- ACRONYMS AND DEFINITIONS
- CDC - Center for Disease Control and Prevention recommendation
- CTE - dosing based on clinical trial(s) and/or expert opinion
- PI - Dosing from Package Insert
- IDSA - Infectious Disease Society of America recommendation
Albendazole (Albenza®)
Dosage forms
Tablet
- 200 mg ($$ for #2)
Dosing
Pediatric
- NOTE: Albendazole is approved in children ≥ 6 years of age. In studies, it has been used in children as young as one year at doses between 10 - 15 mg/kg/day [PMID 15602190, 12915835, 9726343]
- Ascariasis - 400 mg given as a one time dose (CDC)
- Hookworms (A. duodenale, N. americanus) - 400 mg given as a one time dose (CDC)
- Hookworms, zoonotic (A. braziliense, etc.) - 400 mg once daily for 3 days (CDC)
- Neurocysticercosis - see neurocysticercosis treatment recommendations
- Pinworms (enterobiasis) - 10 - 14 mg/kg (max 400 mg) given as a one time dose. May repeat in 2 weeks. (CTE)
- Strongyloides - 400 mg twice a day for 7 days (CDC)
- Trichuriasis - 400 mg once daily for 3 days (CDC)
Adult
- Ascariasis - 400 mg given as a one time dose (CDC)
- Hookworms (A. duodenale, N. americanus) - 400 mg given as a one time dose (CDC)
- Hookworms, zoonotic (A. braziliense, etc.) - 400 mg once daily for 3 - 7 days (CDC)
- Neurocysticercosis - see neurocysticercosis treatment recommendations
- Pinworms (enterobiasis) - 400 mg given as a one time dose. May repeat in 2 weeks. (CTE)
- Strongyloides - 400 mg twice a day for 7 days (CDC)
- Trichuriasis - 400 mg once daily for 3 days (CDC)
Other
- Take with food
- Tablets may be crushed or chewed
- May cause bone marrow suppression. Monitor CBC every 2 weeks while on continuous therapy.
- May cause hepatotoxicity. Monitor LFTs every 2 weeks while on continuous therapy.
- Kidney disease - undergoes negligible kidney excretion; no dose adjustment necessary
Ivermectin | Stromectol® | Sklice® | Soolantra®
Dosage forms
Tablet (Stromectol®)
- 3 mg ($)
Lotion (Sklice®)
- 0.5% ($$$$)
Cream (Soolantra®)
- 1% ($$$$)
Dosing
Pediatric
- Ascariasis - 150 - 200 mcg/kg given as a one time dose (CDC)
- Hookworms, zoonotic (A. braziliense, etc.) - 200 mcg/kg as a single dose (CDC)
- Lice - 400 mcg/kg/dose with one dose given on Day 1 and Day 8. [based on one study in patients ≥ 2 years who weigh at least 15 kg - PMID 20220184]
- Pinworms (enterobiasis) - 200 mcg/kg given as a one time dose and repeated in 10 days [used in some studies - PMID 15344847, 18452885, 2929853]
- Scabies - 200 mcg/kg/dose given one time and then repeated in 8 - 15 days (CTE)
- Strongyloides - 200 mcg/kg given once daily for 1 - 2 days (CDC)
- Trichuriasis - 200 mcg/kg given once daily for 3 days (CDC)
Adult
- Ascariasis - 150 - 200 mcg/kg given as a one time dose (CDC)
- Hookworms, zoonotic (A. braziliense, etc.) - 200 mcg/kg as a single dose (CDC)
- Lice - 400 mcg/kg/dose with one dose given on Day 1 and Day 8. [based on one study - PMID 20220184]
- Pinworms (enterobiasis) - 200 mcg/kg given as a one time dose and repeated in 10 days [used in some studies - PMID 15344847, 18452885, 2929853]
- Scabies - 200 mcg/kg/dose given one time and then repeated in 8 - 15 days (CTE)
- Strongyloides - 200 mcg/kg given once daily for 1 - 2 days (CDC)
- Trichuriasis - 200 mcg/kg given once daily for 3 days (CDC)
Topical therapy (Sklice®)
- Lice - Apply to dry hair and scalp. Leave on for 10 minutes then rinse with water. Approved for patients ≥ 6 months. (PI)
Topical therapy (Soolantra®)
- Rosacea - Apply to affected areas of the face once daily. Use a pea-size amount for each area of the face (forehead, chin, nose, each cheek) that is affected. Spread as a thin layer, avoiding the eyes and lips. (PI)
Efficacy
COVID-19
Other
Dosing chart for 200 mcg/kg doses | |
---|---|
Body weight (kg) | Number of 3 mg tablets of ivermectin |
15 - 24 | 1 |
25 - 35 | 2 |
36 - 50 | 3 |
51 - 65 | 4 |
66 - 79 | 5 |
≥ 80 | 200 mcg/kg |
- When taken with food, absorption is increased two-fold. Manufacturer recommends drug be taken on an empty stomach. Some experts recommend taking with food since studies have shown higher doses are safe and may be more effective [1,2]
- Ivermectin tablets may be crushed and mixed with applesauce
- Kidney disease - no dose adjustment necessary
Mebendazole (Emverm®)
Dosage form
Chewable tablet
- 100 mg ($$$$)
Dosing
Pediatric (> 2 years)
- Ascariasis (roundworm) - 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)
- Hookworms (A. duodenale, N. americanus) - 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)
- Pinworms (enterobiasis) - 100 mg one time dose (PI)
- Trichuriasis (whipworm) - 100 mg twice daily for 3 days (CDC, PI)
Adult
- Ascariasis (roundworm) - 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC)
- Hookworms (A. duodenale, N. americanus) - 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)
- Pinworms (enterobiasis) - 100 mg one time dose (PI)
- Trichuriasis (whipworm) - 100 mg twice daily for 3 days (CDC, PI)
Other
- The tablet may be chewed, swallowed, or crushed and mixed with food
- If the patient is not cured three weeks after treatment, a second course of treatment is advised
Praziquantel (Biltricide®)
Dosage form
Tablet
- 600 mg ($$$$)
S
Dosing
Pediatric
- NOTE: praziquantel is approved in children ≥ 4 years of age. In studies, it has been used in children younger than 4 years at doses of 40 mg/kg [PMID 23236526]
- Neurocysticercosis - see neurocysticercosis treatment recommendations
- Taeniasis (Tapeworms) - 5 - 10 mg/kg given as a one time dose (CDC)
- Schistosomiasis (S. mansoni, S. haematobium, S. intercalatum) - 40 mg/kg/day given in 2 divided doses for 1 day (CDC)
- Schistosomiasis (S. japonicum, S. mekongi) - 60 mg/kg/day given in 3 divided doses for 1 day (CDC)
Adult
- Neurocysticercosis - see neurocysticercosis treatment recommendations
- Taeniasis (Tapeworms) - 5 - 10 mg/kg given as a one time dose (CDC)
- Schistosomiasis (S. mansoni, S. haematobium, S. intercalatum) - 40 mg/kg/day given in 2 divided doses for 1 day (CDC)
- Schistosomiasis (S. japonicum, S. mekongi) - 60 mg/kg/day given in 3 divided doses for 1 day (CDC)
Other
- Take with food
- Swallow tablets whole if able. Tablets have bitter taste.
- Praziquantel undergoes extensive CYP liver metabolism (CYP3A4, CYP1A2, CYP2C19). Strong CYP inducers and inhibitors may affect blood levels of praziquantel. Rifampin should not be taken with praziquantel.
- Kidney disease - no dose adjustment necessary
- PRICE ($) INFO
Pricing legend
- $ = 0 - $50
- $$ = $51 - $100
- $$$ = $101 - $150
- $$$$ = > $150
- Pricing based on one month of therapy at standard dosing in an adult
- Pricing based on information from GoodRX.com®
- Pricing may vary by region and availability
- BIBLIOGRAPHY
- 1 - PMID 12362927 - Pharmacokinetic study
- 2 - PMID 20181973