderly patients. However, as older adults may have reduced hepatic and renal function, monitoring for adverse effects is recommended. Elderly patients should also be assessed for potential drug interactions, as polypharmacy is common in this age group. The drug should be used at the standard weight-based dose with appropriate clinical monitoring.

Missed Dose

Since ivermectin is typically given as a single dose or a two-dose regimen, a missed dose in the traditional sense is unusual. If you forget to take your scheduled second dose for scabies, take it as soon as you remember, provided it is within a reasonable timeframe (up to a few days late). If a significant amount of time has passed, consult your doctor for guidance. Do not take a double dose to make up for a missed one.

Overdose

In case of accidental overdose, seek immediate medical attention. Symptoms of ivermectin overdose may include nausea, vomiting, diarrhea, abdominal pain, dizziness, drowsiness, ataxia (unsteady gait), tremor, and mydriasis (dilated pupils). In severe cases, hypotension, tachycardia, and central nervous system depression may occur. There is no specific antidote for ivermectin overdose. Treatment is supportive, including monitoring of vital signs, airway management, and gastric lavage or activated charcoal if the ingestion was recent. Contact your local poison control center or emergency services immediately.

What Are the Side Effects of Ivermectin Orifarm?

Like all medicines, Ivermectin Orifarm can cause side effects, although not everybody gets them. The type and severity of side effects can vary depending on the parasitic infection being treated. In patients treated for filarial infections, side effects may be related to the inflammatory response triggered by dying parasites (Mazzotti reaction) rather than a direct effect of the drug itself.

The following side effects have been reported with ivermectin use, organized by frequency:

Most side effects of ivermectin when used at recommended doses are mild and transient, typically resolving within a few days without specific treatment. The overall safety profile of ivermectin is well-established, with billions of doses administered globally through mass drug administration programs with a very low incidence of serious adverse events.

The Mazzotti reaction deserves special attention. This reaction occurs specifically in patients with filarial infections and is caused by the immune response to dying microfilariae rather than by ivermectin itself. Symptoms typically begin within 24 to 48 hours of treatment and may include fever, itching, rash, headache, joint pain, lymph node swelling, and in severe cases, hypotension. The severity of the Mazzotti reaction is generally proportional to the microfilarial load. For patients with scabies or strongyloidiasis (non-filarial infections), this type of reaction does not occur.

If you experience any side effects, including those not listed above, talk to your doctor or pharmacist. You can also report side effects directly to your national pharmacovigilance authority to help provide more information on the safety of this medicine.

How Should You Store Ivermectin Orifarm?

Proper storage of Ivermectin Orifarm is essential to maintain the medicine's efficacy and safety throughout its shelf life. Like all medications, ivermectin tablets can degrade if exposed to inappropriate environmental conditions, potentially rendering them less effective or producing harmful breakdown products.

Follow these storage guidelines to ensure your medication remains safe and effective:

• Temperature: Store at room temperature, below 25°C (77°F). Do not refrigerate or freeze the tablets. Avoid exposure to excessive heat, such as leaving the medication in a car on a hot day or near radiators and direct sunlight.
• Light: Keep the tablets in their original packaging to protect them from light. Ivermectin can degrade when exposed to prolonged light exposure.
• Moisture: Protect from moisture. Store in a dry place and keep the blister pack sealed until you are ready to take the tablet. Bathroom cabinets are generally not recommended for medication storage due to the humidity from bathing and showering.
• Children: Keep this medicine out of the sight and reach of children. Store in a secure location where children and pets cannot access it.
• Expiry date: Do not use Ivermectin Orifarm after the expiry date stated on the carton and blister after “EXP”. The expiry date refers to the last day of that month.

Do not dispose of medications via household waste or wastewater. Return any unused or expired medication to your pharmacist for proper disposal. This helps protect the environment and prevents accidental ingestion by others.

What Does Ivermectin Orifarm Contain?

Understanding what your medication contains is important, particularly if you have known allergies to specific pharmaceutical excipients (inactive ingredients). Each Ivermectin Orifarm 3 mg tablet contains the following:

Active substance: Ivermectin 3 mg per tablet. Ivermectin is a semisynthetic derivative of avermectin B1, produced by the soil organism Streptomyces avermitilis. It is a mixture of at least 80% of 22,23-dihydroavermectin B1a and no more than 20% of 22,23-dihydroavermectin B1b.

Other ingredients (excipients):

• Microcrystalline cellulose – A bulking agent and binder derived from plant fiber that gives the tablet its structure and aids in disintegration.
• Pregelatinized starch (maize) – A binder and disintegrant that helps the tablet break apart in the gastrointestinal tract for absorption. Patients with severe corn allergy should be aware of this ingredient, although allergic reactions to pharmaceutical-grade maize starch are exceedingly rare.
• Butylhydroxyanisole (BHA, E320) – An antioxidant that prevents degradation of ivermectin by oxidation. This excipient may rarely cause local skin reactions (e.g., contact dermatitis) or irritation to the eyes and mucous membranes in sensitized individuals.
• Citric acid monohydrate – Used as a pH adjuster to optimize the stability of the formulation.
• Magnesium stearate – A lubricant that prevents the tablet from sticking to manufacturing equipment during production.

Appearance: Ivermectin Orifarm 3 mg tablets are white to off-white, round, flat tablets with a scored line on one side. The breakline allows the tablet to be divided into two equal halves if needed, although the standard dose is based on body weight using whole tablets or multiples thereof.

The tablets are packaged in aluminum/aluminum blisters and are available in pack sizes of 1, 2, 4, 8, 12, 16, and 20 tablets, although not all pack sizes may be marketed in all countries.