Ivermectin: FDA-Approved Uses for Parasites, Scabies & Lice
Ivermectin is a Nobel Prize-winning antiparasitic medication that has transformed the treatment of tropical parasitic diseases and remains the gold-standard treatment for scabies and head lice. Here is a guide to its proven uses.
Need an Ivermectin Prescription?
Scabies and head lice can be evaluated and treated via telehealth — no office visit required.
What Is Ivermectin?
Ivermectin is a macrocyclic lactone antiparasitic derived from the bacterium Streptomyces avermitilis. It was discovered in the 1970s and has since become one of the most important medicines in global health — earning its discoverers the Nobel Prize in Physiology or Medicine in 2015.
It works by binding to glutamate-gated chloride channels found exclusively in invertebrate nerve and muscle cells (not mammalian cells), causing paralysis and death of the parasite. This selectivity is why it is safe for humans at therapeutic doses while lethal to parasites.
FDA-Approved Uses
| Indication | Form | Notes |
|---|---|---|
| Onchocerciasis (river blindness) | Oral | Single annual dose; prevents blindness from Onchocerca volvulus |
| Intestinal strongyloidiasis | Oral | Strongyloides stercoralis — two-dose course; confirm eradication with follow-up stool test |
| Head lice | Topical lotion (Sklice) | Single application; highly effective against all life stages |
| Scabies | Oral (off-label in US; widely guideline-recommended) | 200 mcg/kg single dose; often repeated in 2 weeks |
| Rosacea (skin) | Topical cream (Soolantra 1%) | FDA-approved for inflammatory rosacea papules/pustules; Demodex mite-targeting |
| Crusted (Norwegian) scabies | Oral + topical | More intensive treatment required; highly contagious; treat all contacts |
Dosage
Oral ivermectin dosing is weight-based:
- Scabies: 200 mcg/kg (0.2 mg/kg) as a single oral dose; repeat in 1–2 weeks
- Strongyloidiasis: 200 mcg/kg/day for 1–2 days
- Onchocerciasis: 150 mcg/kg once; annual dosing for disease control programs
Take ivermectin on an empty stomach with a full glass of water for best absorption. Food, especially high-fat foods, significantly increases absorption and can increase side effects.
Treating Scabies with Ivermectin
Scabies is caused by the itch mite Sarcoptes scabiei burrowing into the skin. Symptoms: intense itching (especially at night), a pimple-like rash, burrow tracks. It is highly contagious through close contact.
📋 Key points for scabies treatment
- Treat all household members and close contacts simultaneously — even if not symptomatic
- Wash all clothing, bedding, and towels in hot water; dry on high heat
- Itching can persist for 2–4 weeks after successful treatment — this does not mean treatment failed
- A second dose at 2 weeks is often recommended to kill newly hatched mites
- Permethrin 5% cream (topical) is an alternative for those who cannot take oral ivermectin
Frequently Asked Questions
Is ivermectin safe for humans?
Yes — at FDA-approved doses for appropriate indications. Ivermectin has an excellent safety record over decades of use in hundreds of millions of people worldwide. Side effects at therapeutic doses are generally mild (nausea, dizziness, rash). Serious adverse effects are rare and usually related to the die-off of large parasite burdens (Mazzotti reaction). Ivermectin intended for veterinary use (horses, livestock) should NEVER be used in humans — concentrations are very different and can be toxic.
What about ivermectin and COVID-19?
Multiple high-quality randomized controlled trials — including the large TOGETHER trial and Cochrane reviews — have found ivermectin provides no significant benefit for the prevention or treatment of COVID-19. The FDA and major health organizations do not recommend it for COVID-19. This guide focuses on its proven FDA-approved uses, where it remains a highly valuable medication.
Can I get ivermectin online for scabies?
Yes. Scabies is readily diagnosed based on symptoms and can be evaluated via telehealth. A provider can prescribe oral ivermectin and have it sent to your pharmacy. This is often faster than getting an in-person dermatology appointment. Make sure to mention all household contacts so they can be treated simultaneously.
How much does ivermectin cost without insurance?
Generic ivermectin tablets typically cost $25–$60 depending on the dose needed (weight-based) with a free Rx.com discount card. Compare prices near you at /drug/ivermectin.
Get an Ivermectin Prescription Online
Scabies and lice can be treated via telehealth. A licensed provider can send your prescription today.