Ivermectin for scabies

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In the United States, treating scabies with ivermectin is considered an unlabeled use of the medicine.

Ivermectin is a prescription medicine taken as a pill to kill scabies mites and their eggs.

Doctors may prescribe ivermectin to treat a scabies infestation in certain situations.¹

• People who have a severe or resistant form of scabies infestation, such as crusted (Norwegian) scabies, may be prescribed ivermectin in combination with medicine applied to the skin, such as permethrin. It can be especially helpful for treating HIV-infected people who have scabies.
• A pill form of medicine may be preferred for some people who are unlikely to use topical medicated creams or lotions properly. For example, ivermectin may be the best medicine choice for people with conditions that affect intelligence, such as some people with Down syndrome.
• Ivermectin may help get rid of or prevent scabies for people in group living situations, such as those who live in nursing homes.

Ivermectin is usually not used for children younger than 5 or for pregnant women, because its safety in these people is not known.²

Ivermectin is effective for treating scabies.^{3, 4} One dose may be all that is needed, although sometimes a second dose is given a week or two later.²

Limited data suggests that ivermectin treatment is safe for adults and children who weigh more than 33 lb (15 kg).

Mild side effects may include:

• Stomach upset.
• Vomiting.
• Increase in rash and itching during the first 3 days of treatment.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Ivermectin is getting more attention in the medical community as a treatment option for scabies. But more testing is needed to confirm its safety and to identify the people who would benefit most from it.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Mathieu ME, Wilson BB (2005). Scabies. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practices of Infectious Diseases, 6th ed., chap. 292, pp. 3304–3307. Philadelphia: Elsevier Churchill Livingstone.

2. Stone SP, et al. (2008). Scabies, other mites, and pediculosis. In K Wolff et al., eds., Fitzpatrick's Dermatology in General Medicine, 7th ed., vol. 2, pp. 2029–2037. New York: McGraw-Hill Medical.

3. Johnstone P, Strong M (2008). Scabies, search date October 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

4. Strong M, Johnstone PW (2007). Interventions for treating scabies. Cochrane Database of Systematic Reviews (3).