Ivermectin: For Humans, What It Treats and Tablets

How many 3 mg tablets the strongyloides table lists

The U.S. strongyloidiasis table turns about 200 mcg per kg into 3 mg tablets. Fifteen to 24 kg is one tablet. Twenty-five to 35 kg is two. Thirty-six to 50 kg is three. Fifty-one to 65 kg is four. Sixty-six to 79 kg is five. At 80 kg and over the row is not a tablet number. It says calculate 200 mcg/kg.

A 70 kg adult sits in the five-tablet band. That is 15 mg, about 214 mcg/kg, close to the 200 mcg/kg target. The table starts at 15 kg.

The 150 mcg/kg count is a different table

Onchocerciasis uses about 150 mcg per kg, not the 200 mcg/kg strongyloides rows. One tablet at 15-25 kg. Two at 26-44 kg. Three at 45-64 kg. Four at 65-84 kg. At 85 kg and over, calculate 150 mcg/kg.

The kilogram bands do not match. A 70 kg person is five tablets for strongyloidiasis and four tablets for river blindness.

Mass programs often repeat at 12 months. For one patient, retreatment may be considered as soon as 3 months. The adult worm is not killed. The dose cuts microfilariae.

What a Stromectol tablet looks like

Stromectol 3 mg is a white, round, flat, bevel-edged tablet. One face is coded MSD. The other is 32. Drugs.com lists the imprint as 32 MSD, 6 mm, no score. The U.S. carton is 20 tablets in two foil strips of 10.

Generic ivermectin 3 mg tablets are the same milligram. They will not all carry MSD 32. The Ajanta Pharma USA insert revised April 2026 describes a white to off-white round tablet debossed IV on one side and plain on the other, NDC 27241-293-73, twenty tablets in two foil strips, labelled Rx Only.

Empty stomach with water

Take the tablets on an empty stomach with water. Both labelled U.S. infections use that same instruction.

A 30 mg dose after a high-fat meal (48.6 g of fat) raised bioavailability about 2.5-fold versus 30 mg fasted. That meal study is not an instruction to take the labelled 3 mg count with dinner.

Peak and half-life after a fasting 12 mg dose

After single 12 mg doses in fasting healthy volunteers (a mean 165 mcg/kg), mean peak plasma of the major component sat at about 4 hours: 46.6 ng/mL in one study and 30.6 ng/mL in the other. Plasma half-life is about 18 hours. Less than 1% of the dose leaves in urine.

What the U.S. tablet is labelled to treat

Ivermectin is indicated for intestinal, nondisseminated strongyloidiasis due to Strongyloides stercoralis, and for onchocerciasis due to Onchocerca volvulus.

Cure in the strongyloides trials meant no larvae on at least two stool exams 3 to 4 weeks later. A single 170-200 mcg/kg dose cured 24 of 26 (92%) against albendazole 200 mg twice daily for 3 days in 12 of 22 (55%) in one international study, and 126 of 152 (83%) against 67 of 149 (45%) in a WHO study.

It has no activity against adult Onchocerca. After 150 mcg/kg in one placebo-controlled adult study, skin microfilariae fell 83.2% at day 3 and 99.5% at 3 months. A drop over 90% held to 12 months.

The only contraindication is hypersensitivity to a component of the product.

Scabies is not on the U.S. tablet label

Oral ivermectin is not FDA-approved for scabies. Mayo Clinic still names a pill when prescription creams fail, and for crusted scabies or a weak immune system. They hold it in pregnancy, breastfeeding, and under 15 kg (33 pounds).

CDC clinical care, if oral ivermectin is used for classic scabies, is two doses of 200 µg/kg, 7 to 14 days apart, taken with food. That food line disagrees with the empty-stomach labelled dose. Permethrin 5% cream is FDA-approved for people 2 months and older.

For crusted scabies CDC gives the oral drug with a topical. There is no consensus on how many oral doses. Some experts use three, five, or seven, depending on severity.

Horse paste is not a 3 mg tablet

Horse ivermectin paste 1.87% is labelled for oral use in horses only. Animal DailyMed rows say not for use in humans. Do not use it in horses intended for human consumption.

FDA consumer text: animal products are concentrated for large animals, and the inactive ingredients are not evaluated the same way as a human tablet. After accidental veterinary exposure the Stromectol overdose list includes rash, edema, headache, dizziness, nausea, vomiting, and diarrhea. Seizure, ataxia, and dyspnea have also been reported.

Do not convert a paste syringe into human 3 mg tablets.

The human 3 mg tablet is Rx on the carton

Stromectol and generic ivermectin 3 mg tablets are labelled HUMAN PRESCRIPTION DRUG. The carton says Rx only. That is the federal row.

Pharmacy Times, writing 10 July 2025, named four states with laws that let a human ivermectin product be sold without the usual prescription path: Tennessee (2022), Arkansas and Idaho (2025), and Louisiana (2025, standing order plus a screening tool). Later statutes sit on the same leftover. Texas HB 25 took effect 4 December 2025: a pharmacist may dispense without a patient-specific prescription under written Texas State Board of Pharmacy protocols. Iowa HF 2676 added Iowa Code §126.24; the governor signed it 20 May 2026 and the legislature lists an effective date of 1 July 2026. A pharmacist or pharmacy may distribute ivermectin for human consumption as an over-the-counter medicine. Missouri SB 878 was approved 13 July 2026 and takes effect 28 August 2026. A pharmacist may dispense ivermectin without a prescription under Board of Pharmacy warning-label and protocol rules. The Missouri senate digest says that fill stays behind the counter, not on a self-service shelf.

Those statutes do not rewrite the FDA carton. A feed-store tube is still an animal drug. A human 3 mg count still starts from kilograms.

Louisiana Department of Health issued a standing order on 29 April 2026. A licensed pharmacist may dispense a maximum of 25 tablets to an adult after the screening tool. The attached patient sheet tells the person to take the tablets on an empty stomach with water once daily for five days, with a pound-band count (2 tablets at 55-77 lb, up to 5 tablets at 144 lb and above). That five-day sheet is a state standing-order leftover. The FDA strongyloides table is still a single 200 mcg/kg count.

Where a human 3 mg tablet is filled

A human ivermectin 3 mg tablet is filled at a pharmacy licensed in the state. In the states without their own statute, that fill starts from a prescription written by a clinician licensed there. Ivermectin Report's "near me" walkthrough, retrieved 6 October 2026, says almost any retail pharmacy - chain, grocery, big-box, or independent - can order the tablet once a prescriber writes for it, and that same-day pickup often fails because the bottle is a slow mover and has to be special-ordered.

Call the pharmacy first and ask whether the 3 mg human tablet is on the shelf or on a one- or two-day order. Participation under a standing order or collaborative-practice statute is voluntary in practice. A compounding shop that offers a 24 mg capsule is making a different product than the labelled Stromectol 3 mg carton.

A farm-and-pet aisle that stocks animal dewormer is selling an animal drug. That aisle does not fill the human 3 mg count.

What FDA checks on an online ivermectin buy

FDA's consumer page "How to Buy Medicines Safely From an Online Pharmacy," current as of 2 January 2025, says many sites claim to sell prescription drugs cheaply without a prescription, and that those sites often ship unapproved, counterfeit, or otherwise unsafe medicine outside licensed-pharmacy safeguards. For a human ivermectin tablet bought on the internet, the same BeSafeRx checks apply.

A safe online pharmacy, on that page, always requires a doctor's prescription, gives a physical U.S. address and telephone number, keeps a licensed pharmacist on staff, and is licensed by a state board of pharmacy. FDA tells the buyer to look the pharmacy up in the state-board license database from the BeSafeRx locator. If the pharmacy is not listed, do not use it. A safe pharmacy is licensed in the state where it operates and in the state where the order is going, if those states differ.

Warning signs on the same page: no prescription required; no U.S. license; no pharmacist to call; tablets that look different from the usual pharmacy fill; packaging that is broken, in a foreign language, or missing an expiration date; prices that seem too good to be true. FDA has no regulatory oversight of prescription medicines that sit outside the legitimate U.S. supply chain and cannot guarantee those products.

A site that ships horse paste, or a 24 mg compounded capsule sold as if it were the Stromectol carton, is not the labelled 3 mg tablet.

Cash prices listed for 3 mg tablets

Coupon boards retrieved 6 October 2026 do not agree on one cash number for generic ivermectin 3 mg. GoodRx listed 10 tablets at a $36.45 retail average and a $23.76 coupon price, and 20 tablets at $69.68 retail and $32.26 with a coupon. SingleCare listed an average cash price of $157.58 for 20 tablets of 3 mg and a $27.35 coupon price. Drugs.com's price guide listed 20 tablets from $77.37. Rx.com listed 20 tablets at $66.10 retail and $57.43 with its coupon for ZIP 77433.

Those are coupon-board prints for a date, not a pharmacy's own sticker and not a promise that any one store will match them. Brand Stromectol is a separate ticket from the generic 3 mg row. Insurance copays sit on a different line than cash.

Ivermectin cream is not the 3 mg tablet

Soolantra is ivermectin 1% cream for inflammatory lesions of rosacea. Each gram holds 10 mg of ivermectin. Apply a pea-size amount to each affected area of the face once daily. It is not for the mouth, the eye, or the vagina. Mayo Clinic lists that cream as prescription.

Sklice is ivermectin 0.5% lotion for head lice. Mayo Clinic lists that lotion as OTC. One application on dry hair and scalp, left 10 minutes, then rinsed. It is not a 200 mcg/kg tablet count.

The 3 mg oral tablet is a different product with two labelled worms. Do not treat a rosacea tube as Stromectol.

COVID-19 is not a labelled use

FDA has not authorized or approved ivermectin to prevent or treat COVID-19. The current FDA consumer page says the available clinical-trial data do not show it is effective against COVID-19 in humans.

IDSA recommends against it in outpatients (strong recommendation, moderate certainty) and suggests against it in hospital. The Stromectol indications are two parasites, not a virus.

Cancer is not on the tablet label

The American Cancer Society says ivermectin is not approved to treat any cancer in people or in animals, and no clinical guideline recommends it as a cancer treatment. Claims that it "kills" cancer cells sit on early animal work and petri-dish studies. ACS says those findings are not enough to know whether it could work as an anticancer drug in people, and that it has not gone through the clinical trials needed to show it is safe for that use.

ASCO's clinical notice tells oncologists the same leftover: do not use it to treat cancer, or as an add-on to established cancer therapy, outside a well-designed clinical trial. The notice says there is no robust peer-reviewed clinical evidence that it is safe or effective for any human malignancy, and that doses high enough to copy the lab effect would likely sit above established safety limits. Fenbendazole, which often travels with the same search, is a veterinary drug and has not been approved for use in humans.

One in-progress human study is NCT05318469 at Cedars-Sinai: ivermectin with balstilimab or pembrolizumab in metastatic triple-negative breast cancer. Yuan and colleagues reported the first nine patients at the 2025 ASCO annual meeting (J Clin Oncol 2025;43:16s, abstr e13146). Ivermectin was given by mouth at 30, 45, or 60 mg on days 1-3, 8-10, and 15-17 of a 21-day cycle, with balstilimab 450 mg IV on day 1. Of eight evaluable patients, one had a partial response, one had stable disease, and six had progressive disease. Median progression-free survival was 2.5 months. Those milligram totals are a trial schedule, not the labelled 200 mcg/kg worm table.

Loa loa screening before a river-blindness dose

People with onchocerciasis who also carry a heavy Loa loa load can develop a serious or fatal encephalopathy after a microfilaricide, rarely after ivermectin. After significant exposure to Loa loa-endemic West or Central Africa, assess for loiasis before the dose and follow the person closely afterward.

Reported signs include neck or back pain, red eye, conjunctival hemorrhage, dyspnea, incontinence, trouble standing or walking, confusion, seizures, and coma.

Neurotoxicity, including drowsiness, stupor, coma, and death, has also been reported without onchocerciasis and without Loa loa.

What shows up after a human strongyloides dose

In four trials, 109 people took one or two doses of 170 to 200 mcg/kg. Reactions called related to the tablet: dizziness 2.8%, itch 2.8%, diarrhea 1.8%, nausea 1.8%. Fatigue, abdominal pain, anorexia, constipation, vomiting, somnolence, vertigo, tremor, rash, and hives each sat at 0.9%.

Mazzotti-type and eye reactions from onchocerciasis are not expected on a strongyloides course. After the drug was registered, later reports added orthostatic hypotension, seizures, hepatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and neurotoxicity, including confusion, coma, and death.

Mazzotti reactions after onchocerciasis

Onchocerciasis treatment can bring Mazzotti reactions from dying microfilariae: itch, rash, lymph-node swelling, fever, joint pain. In 963 adults given 100 to 200 mcg/kg, pruritus 27.5%, skin involvement 22.7%, and fever 22.6% worsened in the first 4 days.

Mild cases have been treated with antihistamines or aspirin. Postural hypotension has been treated with oral fluids, lying down, IV saline, or parenteral steroids. Those treatments were not from controlled trials.

Mazzotti-type reactions are not expected when the infection is strongyloidiasis.

Stool checks after strongyloidiasis

The patient line after strongyloidiasis is repeated stool exams to document clearance. In a France study with no chance of reinfection, larvae came back as late as 106 days. At least three stool exams over the three months after treatment. Use a concentration method such as Baermann, because larvae per gram can be very low.

If larvae return, retreatment is indicated. In immunocompromised patients, including people with HIV, repeats at 2-week intervals may be needed and cure may not be achievable. Monthly suppression is mentioned.

Updated: 7 October 2026, 16:40:59 UTC