Ivermectin Information Review By Buy-pharma
Buy Ivermectin, a semisynthetic macrocycle-crystal lactone, is a mixture of avermectin Bi a and BR. It comes from the soil actinomycete
Ivermectin is the drug of choice for onchocerciasis. It is used in mass therapy as a safe and effective means to reduce contamination of mikrofil-Riyami. Ivermectin can be successfully used to treat other forms of filariasis, Strong loidoza, as well as for the destruction of migratory skin of the larvae.
People ivermectin appoint only peroral, but. The drug is rapidly absorbed, reaching maximum plasma concentration (about 50 mg / l), 4 hours after taking a dose of 12 mg. It is widely distributed in the body (volume of distribution is about 50 liters), but slowly and in limited quantities in the medium penetrates the eye. The half-life is 28 hours. Derived almost exclusively from the faeces.
Anthelmintic action and other pharmacological effects of Ivermectin
A. Anthelmintics action. It is known that ivermectin immobilizes nematodes and arthropods (which can cause their death), increasing GABA-ergic signaling in peripheral nerves (chapter 53). Well studied microfilariae-tsidnoe action of ivermectin for onchocerciasis. In addition, recent studies showed that a series of treatments with delta-monthly intervals and more lead to the slow death of some adult worms. The treatment of single dose drugs is fast acting on skin microfilariae and slowly (months) – on microfilariae anterior chamber. Ivermectin also acts on the embryogenesis in female worms (intra-uterine damage and degeneration of microfilariae). Within 2-3 days after receiving the dose the number of skin microfilariae decreases rapidly and remains low for about a year. It is unclear what happens when a repeated dose of ivermectin: a sterilized permanently (or kill) the mature worms, or drug only immobilizes microfilariae, which facilitates their removal retikuloen-dotelialnoy system owner.
B. Pharmacological effect in humans. The drug does not express the pharmacological or toxic effects in humans in part because it hardly penetrates gematoentsefali-energy barriers.
Animal experiments established that ivermectin has a wide border security. However, the introduction of high doses of the drug into mice causes sometimes unexplained maternal deaths and teratogenic effects.
Clinical use of Ivermectin
A. onchocerciasis. Treatment consists of enteral Mr. receiving a single dose of 150 micrograms / kg of water naschak. His repeated at intervals of 6-12 months, based on the level of skin microfilariae. A single dose leads to a marked decrease in the number of skin microfilariae, the number of eosinophils and the elimination (in months) microfilariae from the anterior chamber, some patients have improved disease course anterior segment and dermatitis. Long-time effect re-treatment in lesions posterior segment is not defined.
A comparative study showed that ivermectin is as effective as diethylcarbamazine, reduces the number of microfilariae in the skin and anterior chamber, which determines the symptoms of the disease, but has significantly fewer systemic and ocular adverse reactions. Moreover, the decreased number of microfilariae lasts longer. A comparative study of the visual changes were detected (point keratitis, ho-rioretinity and optic nerve atrophy) in patients treated with diethylcarbamazine, but not in-ivermektin.
B. filariasis, caused by the W. bancrofti.
Comparison of ivermectin and diethylcarbamazine showed that both drugs were equally effective in reducing infection with microfilariae. In some studies have found similar drugs mild side effects (myalgia, headache, fever), other researchers believe ivermectin safer. Ivermectin is convenient to make the scheme a single or double dose (after evaluation of cleansing effect dose of 20 mg / kg given dose of 400 mg / kg), but he has minimal makrofilyaritsidnoe action, so to kill adult worms requires taking diethylcarbamazine.
B. Other Parasites. It is established that ivermectin is effective for infection Mansonella ozzardi, but has no effect when infecting M. perstans. A single dose of the drug partially destroys the microfilariae of Brugia malayi with minimum side effects. When loiasis it can be useful for patients with a high degree of contamination of microfilariae in which the initial therapy of diethylcarbamazine causes complications. Promising results using ivermectin as a treatment for strongyloidiasis: the application of a single dose of 200 mg / kg the cure rate can exceed 90%. The drug is apparently effective for the treatment of ascariasis and possibly for the destruction of migratory skin of the larvae.
Adverse reactions Ivermectin
A side effect of ivermectin recalls the reaction of Mazotti. Its maximum expression is found 2 days after receiving a single dose of enteric. It is believed that the reaction caused by the massive loss of microfilariae, not the toxicity of the drug, especially because of its intensity correlates with the level of infestation of the skin parasites. In the native population an adverse reaction is observed in 5-30% of cases, but it is usually poorly expressed, of short duration and is suppressed by aspirin and antihistamines. The frequency of complications in the adult population in exile (and, possibly, for local children) above. Reaction Mazotti include fever (sometimes occur within a few days), headache, dizziness, drowsiness, weakness, rash, itching growing, diarrhea, joint and muscle pain, hypotension, tachycardia, lymphadenitis, lymphangitis and peripheral edema. More intense reactions occur in 1-3% of people, and severity of the reaction with fever, hypotension and Bronx hospazmom – at 0.3% of the people. I may need steroids for several days. After 1-3 weeks in patients with marked swelling and abscesses, presumably in places where adult worms.
After several days of treatment some patients develop corneal clouding points. Other rare ophthalmological reactions (which may be associated with the disease itself) include swelling of the optic century, anterior uveitis, conjunctivitis, keratitis, optic nerve neuritis, and chorioretinitis horioidity. These reactions are usually not severe and do not cause vision loss and do not require the use of cortico-roidov.
Contraindications and precautions Ivermectin
Since ivermectin increases GAMKergiches-kuyu activity, it is best to avoid concomitant use with other drugs with similar effects, such as barbiturates, benzodiazepines and valproic acid. Ivermectin should not be prescribed for pregnant women. Safety of medication in children younger than 5 years has not been studied. Breastfeeding mothers taking the drug is allowed no earlier than one week after the last dose of the drug
Ivermectin should not be given to patients who may be affected by the permeability of the blood-brain barrier, such as meningitis or African sleeping sickness.