On Ivermectin

Q: Ivermectin is derived from soil mold?

A) True

B) False

Answer: A

Ivermectin gained a lot of (in)famous popularity during COVID-19 due to some reports of its efficacy against the corona virus, though unable to produce any substantial evidence. It is a semisynthetic derivative of avermectin derived from the soil mold named Streptomyces avermitilis. For a clinician at the bedside, two important lessons are:

1. Due to its lipophilic nature, it should be prescribed by actual body weight.

2. Ivermectin is contraindicated in pregnant or lactating women.

Its mechanism of action (MOA) is opening glutamate-sensitive chloride channel currents in helminths.

In obese patients, it may stay in the system longer and result in a longer half-life.

Ivermectin is the first line of treatment in onchocerciasis, and strongyloidiasis. However, it has been utilized against wuchereria bancrofti, Brugia malayi, Loa loa, ascariasis, trichuriasis, enterobiasis, cutaneous larva migrans and Mansonella ozzardi. There is also some evidence of its effectiveness in scabies and lice infestations.

#pharmacology

References:

1. Fox LM. Ivermectin: uses and impact 20 years on. Curr Opin Infect Dis 2006; 19:588.

2. Naquira C, Jimenez G, Guerra JG, et al. Ivermectin for human strongyloidiasis and other intestinal helminths. Am J Trop Med Hyg 1989; 40:304.