Ivermectin Dosage Guide for Humans (2025)
In this Article: Overview of Ivermectin Dosage | Ivermectin Dosage for Adults | Ivermectin Dosage for Children | Ivermectin dosage restrictions | How to take ivermectin | Ivermectin dosage FAQs
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Specifically, ivermectin oral tablet is approved by the Food and Drug Administration (FDA) to treat the following conditions in adults and certain children:
This article describes the dosages of ivermectin oral tablets, as well as the medication’s strength and how to take it.
Drug strengths in the table are in micrograms (mcg). One mcg equals 0.001 milligram (mg). Body weight is measured in kilograms (kg). One kg equals about 2.2 pounds (lb).
It is not uncommon for individuals with onchocerciasis to have a co-infection with the eye worm Loa loa. Of note, ivermectin should not be used for the treatment of onchocerciasis in these individuals due to serious side effects, as there is a risk of fatal encephalopathy from ivermectin facilitating the entry of the Loa loa parasite into the nervous system.
Additionally, certain drugs used in the treatment of filariasis may cause a severe and potentially life-threatening systemic reaction known as the Mazzotti reaction. The use of ivermectin for onchocerciasis may result in individuals experiencing these adverse effects.
In treating onchocerciasis in adults, oral ivermectin is administered as a single 0.15 mg/kg dose meant to be taken on an empty stomach. For resistant disease, this treatment may be repeated after three months.
Scabies is spread by prolonged, direct contact with another person who has scabies. Infestations are common in crowded institutes such as prisons and nursing homes. Ivermectin's efficacy in treating scabies is due to its ability to attack the mite’s nervous system, resulting in the mite's death.
For non-crusted scabies in adults, ivermectin is given in a single dose of 0.2 mg/kg with food. If symptoms persist, this treatment may be repeated in two weeks.
For crusted scabies in adults, ivermectin is given as a 0.2 mg/kg dose on days 1, 2, and 8, with doses on days 9 and 15 sometimes added. It is to be taken WITH food and used along with a topical scabicide. This course may continue to days 22 and 29 for extremely severe cases.
(CDC). Infestations are caused by the bloodsucking parasite Pediculus
humanus on the head and Pediculus pubis (also known as Phthiriasis pubis) in
the pubic region. This parasitic insect pierces human skin and feeds on
human blood. Unlike body lice, these live, breed, lay eggs, and eat while
holding onto the hair shaft. Both are transmitted through contact.
In most adult cases of head lice, topical ivermectin 0.5% lotion can be applied to the head and scalp and left on for 10 minutes. Ivermectin interferes with lice's muscle and nerve functions, paralyzing and then killing them.
In adult cases of refractory head or pubic lice, it can be dosed in tablet form, 0.2 mg/kg of body weight every 10 days for 2 doses for refractory head lice and 0.2 mg/kg of body weight every 1 to 2 weeks for 2 doses for refractory pubic lice.
The safety of ivermectin, as well as its efficacy in the treatment of rosacea,
were analyzed in two randomized, double-blind, vehicle-controlled clinical
trials. Negative side effects were reported in less than 1% of patients and
included skin burning and skin irritation. The exact mechanism of action for
ivermectin in the treatment of rosacea is unknown. However,
some studies
suggest that ivermectin exerts significant anti-inflammatory properties and
effectively suppresses several pro-inflammatory cytokines.
For the treatment of rosacea in adults, ivermectin 1% cream is applied to the affected areas once a day before bedtime.
Ivermectin is contraindicated and not to be used in the setting of prior hypersensitivity allergic reactions to the drug. In addition, it should not be used in individuals with loisasis co-infection.
The effects of ivermectin work relatively quickly. For treatment of strongyloidiasis and onchocerciasis, ivermectin is typically taken in a fasted state as it is lipophilic (“fat-loving”), demonstrating a 2.5-fold increase in bioavailability when taken with a fatty meal. Conversely, for this reason, it is typically taken with food to treat scabies and lice to increase the penetration of the drug into the epidermis.
How long does ivermectin stay in your system?
The half-life of ivermectin in humans is about 18 hours in adults, and the metabolites continue to be excreted in feces for 12 days.
What happens if I miss a dose of ivermectin?
Typically, ivermectin is only dosed once. However, it may need to be administered multiple times in severe cases of parasites. Missing one of these doses could result in parasitic resistance to the medication or failure to reduce the parasitic load adequately.
What interacts with ivermectin?
Generally, ivermectin is an extremely safe and well-tolerated medication. There is some evidence of negative drug interactions when administered with warfarin, as the combination may result in an increased risk of bleeding in some individuals. Getting the medical advice of the healthcare provider is particularly important in this circumstance.
Is it safe to take ivermectin during pregnancy?
Animal studies have shown that ivermectin is teratogenic in very high doses. While there are no adequate and well-controlled trials in pregnant women, the drug's label states that it should not be used during pregnancy.
Ivermectin is excreted in human breast milk in low concentrations. Treatment in breastfeeding mothers should only be considered when the risk of delaying the treatment of the mother is greater than the risk of harm to the newborn.
Sources and References:
- a parasitic infection in the intestinal tract called strongyloidiasis
- a parasitic infection of the eyes and skin called onchocerciasis (River Blindness)
This article describes the dosages of ivermectin oral tablets, as well as the medication’s strength and how to take it.
Overview of ivermectin dosage
The following table highlights the basics of ivermectin oral tablets’ doses. Doses depend on the type of parasitic infection you have and how much you weigh.Drug strengths in the table are in micrograms (mcg). One mcg equals 0.001 milligram (mg). Body weight is measured in kilograms (kg). One kg equals about 2.2 pounds (lb).
| Indication | Standard dosage |
| Strongyloidiasis | 0.2 mg/kg in tablet form for a single dose |
| Onchocerciasis | 0.15 mg/kg in tablet form for a single dose |
| Scabies, non-crusted (off-label) | 0.2 mg/kg in tablet form every 2 weeks for 2 doses |
| Scabies, crusted (off-label) | 0.2 mg/kg in tablet form on days 1, 2, 8, 9, and 15 |
| Pediculosis capitis (oral therapy off-label) | 0.2 mg/kg in tablet form every 10 days for 2 doses, OR 0.5% lotion applied once for 10 minutes, then rinsed off |
| Pediculosis pubis (off-label) | 0.2 mg/kg in tablet form every 1 to 2 weeks for two doses |
| Rosacea inflammatory lesions | 1% cream applied once daily to the affected area |
Be sure to take the dosage your doctor prescribes for you. They’ll determine
the best dosage to fit your needs. In some cases, doctors may adjust your
dosage from those shown above.
Depending on the condition it’s being used to treat, ivermectin oral tablet may be prescribed as a single dose. But in some cases, repeat doses may be needed.
Depending on the condition it’s being used to treat, ivermectin oral tablet may be prescribed as a single dose. But in some cases, repeat doses may be needed.
Ivermectin forms and strengths
Ivermectin is available in the following forms and strengths:Ivermectin dosage for adults
Ivermectin has been approved by the Food and Drug Administration (FDA) for the oral treatment of intestinal parasites in the Strongyloides family and nematode parasites of the Onchocera family, as well as topical treatment of head lice and inflammatory pustules in rosacea. Without an FDA indication, oral ivermectin has also been useful for treating other intestinal parasites, scabies, and scalp and pubic lice in individuals who have failed or are not candidates for other treatments. Adult dosing varies by indication.
It is important to receive correct and timely treatment for strongyloidiasis as recurrent autoinfection may contribute to a more difficult-to-treat hyperinfection syndrome and dissemination of the worms throughout the entire body. Hyperinfection and dissemination can be extremely fatal, with a mortality rate close to 90%, and are more likely to occur in individuals receiving high-dose corticosteroids. For parasitic worms, ivermectin works by paralyzing the worms by blocking chloride channels in nerve and muscle cell membranes. For the treatment of strongyloidiasis in adults, oral ivermectin is administered as a single 0.2 mg/kg dose meant to be taken on an empty stomach.
Ivermectin dosage for strongyloidiasis
Strongyloidiasis is a condition that occurs from infection with the parasitic roundworm Strongyloides stercoralis. Parasitic larvae in contaminated soil penetrate human skin, migrate to the lungs via the bloodstream, and then climb up the airways to be swallowed down into the small intestines. There, the larvae mature into adult female worms, which lay eggs while embedded in the intestinal submucosa. Once these eggs hatch, new larvae can either be passed in the stool or can cause autoinfection by penetrating the intestines or anus.It is important to receive correct and timely treatment for strongyloidiasis as recurrent autoinfection may contribute to a more difficult-to-treat hyperinfection syndrome and dissemination of the worms throughout the entire body. Hyperinfection and dissemination can be extremely fatal, with a mortality rate close to 90%, and are more likely to occur in individuals receiving high-dose corticosteroids. For parasitic worms, ivermectin works by paralyzing the worms by blocking chloride channels in nerve and muscle cell membranes. For the treatment of strongyloidiasis in adults, oral ivermectin is administered as a single 0.2 mg/kg dose meant to be taken on an empty stomach.
Ivermectin dosage for onchocerciasis (River Blindness)
Onchocerciasis is more commonly known as river blindness. It is a parasitic disease caused by the filarial worm Onchocerca volvulus. Repeated bites with infected blackflies transmit this worm from human to human. Once in the blood, these worms migrate to the skin, eyes, and lymphatic system, causing severe itching, disfiguring subcutaneous skin nodules, visual impairment including permanent blindness, and swollen lymph nodes. Ivermectin is the treatment of choice for onchocerciasis and could prevent blindness and reduce the occurrence and severity of skin symptoms when administered early.It is not uncommon for individuals with onchocerciasis to have a co-infection with the eye worm Loa loa. Of note, ivermectin should not be used for the treatment of onchocerciasis in these individuals due to serious side effects, as there is a risk of fatal encephalopathy from ivermectin facilitating the entry of the Loa loa parasite into the nervous system.
Additionally, certain drugs used in the treatment of filariasis may cause a severe and potentially life-threatening systemic reaction known as the Mazzotti reaction. The use of ivermectin for onchocerciasis may result in individuals experiencing these adverse effects.
In treating onchocerciasis in adults, oral ivermectin is administered as a single 0.15 mg/kg dose meant to be taken on an empty stomach. For resistant disease, this treatment may be repeated after three months.
Ivermectin dosage for scabies
Human scabies is a contagious, itchy skin condition caused by the human itch mite Sarcoptes scabiei. These microscopic mites burrow into the upper layer of the skin where they live and lay eggs. Scabies infestations are usually very itchy and accompanied by a pimple-like skin rash. A very severe form of scabies, known as crusted scabies, occurs in individuals with weakened immune systems or neurological diseases. Crusted scabies manifest with thick crusts of skin containing large numbers of scabies mites and eggs.Scabies is spread by prolonged, direct contact with another person who has scabies. Infestations are common in crowded institutes such as prisons and nursing homes. Ivermectin's efficacy in treating scabies is due to its ability to attack the mite’s nervous system, resulting in the mite's death.
For non-crusted scabies in adults, ivermectin is given in a single dose of 0.2 mg/kg with food. If symptoms persist, this treatment may be repeated in two weeks.
For crusted scabies in adults, ivermectin is given as a 0.2 mg/kg dose on days 1, 2, and 8, with doses on days 9 and 15 sometimes added. It is to be taken WITH food and used along with a topical scabicide. This course may continue to days 22 and 29 for extremely severe cases.
Ivermectin dosage for lice
Head lice are very common, with an estimated 6 to 12 million cases occurring each year in the United States among children 3 to 11 years of age, according to the Center for Disease Control
(CDC). Infestations are caused by the bloodsucking parasite Pediculus
humanus on the head and Pediculus pubis (also known as Phthiriasis pubis) in
the pubic region. This parasitic insect pierces human skin and feeds on
human blood. Unlike body lice, these live, breed, lay eggs, and eat while
holding onto the hair shaft. Both are transmitted through contact.In most adult cases of head lice, topical ivermectin 0.5% lotion can be applied to the head and scalp and left on for 10 minutes. Ivermectin interferes with lice's muscle and nerve functions, paralyzing and then killing them.
In adult cases of refractory head or pubic lice, it can be dosed in tablet form, 0.2 mg/kg of body weight every 10 days for 2 doses for refractory head lice and 0.2 mg/kg of body weight every 1 to 2 weeks for 2 doses for refractory pubic lice.
Ivermectin dosage for rosacea
Rosacea is an immunologic and inflammatory facial skin condition resulting in redness, acne-like lesions, and flushing. It is a chronic condition, and treatments are available to control it but not cure it. Management aims to reduce the severity of facial lesions and the frequency of flushing.The safety of ivermectin, as well as its efficacy in the treatment of rosacea,
were analyzed in two randomized, double-blind, vehicle-controlled clinical
trials. Negative side effects were reported in less than 1% of patients and
included skin burning and skin irritation. The exact mechanism of action for
ivermectin in the treatment of rosacea is unknown. However,
some studies
suggest that ivermectin exerts significant anti-inflammatory properties and
effectively suppresses several pro-inflammatory cytokines.For the treatment of rosacea in adults, ivermectin 1% cream is applied to the affected areas once a day before bedtime.
Ivermectin dosage for Children
In the pediatric population, with an FDA indication, ivermectin is used to treat worms and head lice. Off-label, it is prescribed for non-crusted scabies. In tablet preparations, ivermectin is dosed based on weight, to be administered to children weighing more than 15 kg (33 lbs). Treating onchocerciasis may require repeat doses every three to 12 months, and treating scabies may necessitate a second dose in two weeks. In treating head lice, ivermectin topical lotion can be used on children 6 months and older.| Indication | Weight | Recommended dosage |
| Strongyloidiasis | 15-24 kg | 3 mg tablet for a single dose |
| 25-35 kg | 6 mg tablet for a single dose | |
| 36-50 kg | 9 mg tablet for a single dose | |
| 51-65 kg | 12 mg tablet for a single dose | |
| 66-79 kg | 15 mg tablet for a single dose | |
| ≥80 kg | 0.2 mg/kg in tablet form for a single dose | |
| Onchocerciasis | 15-25 kg | 3 mg tablet for a single dose |
| 26-44 kg | 6 mg tablet for a single dose | |
| 45-64 kg | 9 mg tablet for a single dose | |
| 65-84 kg | 12 mg tablet for a single dose | |
| ≥85 kg | 0.15 mg/kg in tablet form for a single dose | |
| Pediculosis capitis | 6 months of age and older, all weights | 0.5% lotion applied once for 10 minutes and then rinsed off |
Ivermectin dosage restrictions
How to take ivermectin
When treating worms, an ivermectin dose should be taken on the day(s) recommended on an empty stomach with water. Ivermectin tablets should be taken with food when treating scabies and lice.- Take your medicine as directed. Do not take medicine that was not prescribed to you or that was prescribed for veterinary use.
- This medication often only needs to be administered once. Your healthcare provider can provide additional doses if you need an extra dose.
- Read and follow the instructions for this medication. Talk with your healthcare professional if you have any questions.
Ivermectin for COVID-19
You may have come across this topic in the last 5 years: Ivermectin for COVID. According to the US FDA, the WHO and most of the regulatory agencies in the world, is ineffective against COVID.
Now, pay attention, the parameter p is the probability that the effectiveness of a given treatment is due to a random chance. So, according to the meta-analysis of ivermectin for COVID, the pooled effectiveness of ivermectin across all outcomes is 60% in 105 studies with a total of 220 thousand patients, it reduced mortality by almost 50% on average, and the p value is less than 1 in 10 billion. So, the chance that ivermectin is ineffective for COVID is less than 1 in 10 billion. (source)
Ivermectin for Cancer
You may have also come across this topic in the last 3 years: Ivermectin for Cancer. To learn more about Ivermectin dosage for Cancer, see Best Ivermectin Dosage for Humans with Cancer or Different Cancer Types.
Ivermectin dosage FAQs
How long does it take ivermectin to work?The effects of ivermectin work relatively quickly. For treatment of strongyloidiasis and onchocerciasis, ivermectin is typically taken in a fasted state as it is lipophilic (“fat-loving”), demonstrating a 2.5-fold increase in bioavailability when taken with a fatty meal. Conversely, for this reason, it is typically taken with food to treat scabies and lice to increase the penetration of the drug into the epidermis.
How long does ivermectin stay in your system?
The half-life of ivermectin in humans is about 18 hours in adults, and the metabolites continue to be excreted in feces for 12 days.
What happens if I miss a dose of ivermectin?
Typically, ivermectin is only dosed once. However, it may need to be administered multiple times in severe cases of parasites. Missing one of these doses could result in parasitic resistance to the medication or failure to reduce the parasitic load adequately.
What interacts with ivermectin?
Generally, ivermectin is an extremely safe and well-tolerated medication. There is some evidence of negative drug interactions when administered with warfarin, as the combination may result in an increased risk of bleeding in some individuals. Getting the medical advice of the healthcare provider is particularly important in this circumstance.
Is it safe to take ivermectin during pregnancy?
Animal studies have shown that ivermectin is teratogenic in very high doses. While there are no adequate and well-controlled trials in pregnant women, the drug's label states that it should not be used during pregnancy.
Ivermectin is excreted in human breast milk in low concentrations. Treatment in breastfeeding mothers should only be considered when the risk of delaying the treatment of the mother is greater than the risk of harm to the newborn.
Sources and References:
https://www.medicalnewstoday.com/articles/drugs-ivermectin-dosage
Ivermectin drug label, NIH DailyMed (2023)
Parasites - , CDC (2024)
Head lice - epidemiology and risk factors, CDC (2024)
Soolantra label, FDA (2014)
New indications for topical ivermectin 1% cream: a case series study, Advances in Dermatology and Allergology (2019)
Ivermectin drug label, NIH DailyMed (2023)
Parasites - , CDC (2024)
Head lice - epidemiology and risk factors, CDC (2024)
Soolantra label, FDA (2014)
New indications for topical ivermectin 1% cream: a case series study, Advances in Dermatology and Allergology (2019)
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