Ivermectin for scabies

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Ivermectin is a prescription medication taken as a pill to kill scabies mites and their eggs. However, in the United States, treating scabies with ivermectin is considered an unlabeled use of the medication.

The role of using ivermectin to treat scabies remains unclear. More study is needed to determine this medication's effectiveness and guidelines for the amount that should be given.¹

However, doctors may prescribe ivermectin to treat a scabies infestation in certain situations.²

• People who have a severe or resistant form of scabies infestation, such as crusted (Norwegian) scabies, may be prescribed ivermectin in combination with medication applied to the skin, such as permethrin. It can be particularly helpful for treating HIV-infected people who have scabies.
• A pill form of medication may be preferred for some people who are unlikely to use topical medicated creams or lotions properly. For example, ivermectin may be the best medication 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.

A medication to treat a scabies infestation is successful when it kills all scabies mites and eggs. More research is needed to find out how effectively ivermectin kills scabies, the amount that should be given, and in which cases it would be the preferred treatment.^{2, 1}

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. However, 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. Stone SP (2003). Scabies and pediculosis. In IM Freedberg et al., eds., Fitzpatrick's Dermatology in General Medicine, 6th ed., vol. 2, chap. 238, pp. 2283–2289. New York: McGraw-Hill.

2. 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.