Ivermectin is an antiparasitic medication. After its discovery in 1975, its first uses were in veterinary medicine to prevent and treat heartworm and acariasis. Approved for human use in 1987, it is used to treat infestations including head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis and lymphatic filariasis. It interferes with the nerves and muscles of parasites, leading to paralysis. It can be taken by mouth, or applied to the skin for external infestations. It belongs to the avermectin family of medications. William Campbell and Satoshi Ōmura were awarded the 2015 Nobel Prize in Physiology or Medicine for its discovery and applications. It is on the World Health Organization's List of Essential Medicines. and is approved by the US Food and Drug Administration (FDA) as an antiparasitic agent. In 2023, it was the 295th most commonly prescribed medication in the United States, with more than 400,000 prescriptions. It is available as a generic medicine. Ivermectin is available in a fixed-dose combination with albendazole. Misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19. Such claims are not backed by credible scientific evidence. Multiple major health organizations, including the US Food and Drug Administration, the US Centers for Disease Control and Prevention, the European Medicines Agency, and the World Health Organization advise against the use of ivermectin for the treatment of COVID-19. Following the MV Hondius hantavirus outbreak, misinformation was spread that ivermectin was an effective treatment of hantavirus.
Medical uses Ivermectin is used to treat human diseases caused by roundworms and a wide variety of external parasites.
Worm infections For river blindness (onchocerciasis) and lymphatic filariasis, ivermectin is typically given as part of mass drug administration campaigns that distribute the drug to all members of a community affected by the disease. Adult worms survive in the skin and eventually recover to produce larval worms again; to keep the worms at bay, ivermectin is given at least once per year for the 10–15-year lifespan of the adult worms. The World Health Organization (WHO) considers ivermectin the drug of choice for strongyloidiasis. Ivermectin is also the primary treatment for Mansonella ozzardi and cutaneous larva migrans. The US Centers for Disease Control and Prevention (CDC) recommends ivermectin, albendazole, or mebendazole as treatments for ascariasis. Ivermectin is sometimes added to albendazole or mebendazole for whipworm treatment, and is considered a second-line treatment for gnathostomiasis. When co-administered, ivermectin and albendazole act in synergy. Ivermectin targets the parasite's nervous and muscular systems, causing paralysis, while albendazole disrupts the parasite's metabolism and energy production. This dual approach immobilizes and kills the parasite and improves the treatment's effectiveness. In January 2025, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive scientific opinion for ivermectin/albendazole for the treatment of infections caused by several types of worm parasites including lymphatic filariasis, a neglected tropical disease. Ivermectin/albendazole is indicated for use in people aged five years of age or older, for the treatment of soil-transmitted helminth infections, caused by different types of intestinal parasitic worms, which are spread through soil contaminated by human feces in areas with poor sanitation. Among the worms responsible for these diseases are hookworms (Ancylostoma duodenale, Necator americanus), roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura) and a roundworm called Strongyloides stercoralis. Ivermectin/albendazole is also indicated for the treatment of microfilaraemia (the presence of worm larvae in the blood) in people with lymphatic filariasis. Lymphatic filariasis is a neglected tropical disease commonly known as elephantiasis, which impairs the lymphatic system and can lead to the abnormal enlargement of body parts, causing pain, severe disability and social stigma. Ivermectin/albendazole is indicated for the treatment of cases of lymphatic filariasis caused by Wuchereria bancrofti, a parasite which is responsible for 90% of cases worldwide.
Mites and insects Ivermectin is also used to treat infection with parasitic arthropods. Scabies – infestation with the mite Sarcoptes scabiei – is most commonly treated with topical permethrin or oral ivermectin. A single application of permethrin is more efficacious than a single treatment of ivermectin. For most scabies cases, ivermectin is used in a two-dose regimen: the first dose kills the active mites, but not their eggs. Over the next week, the eggs hatch, and a second dose kills the newly hatched mites. The two-dose regimen of ivermectin has similar efficacy to the single dose permethrin treatment. Ivermectin is, however, more effective than permethrin when used in the mass treatment of endemic scabies. Similarly, oral ivermectin is increasingly used to control scabies outbreaks in semi-closed institutions (care homes, refugee camps, prisons etc.), where mass topical treatments often fail for logistical reasons. For severe "crusted scabies", where the parasite burden is orders of magnitude higher than usual, the CDC recommends up to seven doses of ivermectin over the course of a month, along with a topical antiparasitic. Both head lice and pubic lice can be treated with oral ivermectin, an ivermectin lotion applied directly to the affected area, or various other insecticides. Ivermectin is also used to treat rosacea and blepharitis, both of which can be caused or exacerbated by Demodex folliculorum mites.
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