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High level briefing

Iverjohn is a brand containing ivermectin, a systemic antiparasitic agent used to eliminate certain worms and ectoparasites. It acts on parasite nerve and muscle cells, producing paralysis and death of susceptible organisms. It is not an antibiotic and will not treat most bacterial or viral infections.

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Important safety note: ivermectin is not authorised in the UK for prevention or treatment of COVID-19.

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Symptoms and signs

Clinicians prescribe Iverjohn for particular parasitic infections after confirming the diagnosis. Dose selection typically depends on the patient weight, the parasite involved along with the clinical situation.

• Threadworm intestinal infection due to Strongyloides stercoralis
• River blindness arising from Onchocerciasis
• Scabies when topical therapy is unsuitable, impractical or has failed; in the UK this may be an off label use
• Selected cases of head lice, usually after topical measures have been tried; often off label

Discuss treatment goals, likely duration and follow up in cooperation with your prescriber. For other medication choices, see an additional choice remedies.

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Strengths and shapes

Iverjohn is usually supplied as film coated oral tablets. Typical tablet strengths in the UK market are 3 mg, 6 mg and 12 mg. Formulation and pack sizes vary by brand and supplier.

Dosing is weight based and varies by condition. Do not alter your dose unless a UK-registered prescriber tells you to. If a repeat dose is planned, your clinician will explain the timing and reason.

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How to take responsibly Iverjohn correctly?

Always follow the directions on your prescription in conjunction with the leaflet supplied. General practical advice:

• Take the tablets with a full glass of water and swallow them.
• Take on an empty stomach where advised: commonly 30 minutes before eating or 2 hours after a meal.
• Do not exceed the dose or frequency prescribed by your clinician.
• Some proof of require a single dose with a planned repeat; keep all follow up appointments.
• If a course is prescribed, complete any planned doses even if symptoms improve early.

If you need tailored advice about a missed tablet, see missed a dose. If you think you might have taken an excessive amount, read information concerning overdosed on pills.

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Medication dose missed

When you forget a dose by mistake, take it as soon as you remember, unless the next scheduled dose is due soon. If it is nearly time for the next dose, skip the dose was skipped and continue as prescribed. Do not try to make up for a dose was skipped with a double dose. For personalised guidance contact your pharmacist or prescriber.

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Overdosing episode

Symptoms of an take an overdose may include numbness, pins and needles, severe dizziness, problems with coordination, breathing difficulties, an irregular heartbeat, or seizures. In the UK call 999 for life threatening emergencies. For urgent but non life threatening concerns use NHS 111. Take the medicine packaging or label with you when seeking help.

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Potential event risks and high level risk warnings

Stop treatment and get urgent medical help if you experience any of the following severe reactions:

• Severe allergic reaction: widespread rash, hives, swelling of the face, lips, tongue or throat, or breathing difficulty
• Chest pain, fainting, convulsions, or a very fast or irregular heartbeat
• Sudden severe eye pain, new vision changes, or marked swelling around the eyes
• Severe blistering or peeling skin reactions, including in the mouth
• Severe confusion, collapse or loss of coordination

More common, usually transient effects include nausea, vomiting, abdominal discomfort, constipation or diarrhoea; cephalalgia or lightheadedness; reduced appetite; muscle or joint aches and tender lymph nodes. In people with onchocerciasis some symptoms result from the immune response to dying parasites (Mazzotti type reactions).

If accompanying effects are severe, persistent or worrying contact your prescriber. You can report suspected reactions through the MHRA Yellow Card scheme; see status of lawful authorization and safety reporting.

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Medication interacting as a shared activity risk factors

Tell your pharmacist or doctor about all prescription, over the counter and herbal products you use. Notable the networked exchange of ideas issues include:

• Strong P-glycoprotein or CYP3A4 inhibitors (for example ritonavir, clarithromycin, verapamil) can increase ivermectin levels; keeping track of metrics or dose adjustment may be needed.
• Warfarin is one example of an anticoagulant medication.: co administration may require closer INR monitoring and vigilance for bleeding.
• Other medicines that cause drowsiness or dizziness may add to these effects and increase the risk of accidents.
• Grapefruit or grapefruit juice can affect drug metabolism and is often best avoided unless your clinician advises otherwise.
• Herbal remedies, including St. Johns wort, can interact with prescription medicines; disclose them to your prescriber.

If several clinicians are involved in your care, make sure each one has a full list of your medicines.

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Steps to take before use

Before you begin the process Iverjohn, mention any of the following to your clinician:

• A history of liver disease or abnormal liver blood tests
• Significant respiratory conditions, including severe asthma
• Documented allergy to ivermectin or any component of tablets.
• If you are pregnant and planning a pregnancy, or breastfeeding
• Recent travel to or residence in areas where Loa loa is endemic (West or Central Africa); special assessment may be needed
• Little ones under 15 kg generally need specialist assessment and dosing guidelines

If new eye, vision or neurological symptoms develop after starting treatment seek medical review promptly. See who should not take this medicine additional information is available.

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Reasons to avoid use

• Known hypersensitivity to ivermectin or any of the product components
• Use of veterinary ivermectin products in humans is contraindicated and unsafe

Use in young children under 15 kg should be determined by a specialist service only.

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Follow-up after monitoring of operational health

• Certain infections require follow up tests such as stool examinations, skin snips or serology to confirm eradication; attend any scheduled reviews.
• If repeated or prolonged courses are expected your clinician may recommend periodic blood tests such as liver function tests.
• Report ongoing abdominal pain, new visual symptoms or neurological problems without delay.

If you are unsure of the next steps, ask your prescriber to explain the expected timeline and any vigilant monitoring that will be done. See markers for condition specific details.

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How to keep items safely

• Keep tablets at room temperature below 30 degrees C (86 F) in a dry place.
• Store in the original container with the lid closed and keep out of sight and reach of children.
• Do not use after the date of expiry printed on the container. Bring back unused medicines or expired medications to a pharmacy for safe disposal.

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Holistic medicine and related therapies

The choice of an a substitute choice depends on the parasite, clinical circumstance and Guidance aligned with UK standards. Popular a substitute choice options include:

• Albendazole: broad spectrum oral anthelmintic used for many intestinal worms; dosing varies by indication.
• Praziquantel treatment option: preferred for many tapeworm and fluke infections.
• Mebendazole: used for threadworm, roundworm and whipworm.
• Permethrin 5 percent cream: topical first line for scabies; oral ivermectin is reserved for outbreaks, refractory cases or when topical therapy is not suitable.
• Benzyl benzoate, malathion or dimeticone based lotions: topical options for scabies or head lice in selected cases.
• Doxycycline: used in onchocerciasis to target Wolbachia bacteria; this acts indirectly and is not an acute substitute for ivermectin.
• Moxidectin: related antiparasitic used in some programmes for onchocerciasis; UK availability may be limited.

Costs vary between options. Discuss clinical suitability and budget with a UK prescriber or pharmacist. See comparative price analysis for ballpark ranges.

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Indicative price levels in the UK

Private prices change by pharmacy, brand and pack size. The NHS may provide supply where clinically appropriate under NHS prescribing rules. The ranges below are approximate and for guidance purposes.

• Ivermectin oral tablets (private supply): typically from around 15 to 45 pounds depending on strength and quantity.
• Albendazole or mebendazole: often between 5 and 25 pounds depending on product and pack size.
• Permethrin 5 percent cream: approximately 6 to 15 pounds per tube.
• Topical ivermectin 1 percent cream (licensed for rosacea): commonly 20 to 60 pounds per tube.
• Praziquantel for parasitic infections: frequently more expensive, roughly 20 to 80 pounds or more depending on dose and brand.

In England a standard NHS prescription charge usually applies per item unless you qualify for an exemption. Prescription charging systems differ in Scotland, Wales and Northern Ireland. Private consultations may include a prescriber fee in addition to the medicine price.

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Information on UK law and safety

• Status: ivermectin for human use is a Prescription Only Medicine (POM) in the UK.
• Supply: a valid prescription from a UK registered prescriber is required. Online sales must come from a GPhC registered pharmacy that uses the official distance selling logo.
• Importation: importing POMs for personal use normally needs a valid prescription and may be limited to a small supply; customs rules and carrier policies can apply. Check before ordering from abroad.
• Off label use: UK prescribers may lawfully prescribe licensed medicines off label when clinically appropriate, with informed consent and appropriate documentation.
• Advertising: direct to consumer promotion of POMs is restricted under MHRA rules.
• Veterinary products: do not use veterinary ivermectin formulations for humans; this is unsafe and inappropriate.
• The MHRA Yellow Card scheme is for reporting suspected adverse reactions as part of safety reporting.
• Travel advice: carry medicines in original packaging with a copy of your prescription and confirm the findings destination country rules in advance.

If you are uncertain about lawful access or what is appropriate for your situation seek advice from a pharmacist or the prescriber who issued your prescription.

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The FAQ section

Is Iverjohn an antibiotic drug?

No. Iverjohn contains ivermectin, an antiparasitic medicine used against certain worms and ectoparasites. It does not treat most bacterial or viral infections.

Should I take it with meals?

Most regimens advise taking ivermectin on an empty stomach, commonly 30 minutes before a meal or 2 hours after food. Follow the instructions on your prescription or leaflet. See how to take this see details for more facts and data.

What does it mean if I feel better after one dose?

Do not skip scheduled doses or follow up reviews. Some infections require repeat dosing or tests to confirm cure even if symptoms resolve.

When would I need to seek urgent aid?

Seek immediate help for severe allergic reactions, breathing problems, convulsions, sudden vision changes or collapse. Call 999 or switch to your nearest emergency department. For other urgent concerns use NHS 111.

Is ivermectin a prescription-only medicine in the United Kingdom?

Yes. It is classified as a Prescription Only Medicine. See Safety and guidance for legal compliance for the United Kingdom for more details about this.

Is it safe to drive after using ivermectin?

Ivermectin has the potential to induce dizziness or drowsiness in some individuals. Do not drive or operate machinery if you feel impaired.

Can youngsters take it?

The younger crowd under 15 kg generally need specialist advice. Dosing for children is weight based and must be prescribed by a clinician.

Can I drink alcohol while I am prescribed ivermectin?

There is no direct major the dynamic of social contact known, but alcohol can worsen dizziness or nausea. It may be sensible to avoid alcohol until you know how you react to the medicine.

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