Ivermectin

Also known as: Soolantra (1% cream brand), Stromectol (oral brand), avermectin antiparasitic

DermatologyOther

In plain English

Ivermectin is an anti-parasite medicine. As a 1% cream it is an effective, FDA-approved treatment for the bumps of rosacea (it targets Demodex mites and inflammation). As a pill it treats parasitic infections such as scabies, lice, and certain worm diseases. The compounded oral forms in this catalog are used for parasitic/off-label indications under a prescriber's direction.

The science

Ivermectin binds glutamate-gated chloride channels (and other ligand-gated channels) in invertebrate nerve/muscle cells, causing paralysis and death of parasites and mites; in rosacea it also has anti-inflammatory activity and reduces Demodex density. Two identical randomized, vehicle-controlled trials showed 1% cream achieved clear/almost-clear (IGA) in about 38-40% versus 12-19% with vehicle and reduced inflammatory lesions by roughly 75%. Mammalian selectivity reflects low affinity for mammalian channels and limited CNS penetration (P-glycoprotein efflux).

References

• Stein L et al., ivermectin 1% cream for papulopustular rosacea (two RCTs), J Drugs Dermatol 2014
• Ivermectin, LiverTox (NCBI Bookshelf)