Ivermectin is the most used veterinary antiparasitic worldwide. There are thousands of generic brands for livestock, horses and pets. It is used in all imaginable formulations: pour-ons, feed additives, drenches and injectables for livestock, oral pastes and gels for horses, tablets, pills, etc, oral suspensions and injectables for pets, etc. It is both used alone or in combination with many other active ingredients.

It is effective against roundworms (gastrointestinal, respiratory, renal, in the skin, etc.) and depending on the delivery form and the dosage also against a number of external parasites such as lice, mites and various myiasis. However, it is ineffective against tapeworms and flukes, and at the usual use recommendations it doesn't control e.g. fleas, stable flies, mosquitoes, horse flies, multi-host ticks (e.g. Amblyomma spp, Dermacentor spp, Haemaphysalis spp, Ixodes spp, Rhipicephalus spp, etc.) and several other external parasites. In the last years it has been increasingly used in many countries against cattle ticks (Boophilus = Rhipicephalus microplus) and horn flies (Haematobia irritans), but efficacy against these parasites is often mediocre and insufficient.

The following table reproduces some usual dosing recommendations for ivermectin for dogs issued by manufacturers or documented in the scientific literature. They may not be approved in some countries.

Dosing recommendations for IVERMECTIN: DOGS
Warning!: dogs with the MDR-1 mutation (e.g. Collies) sensitive to ivermectin: Max. single oral dose without syntptoms: 0,06 mg/kg (= 60 mcg/kg). >0,1 mg/kg massive neurological symptoms; >0,15 mg/kg comatose conditions with possible fatal outcome.
Delivery Parasites Dose (against ivermectin-susceptible parasites)
Intramuscular Ancylostoma spp (prevention of pre-natal or lactogenic infection) 0.3-1,0 mg/kg on days 45 y 55 of pregnancy
Oral Ancylostoma caninum 0.04 mg/kg
Oral Capillaria spp 0.02 mg/kg
Oral Dirofilaria immitis: prophylaxis 0.006 mg/kg 1x/month
Oral Dirofilaria immitis: larvae ≤2 months 0.006 mg/kg 1x
Oral Dirofilaria immitis: larvae 3-4 months 0.006 mg/kg 1x/month during 12 months
Oral Dirofilaria immitis: larvae 5-6 months 0.006 mg/kg 1x/month during 31 months
Oral Dirofilaria immitis: microfilariae 3-4 weeks after treatment against adults 0.05 mg/kg; or 6 weeks after treatment against adults 0.05-0.2 mg/kg. In case of side effects supply liquid and corticosteroids. After 3 weeks check for microfilariae in the blood: if negative start prophylaxis. If positive repeat a week later if microfilariae are found 4 weeks after treatment.
Oral Strongyloides stercoralis 0.02 mg/kg
Oral Trichuris spp 0.02 mg/kg
Oral Uncinaria stenocephala 0.04 mg/kg
Oral Cheyletiella spp 0.2-0.3 mg/kg 1x weekly during 6-8 weeks
Oral Demodicosis, generalized 0.4 mg/kg/day; after negative skin scrapping continue treatment for 4 weeks: average duration : 16 weeks. Or 0.6 mg/kg/day; after negative skin scrapping continue treatment for 2-4 weeks: average duration: 10 weeks. To reduce the risk of side effects try increasing doses during the first days (e.g. 0.1 mg/kg - 0.2 mg/kg - 0.3 mg/kg, etc.).
Oral Sarcoptes scabiei 0.2-0.4 mg/kg, 2-4x with 7 days interval
Subcutaneous Ancylostoma caninum 0.04 mg/kg
Subcutaneous Angiostrongylus vasorum 0.2 mg/kg, rep after 1 week
Subcutaneous Capillaria plica 0.02 mg/kg
Subcutaneous Dirofilaria immitis: microfilariae 0.05 mg/kg; or 0.1 mg/kg 6 weeks after treatment against adults; or 0.2 mg/kg 2 weeks after treatment against adults.
Subcutaneous Filaroides hirthi 1 mg/kg, rep after 1 week
Subcutaneous Filaroides osleri 0.4 mg/kg, rep after 4 weeks
Subcutaneous Toxascaris, Toxocara, Trichuris 0.2 mg/kg
Subcutaneous Uncinaria stenocephala 0.04 mg/kg
Subcutaneous Cheyletiella spp 0.2-0.3 mg/kg every 14 days during 6-8 weeks
Subcutaneous Otodectes cynotis 0.2-0.4 mg/kg, rep after 2 weeks if needed
Subcutaneous Pneumonyssoides caninum 0.2 mg/kg
Subcutaneous Sarcoptes scabiei 0.2-0.4 mg/kg, rep after 2 weeks if needed
Subcutaneous Lice 0.2 mg/kg
Topical (pour-on, spot-on) Demodex canis 1.5 mg/kg 3x/week, x 3-6 weeks; efficacy lower than after oral treatment
Topical (pour-on, spot-on) Sarcoptes scabiei 0.5 mg/kg, rep after 15 days

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Dosing recommendations for antiparasitics depend on national regulations. National regulatory authorities determine whether a product is approved for a given indication, i.e. use on a particular host at a specific dose and against a specific parasiteCheck the labels of the products available in your country for specific information on approved indications.

In most finished products, efficacy and safety depend not only on the amount of active ingredient(s) but also on their formulations (i.e. the type and amount of so-called inert ingredients), particularly in injectables and in topical pour-ons and spot-ons. These inert ingredients can significantly affect the pharmacokinetic behavior (e.g. absorption through the skin or from the injection site, distribution within the body, spreading throughout the body surface, etc.). Generic products usually contain the same amount of active ingredient(s) as the original product, but often in quite different formulations. In many cases, the curative (therapeutic) efficacy of the different formulations is quite comparable, but the protective (prophylactic) efficacy that determines the length of protection against re-infestations may be rather different.

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