Ivermectin STADA: Uses, Dosage & Side Effects
A topical anti-inflammatory and anti-parasitic cream (ivermectin 10 mg/g) used to treat the inflammatory papules and pustules of rosacea in adults
Ivermectin STADA is a prescription topical cream containing ivermectin at a concentration of 10 mg/g (1%). It is indicated for the treatment of inflammatory papules and pustules associated with rosacea (papulopustular rosacea) in adults. Ivermectin is an avermectin derivative originally developed as an anti-parasitic agent, but when applied topically it exerts dual anti-inflammatory and anti-parasitic effects that address the underlying pathophysiology of rosacea. The cream is applied once daily to affected areas of the face. Ivermectin STADA is manufactured by STADA Arzneimittel AG and is a generic equivalent of the originator product Soolantra.
Quick Facts: Ivermectin STADA
Key Takeaways
- Ivermectin STADA cream (10 mg/g) is a once-daily topical treatment for inflammatory papules and pustules of rosacea in adults, working through combined anti-inflammatory and anti-parasitic mechanisms.
- Clinical trials have demonstrated that ivermectin cream significantly reduces inflammatory lesion counts, with approximately 40–50% of patients achieving clear or almost clear skin by week 12, and results continue to improve with extended use up to 52 weeks.
- The cream is applied once daily to affected facial areas after cleansing. A pea-sized amount is typically sufficient for each area (forehead, chin, nose, and each cheek). It should not be applied to the eyes, lips, or inside the mouth or nose.
- Ivermectin cream has a favorable safety profile with minimal side effects. The most commonly reported adverse reaction is a transient burning sensation at the application site, occurring in approximately 1% of patients.
- Systemic absorption from topical application is very low (steady-state Cmax approximately 2.1 ng/mL), resulting in minimal systemic side effects compared to oral ivermectin formulations used for parasitic infections.
What Is Ivermectin STADA and What Is It Used For?
Ivermectin STADA cream contains the active substance ivermectin, a semi-synthetic derivative of avermectin B1a, which was originally isolated from the soil bacterium Streptomyces avermitilis. The discovery of avermectins earned Satoshi Omura and William C. Campbell the 2015 Nobel Prize in Physiology or Medicine for their contributions to therapies against parasitic infections. While ivermectin has been used orally for decades to treat parasitic infections such as onchocerciasis (river blindness) and lymphatic filariasis, its topical formulation represents a significant advance in the treatment of papulopustular rosacea.
Rosacea is a chronic inflammatory skin condition that primarily affects the central face—the cheeks, nose, forehead, and chin. It is estimated to affect approximately 5–10% of the global population, with higher prevalence among individuals of Northern European descent and those with fair skin. Papulopustular rosacea, the subtype for which Ivermectin STADA is indicated, is characterized by persistent central facial erythema (redness) accompanied by inflammatory papules (raised red bumps) and pustules (pus-filled bumps) that can be easily mistaken for acne. Unlike acne vulgaris, however, rosacea does not involve comedones (blackheads or whiteheads), and its underlying pathophysiology is fundamentally different.
The precise causes of rosacea remain incompletely understood, but current research points to a complex interplay of factors including dysregulated innate immune responses, neurovascular dysfunction, and environmental triggers. One factor that has received considerable attention is the role of Demodex folliculorum mites—microscopic arthropods that normally inhabit human hair follicles and sebaceous glands. Studies have consistently demonstrated that individuals with rosacea harbor significantly higher densities of Demodex mites on their facial skin compared to healthy controls, with mite counts often 5 to 10 times greater. These mites and the bacteria they carry (particularly Bacillus oleronius) are thought to trigger and amplify the inflammatory cascade that characterizes papulopustular rosacea.
Dual Mechanism of Action
Ivermectin STADA exerts its therapeutic effects through two complementary mechanisms that address key components of rosacea pathophysiology:
Anti-inflammatory activity: Topical ivermectin inhibits the production of pro-inflammatory cytokines and chemokines. Specifically, it has been shown to suppress lipopolysaccharide (LPS)-induced activation of NF-κB signaling in immune cells, which reduces the release of inflammatory mediators including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-8 (IL-8). By dampening this inflammatory cascade, ivermectin reduces the redness, swelling, and discomfort associated with rosacea papules and pustules. Additionally, ivermectin may modulate cathelicidin (LL-37) processing, an antimicrobial peptide that is aberrantly overexpressed in rosacea skin and contributes to inflammation and vascular changes.
Anti-parasitic activity: Ivermectin is a potent acaricide that eliminates Demodex folliculorum mites by binding to glutamate-gated chloride channels in the mites’ nervous system. This binding causes an influx of chloride ions, leading to hyperpolarization of nerve and muscle cells, paralysis, and death of the parasites. By reducing the Demodex population on facial skin, ivermectin removes a significant trigger for inflammatory responses in susceptible individuals.
Clinical Efficacy
The efficacy of topical ivermectin 10 mg/g cream for rosacea has been established in two pivotal Phase III randomized, double-blind, vehicle-controlled clinical trials (PIVOTAL I and PIVOTAL II) involving over 1,300 patients with moderate to severe papulopustular rosacea. These studies demonstrated that ivermectin cream, applied once daily for 12 weeks, was significantly superior to vehicle (placebo) in reducing inflammatory lesion counts and achieving Investigator’s Global Assessment (IGA) scores of “clear” or “almost clear.”
At 12 weeks, approximately 38–40% of ivermectin-treated patients achieved IGA success (clear or almost clear) compared to 11–18% in the vehicle group. The mean reduction in inflammatory lesion count was approximately 75% in the ivermectin group versus 45–50% in the vehicle group. A 40-week extension study further demonstrated that the benefits of ivermectin cream continued to improve with longer use, with approximately 71% of patients achieving IGA success by week 52 of continuous treatment.
A head-to-head study comparing ivermectin cream with metronidazole 0.75% cream (a previous first-line treatment for rosacea) over 16 weeks showed that ivermectin was significantly more effective, with higher IGA success rates and greater inflammatory lesion reduction. This established ivermectin as the preferred topical treatment for papulopustular rosacea in many international guidelines.
Ivermectin STADA is a topical cream for facial rosacea and is fundamentally different from oral ivermectin tablets used for parasitic infections. The topical formulation results in very low systemic absorption (plasma levels of approximately 2 ng/mL at steady state), which is far below the concentrations needed for systemic antiparasitic effects. The two formulations are intended for entirely different conditions and should never be interchanged without medical guidance.
What Should You Know Before Using Ivermectin STADA?
Contraindications
Ivermectin STADA cream must not be used if you have a known hypersensitivity (allergy) to ivermectin or to any of the other ingredients contained in the formulation. Allergic reactions to topical ivermectin are rare but may manifest as worsening redness, hives, swelling, or difficulty breathing. If you experience any signs of an allergic reaction after applying the cream, wash it off immediately with water and contact your healthcare provider.
The cream is intended exclusively for external topical use on the facial skin. It must not be ingested, applied to the eyes or eyelids, applied to mucous membranes (inside the mouth, nostrils, or genitals), or used on open wounds, severely inflamed skin, or areas with active skin infections. If accidental contact with the eyes occurs, rinse thoroughly with clean water immediately. If eye irritation persists, seek medical attention.
Warnings and Precautions
Before starting treatment with Ivermectin STADA, discuss the following with your doctor to ensure safe and effective use:
- Liver disease: Ivermectin is metabolized primarily by the liver (via CYP3A4 enzymes). Although systemic absorption from topical application is very low, patients with severe hepatic impairment should be monitored, as reduced liver function could theoretically lead to higher plasma levels of the drug.
- Immune system disorders: If you have a weakened immune system or are taking immunosuppressive medications, inform your doctor. While topical ivermectin has minimal systemic effects, immune status may influence the skin’s response to treatment and the course of rosacea.
- Other skin conditions: If you have eczema, contact dermatitis, or other inflammatory skin conditions on the face in addition to rosacea, let your doctor know, as these conditions may be exacerbated by topical treatments or may complicate the clinical picture.
- Rosacea triggers: While Ivermectin STADA treats the inflammatory component of rosacea, it does not eliminate underlying triggers such as sun exposure, extreme temperatures, alcohol, spicy foods, stress, or hot beverages. Continuing to manage these triggers alongside medication is essential for optimal results.
- Initial worsening: Some patients may experience a temporary worsening of rosacea symptoms when beginning treatment. This can be related to the inflammatory response triggered by dying Demodex mites. This reaction is usually mild, transient, and does not require discontinuation of treatment. If symptoms are severe or persistent, consult your doctor.
Ivermectin STADA is for facial use only. Avoid getting the cream in your eyes, on your lips, inside your mouth, or inside your nostrils. If accidental contact occurs, rinse the affected area immediately with plenty of water. Do not apply to broken or irritated skin. Wash your hands thoroughly after applying the cream to avoid inadvertent transfer to the eyes or other sensitive areas.
Pregnancy and Breastfeeding
Ivermectin STADA should not be used during pregnancy unless clearly necessary and the potential benefit outweighs the potential risk to the fetus. There are limited clinical data on the use of topical ivermectin in pregnant women. Animal reproductive toxicity studies with oral ivermectin (at doses resulting in much higher systemic exposure than topical application) have shown evidence of developmental toxicity at maternally toxic doses. Although systemic absorption from topical application is very low, the precautionary principle applies. If you are pregnant or planning to become pregnant, discuss treatment options with your doctor before starting Ivermectin STADA.
Ivermectin is excreted in human breast milk following oral administration. Although the amount that would reach breast milk after topical facial application is expected to be extremely small, it is not possible to completely exclude a risk to the nursing infant. A decision should be made whether to discontinue breastfeeding or to discontinue treatment with Ivermectin STADA, taking into account the benefit of breastfeeding for the child and the benefit of treatment for the mother. Discuss this decision with your healthcare provider.
Driving and Operating Machinery
Ivermectin STADA cream has no known effect on the ability to drive or operate machinery. The medication is applied topically to the face and has very low systemic absorption, so it does not cause drowsiness, dizziness, visual disturbances, or any other effects that would impair driving or the use of machines.
Children and Adolescents
The safety and efficacy of Ivermectin STADA cream have not been established in children and adolescents under 18 years of age. Rosacea is uncommon in this age group, and the cream should not be used in patients under 18 unless specifically directed by a dermatologist who has considered the risks and benefits in the individual case.
How Does Ivermectin STADA Interact with Other Drugs?
One of the significant clinical advantages of Ivermectin STADA as a topical treatment is its minimal potential for drug interactions. After topical application of ivermectin 10 mg/g cream to the face, systemic absorption is very low. Steady-state plasma concentrations reach approximately 2.1 ng/mL after two weeks of daily application, which is far below the systemic concentrations achieved with oral ivermectin (typically 30–50 ng/mL after a standard oral dose). At these very low plasma levels, the likelihood of systemically mediated drug interactions is negligible.
No formal drug interaction studies have been conducted specifically with topical ivermectin cream. However, based on the known pharmacology of ivermectin and the very low systemic exposure from topical application, the following theoretical considerations and practical precautions should be noted:
| Interacting Drug/Class | Type | Clinical Significance | Recommendation |
|---|---|---|---|
| Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir) | Pharmacokinetic (theoretical) | May theoretically increase plasma ivermectin levels, though clinical significance is low given minimal absorption | No dosage adjustment needed. Monitor for unusual skin reactions if used concurrently with strong CYP3A4 inhibitors. |
| Topical retinoids (tretinoin, adapalene) at the same site | Physical/Pharmacodynamic | May increase skin irritation when applied to the same facial area | If both are prescribed, apply at different times of day (e.g., ivermectin in the morning, retinoid at night). Discuss with your dermatologist. |
| Topical corticosteroids at the same site | Pharmacodynamic | Long-term topical corticosteroid use can worsen rosacea (steroid rosacea). No direct interaction with ivermectin, but corticosteroid use on the face is generally discouraged in rosacea | Avoid long-term topical corticosteroids on the face if you have rosacea. Discuss alternatives with your doctor. |
| Other topical rosacea treatments (metronidazole, azelaic acid, brimonidine) | Physical | No pharmacological interaction identified. Combination therapy may be beneficial under medical supervision | Apply products at different times of day if using combination therapy. Follow your dermatologist’s instructions. |
| Oral ivermectin tablets | Additive exposure | Concurrent use would increase total ivermectin exposure, though topical contribution is minimal | Inform your doctor if you are also taking oral ivermectin for any condition. |
It is important to note that many patients with rosacea use combination topical regimens that may include ivermectin alongside other products such as azelaic acid 15% gel, metronidazole 0.75% cream, or brimonidine gel for redness control. These combinations are generally well tolerated when products are applied at different times of the day (for example, ivermectin in the morning and another treatment in the evening). Your dermatologist can advise on the optimal combination and timing for your individual treatment plan.
Always inform your healthcare provider about all medications you are currently using, including prescription drugs, over-the-counter products, herbal supplements, and other topical skincare products applied to the face. Although significant interactions with Ivermectin STADA are highly unlikely, providing a complete medication history ensures the safest possible care.
What Is the Correct Dosage of Ivermectin STADA?
Ivermectin STADA cream should be used exactly as prescribed by your doctor. The standard dosing regimen is simple and straightforward: apply the cream once daily to the affected areas of the face. Consistent daily application is important for achieving optimal therapeutic results, as the dual anti-inflammatory and anti-parasitic effects build up over time with regular use.
Adults
Standard Dosing for Adults with Papulopustular Rosacea
Frequency: Once daily
Amount: A pea-sized amount (approximately 0.5 g) for each of the five facial areas
Application areas: Forehead, chin, nose, left cheek, and right cheek
Total daily dose: Approximately 1 g of cream per application (covering the full face)
Duration: Up to 4 months per treatment course. Treatment can be repeated if papules and pustules recur
Expected response: Improvement typically begins within 4 weeks; significant results by 8–12 weeks
Application Instructions
Follow these steps for each application of Ivermectin STADA cream:
- Cleanse your face with a gentle, non-irritating cleanser appropriate for sensitive or rosacea-prone skin. Pat dry with a clean, soft towel. Do not rub the skin vigorously, as mechanical irritation can trigger rosacea flares.
- Wait until the skin is completely dry before applying the cream. Applying to damp skin may increase absorption and potentially increase the risk of irritation.
- Squeeze a pea-sized amount of cream onto your fingertip for each of the five facial areas: forehead, chin, nose, left cheek, and right cheek.
- Apply a thin, even layer of cream to each area, spreading it gently across the skin. Avoid the eyes, eyelids, lips, mouth, and inside the nostrils.
- Wash your hands thoroughly with soap and water immediately after application to prevent inadvertent transfer of the cream to the eyes or other sensitive areas.
- Allow the cream to dry before applying any other facial products such as moisturizer, sunscreen, or cosmetics.
Ivermectin STADA can be applied at any time of day, but most patients find it convenient to incorporate it into their morning or evening skincare routine. Whichever time you choose, try to apply it at approximately the same time each day for consistency.
Children
Ivermectin STADA cream is not recommended for use in children and adolescents under 18 years of age. The safety and efficacy of topical ivermectin in this population have not been established. Rosacea is uncommon in children, and if a young patient presents with rosacea-like symptoms, a pediatric dermatologist should be consulted for appropriate diagnosis and management.
Elderly
No dosage adjustment is required for elderly patients. Clinical trials included patients aged 18 to 92 years, and no significant differences in safety or efficacy were observed across age groups. The same once-daily application regimen applies regardless of age. Elderly patients with rosacea should follow the same application instructions and precautions as younger adults.
Missed Dose
If you forget to apply Ivermectin STADA cream at your usual time, apply it as soon as you remember on the same day. If you do not remember until the following day, simply skip the missed dose and continue with your regular daily application. Do not apply a double amount of cream to make up for a missed dose. Missing an occasional application is unlikely to significantly affect your treatment outcome, but consistent daily use produces the best results.
Overdose
If an excessive amount of cream is applied to the face, remove the excess by washing the area with gentle cleanser and water. Topical overdose may increase the risk of local skin irritation but is unlikely to cause systemic effects given the low level of absorption. If Ivermectin STADA cream is accidentally swallowed, seek immediate medical advice. Supportive care should be provided as appropriate. Contact your local poison control center or emergency department for guidance.
| Patient Group | Dosage | Frequency | Duration |
|---|---|---|---|
| Adults (18+ years) | Pea-sized amount per facial area (~1 g total) | Once daily | Up to 4 months; repeat as needed |
| Elderly | Same as adults – no adjustment needed | Once daily | Up to 4 months; repeat as needed |
| Hepatic impairment | Same as adults (monitor in severe impairment) | Once daily | As directed by physician |
| Children (<18 years) | Not recommended | N/A | N/A |
What Are the Side Effects of Ivermectin STADA?
Like all medicines, Ivermectin STADA cream can cause side effects, although not everyone will experience them. Compared to many other topical treatments for skin conditions, ivermectin cream has an exceptionally favorable safety profile. The low incidence of side effects is partly attributable to the minimal systemic absorption of the drug when applied topically, and partly to the intrinsic tolerability of the formulation on sensitive, rosacea-prone skin.
In clinical trials involving over 1,300 patients treated with ivermectin cream for up to 52 weeks, the overall incidence of adverse events was comparable to that seen with vehicle (placebo) cream. This indicates that many of the skin sensations patients experience may be related to the cream base itself or to the underlying rosacea rather than to the ivermectin active ingredient.
It is important to distinguish between true side effects of the medication and normal symptoms of rosacea. Rosacea itself causes facial redness, burning, stinging, and skin sensitivity, and these symptoms may fluctuate during treatment regardless of the medication used. If you are unsure whether a symptom represents a side effect or a rosacea flare, contact your healthcare provider for guidance.
Common
Affects up to 1 in 10 patients
- Burning sensation at the application site (approximately 1.2%)
Uncommon
Affects up to 1 in 100 patients
- Skin irritation at the application site
- Pruritus (itching) at the application site
- Dry skin (xerosis) at the application site
Rare
Affects fewer than 1 in 1,000 patients
- Contact dermatitis at the application site
- Skin exfoliation (peeling) at the application site
- Erythema (redness) worsening at the application site
Not Known
Frequency cannot be estimated from available data
- Allergic reactions (hypersensitivity)
- Transient worsening of rosacea (initial flare)
Initial Worsening of Rosacea
Some patients may notice a temporary flare of their rosacea symptoms during the first 1–2 weeks of treatment. This phenomenon is thought to be related to the immune response triggered by the death of Demodex mites in the skin, similar to the Mazzotti-like reaction sometimes seen with oral ivermectin treatment of parasitic infections. The initial worsening is typically mild, consisting of a transient increase in redness, papules, or a stinging sensation. This reaction usually resolves spontaneously within a few days to two weeks as treatment continues. If the worsening is severe or does not resolve, consult your doctor.
Long-Term Safety
The long-term safety of topical ivermectin cream has been evaluated in studies lasting up to 52 weeks of continuous use. No cumulative toxicity, increased side effect frequency, or new safety signals emerged during extended treatment. The cream did not cause skin thinning (atrophy), telangiectasia, or other adverse effects commonly associated with long-term use of topical corticosteroids, making it suitable for the prolonged or repeated treatment courses that the chronic nature of rosacea often requires.
Systemic side effects are not expected with topical application because the plasma concentrations achieved (approximately 2.1 ng/mL at steady state) are far below the threshold for systemic pharmacological activity. The systemic effects associated with oral ivermectin (such as dizziness, gastrointestinal symptoms, or neurological effects) have not been reported with the topical cream formulation.
Stop using Ivermectin STADA and contact your doctor or seek medical attention immediately if you experience: signs of a severe allergic reaction such as difficulty breathing, swelling of the face, lips, or throat, widespread hives, or severe rash; severe skin blistering, peeling, or open sores at the application site; or significant worsening of rosacea symptoms that does not resolve within two weeks of starting treatment.
How Should You Store Ivermectin STADA?
Proper storage of Ivermectin STADA cream is important to maintain the stability, efficacy, and safety of the medication throughout the treatment course. The cream is supplied in aluminum tubes with a polyethylene screw cap, and the following storage conditions should be observed:
- Temperature: Store at or below 30°C (86°F). Do not refrigerate or freeze the cream. Avoid storing the tube in areas exposed to excessive heat, such as in direct sunlight, near radiators or heaters, or in a vehicle during hot weather. Exposure to extreme temperatures may alter the consistency and stability of the cream.
- Keep out of reach of children: Store Ivermectin STADA in a location that is inaccessible to children. Accidental ingestion of the cream by a child could potentially cause adverse effects and should prompt immediate medical consultation.
- Expiration date: Do not use Ivermectin STADA after the expiration date (EXP) printed on the tube and outer carton. The expiration date refers to the last day of that month. Using expired medication may result in reduced efficacy.
- After opening: Once the tube has been opened, the cream should be used within 6 months. Write the date of first opening on the carton to help you track this. Discard any remaining cream after 6 months, even if the expiration date has not been reached.
- Tube care: Always replace the cap tightly after each use to prevent the cream from drying out and to maintain hygienic conditions. Do not transfer the cream to another container.
- Disposal: Do not dispose of Ivermectin STADA by flushing it down the toilet or pouring it into drains. Return unused or expired medication to a pharmacy for proper disposal. This helps protect the environment from pharmaceutical contamination.
Ivermectin STADA cream is a white to pale yellow, smooth cream. If the cream has changed color, consistency, or developed an unusual odor, do not use it. Consult your pharmacist for a replacement.
What Does Ivermectin STADA Contain?
Understanding the complete composition of Ivermectin STADA cream is important, particularly for patients with known allergies or sensitivities to specific pharmaceutical ingredients. The formulation has been carefully designed to deliver ivermectin effectively to the skin while being gentle enough for daily use on the sensitive, rosacea-prone facial skin.
Active Ingredient
The active substance is ivermectin. Each gram of cream contains 10 mg of ivermectin, equivalent to a 1% concentration (10 mg/g). Ivermectin is a semi-synthetic derivative of avermectin B1a, a macrocyclic lactone compound isolated from the fermentation products of Streptomyces avermitilis. Its molecular formula is C48H74O14 (ivermectin B1a component), and it has a molecular weight of approximately 875.1 g/mol. The compound is lipophilic, which facilitates penetration into the skin and sebaceous glands where Demodex mites reside.
Inactive Ingredients (Excipients)
| Ingredient | Function | Notes |
|---|---|---|
| Glycerol | Humectant / Moisturizer | Helps maintain skin hydration |
| Isopropyl palmitate | Emollient / Skin conditioning | Aids absorption and provides smooth texture |
| Carbomer | Thickening agent | Provides cream consistency |
| Dimethicone | Skin protectant / Emollient | Creates protective barrier; improves spreadability |
| Cetyl alcohol | Emulsifier / Thickener | May cause local skin reactions in sensitive individuals |
| Stearyl alcohol | Emulsifier / Stabilizer | May cause local skin reactions in sensitive individuals |
| Methyl parahydroxybenzoate (E218) | Preservative | May cause allergic reactions (possibly delayed) |
| Propyl parahydroxybenzoate (E216) | Preservative | May cause allergic reactions (possibly delayed) |
| Propylene glycol | Solvent / Humectant | May cause skin irritation in sensitive individuals |
| Purified water | Vehicle / Solvent | Base component of cream formulation |
Important Information About Excipients
Ivermectin STADA cream contains several inactive ingredients that may cause reactions in sensitive individuals:
- Methyl parahydroxybenzoate (E218) and propyl parahydroxybenzoate (E216): These preservatives (parabens) may cause allergic reactions, which may be delayed in onset. Patients with a known sensitivity to parabens should discuss this with their doctor before starting treatment.
- Cetyl alcohol and stearyl alcohol: These fatty alcohols may cause local skin reactions such as contact dermatitis in sensitive individuals. This is different from ethanol (drinking alcohol) and does not cause drying of the skin.
- Propylene glycol: This solvent may cause skin irritation in some patients. If you have previously experienced reactions to products containing propylene glycol, inform your healthcare provider.
Ivermectin STADA cream is available in tubes containing 15 g, 30 g, 45 g, or 60 g of cream. Not all pack sizes may be marketed in all countries. The cream is white to pale yellow in appearance with a smooth, homogeneous consistency. It is easily spread on the skin and absorbs without leaving a greasy residue, making it suitable for daytime application under cosmetics or sunscreen.
Frequently Asked Questions About Ivermectin STADA
Ivermectin STADA cream (10 mg/g) is a prescription topical medication used to treat the inflammatory papules and pustules of rosacea in adults. Rosacea is a chronic skin condition that causes redness, visible blood vessels, and bumps on the face. Ivermectin cream works through dual anti-inflammatory and anti-parasitic mechanisms—reducing inflammation while also eliminating Demodex folliculorum mites that contribute to rosacea flares.
Most patients begin to see improvement within 4 weeks of starting treatment, with significant reductions in inflammatory lesions by 8 to 12 weeks. In clinical trials, approximately 40% of patients achieved “clear” or “almost clear” skin by week 12. Results continue to improve with extended use, with up to 71% of patients achieving this level of improvement by 52 weeks. For the best results, use the cream consistently once daily as prescribed.
Yes. Apply Ivermectin STADA first to clean, dry skin and allow it to absorb and dry before applying moisturizer, sunscreen, or cosmetics. Sun protection is particularly important for rosacea patients, as UV exposure is a common trigger for flares. Use a broad-spectrum SPF 30+ sunscreen daily, ideally one formulated for sensitive skin. Choose gentle, fragrance-free skincare products and mineral-based cosmetics to minimize skin irritation.
No, they are fundamentally different products. Ivermectin STADA is a topical cream applied to the face specifically for rosacea. Oral ivermectin tablets are used systemically for parasitic infections such as river blindness and strongyloidiasis. The topical cream produces very low blood levels (approximately 2 ng/mL), far below the levels achieved with oral tablets (30–50 ng/mL). This means the topical cream has a much lower risk of systemic side effects. The two formulations are not interchangeable.
Rosacea is a chronic condition, and symptoms may recur after stopping treatment. However, many patients maintain improvement for varying periods after a treatment course. If papules and pustules return, treatment with Ivermectin STADA can be restarted. Some patients benefit from long-term maintenance therapy. Your dermatologist can develop a personalized treatment plan that may include intermittent or ongoing use of ivermectin cream alongside lifestyle modifications to manage triggers.
Ivermectin STADA and Soolantra contain the same active ingredient (ivermectin) at the same concentration (10 mg/g). Soolantra is the original branded product developed by Galderma, while Ivermectin STADA is a generic equivalent manufactured by STADA Arzneimittel AG. Generic medicines must meet the same quality, safety, and efficacy standards as the originator product to receive regulatory approval. The main difference is typically in price, with generic versions generally being more affordable.
References
- European Medicines Agency (EMA). Ivermectin 10 mg/g cream – Summary of Product Characteristics. Last updated 2025. Available from: www.ema.europa.eu
- Stein Gold L, Kircik L, Fowler J, et al. Efficacy and safety of ivermectin 1% cream in treatment of papulopustular rosacea: results of two randomized, double-blind, vehicle-controlled pivotal studies. Journal of Drugs in Dermatology. 2014;13(3):316–323.
- Taieb A, Ortonne JP, Ruzicka T, et al. Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. British Journal of Dermatology. 2015;172(4):1103–1110.
- Schaller M, Gonser L, Röhrl J, et al. Ivermectin cream 1% in papulopustular rosacea: a randomized, double-blind, vehicle-controlled, long-term extension study. Journal of the European Academy of Dermatology and Venereology. 2017;31(10):1706–1714.
- van Zuuren EJ, Fedorowicz Z, Carter B, et al. Interventions for rosacea. Cochrane Database of Systematic Reviews. 2015;(4):CD003262.
- Two AM, Wu W, Gallo RL, et al. Rosacea: Part I. Introduction, categorization, histology, pathogenesis, and risk factors. Journal of the American Academy of Dermatology. 2015;72(5):749–758.
- Forton FMN, De Maertelaer V. Two consecutive standardized skin surface biopsies: an improved sampling method to evaluate Demodex density as a diagnostic tool for rosacea and demodicosis. Acta Dermato-Venereologica. 2017;97(2):242–248.
- U.S. Food and Drug Administration (FDA). Soolantra (ivermectin) cream 1% – Prescribing Information. Last revised 2024. Available from: www.accessdata.fda.gov
- Schaller M, Almeida LMC, Engel D, et al. Recommendations for rosacea diagnosis, classification, and management: update from the global ROSacea COnsensus (ROSCO) panel 2023. British Journal of Dermatology. 2024;190(1):14–26.
- National Rosacea Society. Rosacea treatment and management: a comprehensive review. Updated 2024. Available from: www.rosacea.org
Medical Editorial Team
This article was written and reviewed by the iMedic Medical Editorial Team, specialists in dermatology and clinical pharmacology.
Conflict of Interest: The iMedic editorial team has no financial relationships with pharmaceutical companies. All content is independently produced with no commercial funding or advertising influence.