Ivecop (Ivermectin)
Also sold as: Ivecop, Ivermec, Iverotaj, Scabo, Stromectol
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 3mg, 6mg, 12mg +1
Indications
- Scabies (crusted/Norwegian scabies; severe or treatment-resistant conventional scabies)
- Strongyloidiasis (Strongyloides stercoralis — first-line)
- Lymphatic filariasis (Wuchereria bancrofti — mass drug administration + albendazole)
- Onchocerciasis (river blindness)
- Loiasis (with caution — see contraindications)
- Pediculosis capitis (head lice) — second-line oral or topical
- Cutaneous larva migrans
Adult Dosing
Scabies (severe/crusted)
200 mcg/kg PO as a single dose, repeated at Day 8 and Day 15 (crusted: additional doses Day 22 and 29)
Use with topical permethrin/benzyl benzoate. 12 mg single dose for 60 kg adult.
Strongyloidiasis
200 mcg/kg PO once daily for 2 days
Repeat stool examination at 2–4 weeks. Immunocompromised: longer courses needed.
Onchocerciasis / lymphatic filariasis
150 mcg/kg (oncho) or 200 mcg/kg (filariasis) PO once annually (mass drug administration)
Annual dose in endemic areas programme
Pediatric Dosing
Not established in children < 15 kg or < 5 years (blood-brain barrier incomplete in young children — GABA neurotoxicity risk)
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Any CrCl | No dose adjustment required — primarily faecally excreted |
Hepatic Adjustment
Use cautiously in severe hepatic impairment — CYP3A4 metabolism
Pregnancy & Lactation
Pregnancy: Category C
Avoid in 1st trimester — teratogenicity in animals. For mass drug administration programmes: exclude pregnancy. Scabies in pregnancy: topical permethrin preferred. Strongyloidiasis in pregnancy (life-threatening): benefit may outweigh risk — specialist decision.
Lactation: Caution
Excreted in breast milk in small amounts. WHO mass drug administration programmes exclude breastfeeding mothers in first week postpartum. For individual patient treatment: benefit vs risk discussion.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Warfarin | Ivermectin can increase INR — monitor closely | Moderate |
| Ivermectin in Loa loa endemic areas | Patients with high Loa loa microfilaraemia (> 30,000/mL) can develop severe/fatal encephalopathy — screen for Loa loa before treatment in endemic areas (Central/West Africa) | Major |
DoctorScribe — AI Medical Scribe
Stop looking up Ivecop — just speak the prescription
"Ivecop as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Mazzotti reaction (Herxheimer-like reaction from dying parasites — fever, headache, itching, rash, hypotension — typically 24–48 hours after dose, especially in onchocerciasis)
- Nausea
- Dizziness
- Diarrhoea
- Pruritus
Serious / Discontinue If
- Encephalopathy in Loa loa co-infection (Central Africa — rare in India)
- CNS toxicity in individuals with abnormal blood-brain barrier or at extremes of weight
- Mazzotti severe reaction (hypotension, syncope)
Contraindications
- Weight < 15 kg or < 5 years old (standard oral use)
- Concurrent CNS-active drugs (mefloquine, HIV drugs — variable interaction)
- Loa loa co-infection with high microfilaraemia > 30,000/mL (encephalopathy)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Ivecop 6mg | Menarini India (Natco) | 4 tab ₹95 |
| Scabo 6mg | Cipla | 4 tab ₹88 |
| Iverotaj 6mg | Torrent | 4 tab ₹82 |
Monitoring Required
- Scabies: clinical re-examination at 4 weeks (re-treatment if active infestation)
- Stool microscopy (strongyloidiasis) at 2–4 weeks post-treatment
- Onchocerciasis: microfilarial count post-treatment
- Mazzotti reaction monitoring in onchocerciasis (24–48h post-dose)
Patient Counseling Points
- Take on empty stomach — 30 minutes before food for maximum absorption
- Scabies: wash all clothing, towels, and bedding at 60°C on the day of treatment; treat all household contacts simultaneously
- Itching may worsen temporarily after dose (dying parasites) — this is expected and not an allergy
- Strongyloidiasis: repeat stool test after 3–4 weeks to confirm clearance
- Keep the prescription — ivermectin is a Schedule H medicine
Stop Googling drug references mid-consultation
EasyClinic auto-flags Ivecop interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Rajesh Kulkarni, MD (Infectious Diseases), Consultant Infectious Disease Specialist
Last reviewed: 2026-04-01
References
- WHO Ivermectin Guidelines
- IDSA Parasitic Infections Guidelines
- BNF — Ivermectin
- Cochrane — Ivermectin for Scabies
- NVBDCP Filariasis MDA Programme India