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Identification
NameIvermectin
Accession NumberDB00602  (APRD01058)
TypeSmall Molecule
GroupsApproved, Vet Approved
Description

Ivermectin is a broad-spectrum anti-parasite medication. It was first marketed under the name Stromectol® and used against worms (except tapeworms), but, in 2012, it was approved for the topical treatment of head lice infestations in patients 6 months of age and older, and marketed under the name Sklice™ as well. Ivermectin is mainly used in humans in the treatment of onchocerciasis, but is also effective against other worm infestations (such as strongyloidiasis, ascariasis, trichuriasis and enterobiasis).

Structure
Thumb
Synonyms
Ivermectin
Ivermectina
Ivermectine
Ivermectinum
External Identifiers
  • MK 933
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Rosivercream1 %topicalGalderma Canada Inc2015-05-25Not applicableCanada
Sklicelotion.585 g/117gtopicalSanofi Pasteur, Inc2012-07-09Not applicableUs
Soolantracream10 mg/gtopicalGalderma Laboratories, L.P.2015-01-01Not applicableUs
Stromectoltablet3 mg/1oralMerck Sharp & Dohme Corp.1996-11-22Not applicableUs
Stromectoltablet3 mg/1oralDepartment Of State Health Services, Pharmacy Branch1996-11-22Not applicableUs
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Ivermectintablet3 mg/1oralEdenbridge Pharmaceuticals, LLC2014-11-15Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
AscapilAbbott
DetebencilRoux-Ocefa
ErmetinUnipharm
GotaxMetlen
ImectinPulse
IvectinAristopharma
IveraBeximco
IvergotLicol
IvermecUCI
IvextermValeant
IvoriInvision
KaonolMediderm
KiloxBussié
MaikedingHisun
QuanoxDermacare
RevectinaSolvay
ScaboDelta
ScavistaZuventus
SecuroValeant
VermectinAtlantic Lab
Brand mixturesNot Available
SaltsNot Available
Categories
UNII8883YP2R6D
CAS number70288-86-7
WeightAverage: 1736.1589
Monoisotopic: 1735.000064088
Chemical FormulaC95H146O28
InChI KeyInChIKey=SPBDXSGPUHCETR-CVSKBELMSA-N
InChI
InChI=1S/C48H74O14.C47H72O14/c1-11-25(2)43-28(5)17-18-47(62-43)23-34-20-33(61-47)16-15-27(4)42(26(3)13-12-14-32-24-55-45-40(49)29(6)19-35(46(51)58-34)48(32,45)52)59-39-22-37(54-10)44(31(8)57-39)60-38-21-36(53-9)41(50)30(7)56-38;1-24(2)41-27(5)16-17-46(61-41)22-33-19-32(60-46)15-14-26(4)42(25(3)12-11-13-31-23-54-44-39(48)28(6)18-34(45(50)57-33)47(31,44)51)58-38-21-36(53-10)43(30(8)56-38)59-37-20-35(52-9)40(49)29(7)55-37/h12-15,19,25-26,28,30-31,33-45,49-50,52H,11,16-18,20-24H2,1-10H3;11-14,18,24-25,27,29-30,32-44,48-49,51H,15-17,19-23H2,1-10H3/b13-12+,27-15+,32-14+;12-11+,26-14+,31-13+/t25-,26+,28+,30+,31+,33-,34+,35+,36+,37+,38+,39+,40-,41+,42+,43-,44+,45-,47-,48-;25-,27-,29-,30-,32+,33-,34-,35-,36-,37-,38-,39+,40-,41+,42-,43-,44+,46+,47+/m10/s1
IUPAC Name
(1'R,2R,4'S,5S,6R,8'R,10'E,12'S,13'S,14'E,16'E,20'R,21'R,24'S)-21',24'-dihydroxy-12'-{[(2R,4S,5S,6S)-5-{[(2S,4S,5S,6S)-5-hydroxy-4-methoxy-6-methyloxan-2-yl]oxy}-4-methoxy-6-methyloxan-2-yl]oxy}-5,11',13',22'-tetramethyl-6-(propan-2-yl)-3',7',19'-trioxaspiro[oxane-2,6'-tetracyclo[15.6.1.1⁴,⁸.0²⁰,²⁴]pentacosane]-10',14',16',22'-tetraen-2'-one; (1'R,2R,4'S,5S,6R,8'R,10'E,12'S,13'S,14'E,16'E,20'R,21'R,24'S)-6-[(2R)-butan-2-yl]-21',24'-dihydroxy-12'-{[(2R,4S,5S,6S)-5-{[(2S,4S,5S,6S)-5-hydroxy-4-methoxy-6-methyloxan-2-yl]oxy}-4-methoxy-6-methyloxan-2-yl]oxy}-5,11',13',22'-tetramethyl-3',7',19'-trioxaspiro[oxane-2,6'-tetracyclo[15.6.1.1⁴,⁸.0²⁰,²⁴]pentacosane]-10',14',16',22'-tetraen-2'-one
SMILES
CO[[email protected]]1C[C@@H](O[C@@H](C)[C@@H]1O)O[[email protected]]1[[email protected]](C)O[[email protected]](C[C@@H]1OC)O[[email protected]]1[C@@H](C)\C=C\C=C2/CO[C@@H]3[[email protected]](O)C(C)=C[C@@H](C(=O)O[[email protected]]4C[C@@H](C\C=C1/C)O[C@@]1(CC[[email protected]](C)[C@@H](C(C)C)O1)C4)[C@]23O.CC[C@@H](C)[[email protected]]1O[C@@]2(CC[C@@H]1C)O[C@@H]1C\C=C(C)\[C@@H](O[C@@H]3O[C@@H](C)[[email protected]](O[C@@H]4O[C@@H](C)[[email protected]](O)[C@@H](OC)C4)[C@@H](OC)C3)[C@@H](C)\C=C\C=C3/CO[C@@H]4[[email protected]](O)C(C)=C[C@@H](C(=O)O[C@@H](C1)C2)[C@]34O
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as macrolides and analogues. These are organic compounds containing a lactone ring of at least twelve members.
KingdomOrganic compounds
Super ClassPhenylpropanoids and polyketides
ClassMacrolides and analogues
Sub ClassNot Available
Direct ParentMacrolides and analogues
Alternative Parents
Substituents
  • Macrolide
  • Oxane
  • Monosaccharide
  • Saccharide
  • Tertiary alcohol
  • Oxolane
  • Secondary alcohol
  • Lactone
  • Carboxylic acid ester
  • Oxacycle
  • Organoheterocyclic compound
  • Monocarboxylic acid or derivatives
  • Ether
  • Dialkyl ether
  • Carboxylic acid derivative
  • Acetal
  • Hydrocarbon derivative
  • Organooxygen compound
  • Carbonyl group
  • Alcohol
  • Aliphatic heteropolycyclic compound
Molecular FrameworkNot Available
External DescriptorsNot Available
Pharmacology
IndicationFor the treatment of intestinal (i.e., nondisseminated) strongyloidiasis due to the nematode parasite Strongyloides stercoralis. Also for the treatment of onchocerciasis (river blindness) due to the nematode parasite Onchocerca volvulus. Can be used to treat scabies caused by Sarcoptes scabiei.
PharmacodynamicsIvermectin is a semisynthetic, anthelminitic agent. It is an avermectin which a group of pentacyclic sixteen-membered lactone (i.e. a macrocyclic lactone disaccharide) derived from the soil bacterium Streptomyces avermitilis. Avermectins are potent anti-parasitic agents. Ivermectin is the most common avermectin. It is a broad spectrum antiparasitic drug for oral administration. It is sometimes used to treat human onchocerciasis (river blindness). It is the mixture of 22,23-dihydro-avermectin B1a (at least 90%) and 22,23-dihydro-avermectin B1b (less than 10%).
Mechanism of actionIvermectin binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate muscle and nerve cells of the microfilaria. This binding causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell, leading to paralysis and death of the parasite. Ivermectin also is believed to act as an agonist of the neurotransmitter gamma-aminobutyric acid (GABA), thereby disrupting GABA-mediated central nervous system (CNS) neurosynaptic transmission. Ivermectin may also impair normal intrauterine development of O. volvulus microfilariae and may inhibit their release from the uteri of gravid female worms.
Related Articles
AbsorptionModerately well absorbed. Improved absorption with high fat meal.
Volume of distribution

The volume of distribution is 3 to 3.5 L/kg and it does not cross the blood-brain barrier.

Protein binding93%
Metabolism

Primarily hepatic. Ivermectin and/or its metabolites are excreted almost exclusively in the feces over an estimated 12 days, with less than 1 % of the administered dose excreted in the urine.

Route of eliminationIvermectin is metabolized in the liver, and ivermectin and/or its metabolites are excreted almost exclusively in the feces over an estimated 12 days, with less than 1% of the administered dose excreted in the urine.
Half life16 hours (also reported at 22-28 hours)
ClearanceNot Available
ToxicityLD50 = 29.5 mg/kg (Mouse, oral). LD50 = 10 mg/kg (Rat, oral). Adverse effects include muscle or joint pain, dizziness, fever, headache, skin rash, fast heartbeat.
Affected organisms
  • Parasitic nematodes and other roundworms
  • Head lice
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.8146
Blood Brain Barrier-0.549
Caco-2 permeable-0.8192
P-glycoprotein substrateSubstrate0.8771
P-glycoprotein inhibitor IInhibitor0.805
P-glycoprotein inhibitor IIInhibitor0.8192
Renal organic cation transporterNon-inhibitor0.7384
CYP450 2C9 substrateNon-substrate0.8877
CYP450 2D6 substrateNon-substrate0.886
CYP450 3A4 substrateSubstrate0.7714
CYP450 1A2 substrateNon-inhibitor0.9129
CYP450 2C9 inhibitorNon-inhibitor0.8366
CYP450 2D6 inhibitorNon-inhibitor0.928
CYP450 2C19 inhibitorNon-inhibitor0.8793
CYP450 3A4 inhibitorNon-inhibitor0.7957
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.8073
Ames testNon AMES toxic0.8295
CarcinogenicityNon-carcinogens0.9622
BiodegradationNot ready biodegradable0.9759
Rat acute toxicity3.5285 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9471
hERG inhibition (predictor II)Non-inhibitor0.5536
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
Manufacturers
  • Merck and co inc
Packagers
Dosage forms
FormRouteStrength
Creamtopical1 %
Lotiontopical.585 g/117g
Creamtopical10 mg/g
Tabletoral3 mg/1
Prices
Unit descriptionCostUnit
Stromectol 20 3 mg tablet Box116.13USD box
Ivermectin powder14.0USD g
Stromectol 3 mg tablet5.58USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5952372 No1998-09-182018-09-18Us
US6103248 No1998-05-222018-05-22Us
US6133310 No1999-04-262019-04-26Us
US7550440 No2004-04-222024-04-22Us
US8080530 No2004-04-222024-04-22Us
US8093219 No2004-04-222024-04-22Us
US8415311 No2004-04-222024-04-22Us
US8470788 No2004-04-222024-04-22Us
US8791153 No2007-10-122027-10-12Us
US8815816 No2004-04-222024-04-22Us
US8927595 No2007-10-122027-10-12Us
US9089587 No2014-03-132034-03-13Us
US9233117 No2014-03-132034-03-13Us
US9233118 No2014-03-132034-03-13Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
melting point155 °CNot Available
water solubilityInsolubleNot Available
Predicted Properties
PropertyValueSource
logP5.83ChemAxon
pKa (Strongest Acidic)12.47ChemAxon
pKa (Strongest Basic)-3.4ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count13ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area170.06 Å2ChemAxon
Rotatable Bond Count15ChemAxon
Refractivity230.33 m3·mol-1ChemAxon
Polarizability96.87 Å3ChemAxon
Number of Rings14ChemAxon
Bioavailability0ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
References
Synthesis Reference

Shuet-Hing L. Chiu, Josephine R. Carlin, Rae Taub, “Ivermectin derivative compounds and process for preparing the same.” U.S. Patent US4963667, issued June, 1982.

US4963667
General ReferencesNot Available
External Links
ATC CodesP02CF01D11AX22
AHFS Codes
  • 8:08
PDB EntriesNot Available
FDA labelDownload (60.2 KB)
MSDSDownload (73.4 KB)
Interactions
Drug Interactions
Drug
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Ivermectin.
AcenocoumarolIvermectin may increase the anticoagulant activities of Acenocoumarol.
AcetaminophenThe serum concentration of Ivermectin can be increased when it is combined with Acetaminophen.
Acetylsalicylic acidThe serum concentration of Acetylsalicylic acid can be increased when it is combined with Ivermectin.
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Ivermectin.
AlbendazoleThe serum concentration of Ivermectin can be increased when it is combined with Albendazole.
AldosteroneThe serum concentration of Ivermectin can be decreased when it is combined with Aldosterone.
AldosteroneThe serum concentration of Aldosterone can be increased when it is combined with Ivermectin.
AlectinibThe serum concentration of Ivermectin can be increased when it is combined with Alectinib.
AlfentanilThe serum concentration of Ivermectin can be increased when it is combined with Alfentanil.
AlitretinoinThe serum concentration of Alitretinoin can be increased when it is combined with Ivermectin.
AmantadineThe serum concentration of Ivermectin can be increased when it is combined with Amantadine.
AmbrisentanThe serum concentration of Ambrisentan can be increased when it is combined with Ivermectin.
Aminohippuric acidThe serum concentration of Ivermectin can be increased when it is combined with Aminohippuric acid.
AmiodaroneThe serum concentration of Ivermectin can be decreased when it is combined with Amiodarone.
AmitriptylineThe serum concentration of Ivermectin can be increased when it is combined with Amitriptyline.
AmlodipineThe serum concentration of Ivermectin can be increased when it is combined with Amlodipine.
AmodiaquineThe serum concentration of Ivermectin can be decreased when it is combined with Amodiaquine.
AmprenavirThe serum concentration of Ivermectin can be decreased when it is combined with Amprenavir.
AmsacrineThe serum concentration of Ivermectin can be increased when it is combined with Amsacrine.
ApixabanThe serum concentration of Apixaban can be increased when it is combined with Ivermectin.
AprepitantThe serum concentration of Ivermectin can be increased when it is combined with Aprepitant.
Arsenic trioxideThe serum concentration of Arsenic trioxide can be increased when it is combined with Ivermectin.
AstemizoleThe serum concentration of Ivermectin can be increased when it is combined with Astemizole.
AtazanavirThe serum concentration of Atazanavir can be increased when it is combined with Ivermectin.
AtenololThe serum concentration of Ivermectin can be increased when it is combined with Atenolol.
AtomoxetineThe metabolism of Ivermectin can be decreased when combined with Atomoxetine.
AtorvastatinThe serum concentration of Ivermectin can be increased when it is combined with Atorvastatin.
AxitinibThe serum concentration of Axitinib can be increased when it is combined with Ivermectin.
AzelastineThe serum concentration of Ivermectin can be increased when it is combined with Azelastine.
AzithromycinThe serum concentration of Ivermectin can be increased when it is combined with Azithromycin.
BenzocaineThe serum concentration of Ivermectin can be increased when it is combined with Benzocaine.
BepridilThe serum concentration of Ivermectin can be increased when it is combined with Bepridil.
BetamethasoneThe serum concentration of Betamethasone can be increased when it is combined with Ivermectin.
BexaroteneThe serum concentration of Ivermectin can be decreased when it is combined with Bexarotene.
BiperidenThe serum concentration of Ivermectin can be increased when it is combined with Biperiden.
BoceprevirThe metabolism of Ivermectin can be decreased when combined with Boceprevir.
BoceprevirThe serum concentration of Boceprevir can be increased when it is combined with Ivermectin.
BortezomibThe metabolism of Ivermectin can be decreased when combined with Bortezomib.
BosentanThe serum concentration of Ivermectin can be decreased when it is combined with Bosentan.
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Ivermectin.
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Ivermectin.
BromocriptineThe serum concentration of Ivermectin can be increased when it is combined with Bromocriptine.
BuprenorphineThe serum concentration of Ivermectin can be increased when it is combined with Buprenorphine.
BuspironeThe serum concentration of Ivermectin can be increased when it is combined with Buspirone.
CabazitaxelThe serum concentration of Cabazitaxel can be increased when it is combined with Ivermectin.
CaffeineThe serum concentration of Caffeine can be increased when it is combined with Ivermectin.
CamptothecinThe serum concentration of Camptothecin can be increased when it is combined with Ivermectin.
CanagliflozinThe serum concentration of Canagliflozin can be increased when it is combined with Ivermectin.
CandesartanThe serum concentration of Ivermectin can be increased when it is combined with Candesartan.
CaptoprilThe serum concentration of Ivermectin can be increased when it is combined with Captopril.
CarbamazepineThe serum concentration of Ivermectin can be decreased when it is combined with Carbamazepine.
CarbamazepineThe serum concentration of Carbamazepine can be increased when it is combined with Ivermectin.
CarfilzomibThe serum concentration of Carfilzomib can be increased when it is combined with Ivermectin.
CarvedilolThe serum concentration of Ivermectin can be increased when it is combined with Carvedilol.
CaspofunginThe serum concentration of Ivermectin can be increased when it is combined with Caspofungin.
CeritinibThe serum concentration of Ivermectin can be increased when it is combined with Ceritinib.
CerivastatinThe serum concentration of Cerivastatin can be increased when it is combined with Ivermectin.
ChloroquineThe serum concentration of Ivermectin can be decreased when it is combined with Chloroquine.
ChlorpromazineThe serum concentration of Ivermectin can be increased when it is combined with Chlorpromazine.
ChlorpropamideThe serum concentration of Ivermectin can be increased when it is combined with Chlorpropamide.
ChlorprothixeneThe serum concentration of Ivermectin can be increased when it is combined with Chlorprothixene.
CholesterolThe serum concentration of Ivermectin can be increased when it is combined with Cholesterol.
Cholic AcidThe serum concentration of Ivermectin can be decreased when it is combined with Cholic Acid.
CilazaprilThe serum concentration of Ivermectin can be increased when it is combined with Cilazapril.
CimetidineThe serum concentration of Ivermectin can be decreased when it is combined with Cimetidine.
CimetidineThe serum concentration of Cimetidine can be increased when it is combined with Ivermectin.
CiprofloxacinThe serum concentration of Ivermectin can be increased when it is combined with Ciprofloxacin.
CisplatinThe serum concentration of Cisplatin can be increased when it is combined with Ivermectin.
CitalopramThe serum concentration of Citalopram can be increased when it is combined with Ivermectin.
ClarithromycinThe serum concentration of Ivermectin can be increased when it is combined with Clarithromycin.
ClemastineThe metabolism of Ivermectin can be decreased when combined with Clemastine.
ClobazamThe serum concentration of Clobazam can be increased when it is combined with Ivermectin.
ClofazimineThe serum concentration of Ivermectin can be increased when it is combined with Clofazimine.
ClomifeneThe serum concentration of Clomifene can be increased when it is combined with Ivermectin.
ClomipramineThe serum concentration of Ivermectin can be increased when it is combined with Clomipramine.
ClonidineThe serum concentration of Clonidine can be increased when it is combined with Ivermectin.
ClopidogrelThe serum concentration of Clopidogrel can be increased when it is combined with Ivermectin.
ClotrimazoleThe metabolism of Ivermectin can be decreased when combined with Clotrimazole.
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Ivermectin.
CobicistatThe serum concentration of Ivermectin can be increased when it is combined with Cobicistat.
CobimetinibThe serum concentration of Cobimetinib can be increased when it is combined with Ivermectin.
ColchicineThe serum concentration of Ivermectin can be increased when it is combined with Colchicine.
ColforsinThe serum concentration of Ivermectin can be increased when it is combined with Colforsin.
ConivaptanThe serum concentration of Ivermectin can be increased when it is combined with Conivaptan.
Conjugated Equine EstrogensThe serum concentration of Conjugated Equine Estrogens can be increased when it is combined with Ivermectin.
CrizotinibThe metabolism of Ivermectin can be decreased when combined with Crizotinib.
CrizotinibThe serum concentration of Crizotinib can be increased when it is combined with Ivermectin.
CyclophosphamideThe serum concentration of Ivermectin can be increased when it is combined with Cyclophosphamide.
CyclosporineThe metabolism of Ivermectin can be decreased when combined with Cyclosporine.
CyclosporineThe serum concentration of Cyclosporine can be increased when it is combined with Ivermectin.
Dabigatran etexilateThe serum concentration of Dabigatran etexilate can be increased when it is combined with Ivermectin.
DabrafenibThe serum concentration of Ivermectin can be decreased when it is combined with Dabrafenib.
DabrafenibThe serum concentration of Dabrafenib can be increased when it is combined with Ivermectin.
DaclatasvirThe serum concentration of Ivermectin can be increased when it is combined with Daclatasvir.
DactinomycinThe serum concentration of Ivermectin can be increased when it is combined with Dactinomycin.
DapagliflozinThe serum concentration of Dapagliflozin can be increased when it is combined with Ivermectin.
DarunavirThe metabolism of Ivermectin can be decreased when combined with Darunavir.
DasatinibThe serum concentration of Ivermectin can be increased when it is combined with Dasatinib.
DaunorubicinThe serum concentration of Ivermectin can be decreased when it is combined with Daunorubicin.
DaunorubicinThe serum concentration of Daunorubicin can be increased when it is combined with Ivermectin.
DebrisoquinThe serum concentration of Debrisoquin can be increased when it is combined with Ivermectin.
DeferasiroxThe serum concentration of Ivermectin can be decreased when it is combined with Deferasirox.
DelavirdineThe metabolism of Ivermectin can be decreased when combined with Delavirdine.
DesipramineThe serum concentration of Ivermectin can be increased when it is combined with Desipramine.
DesloratadineThe serum concentration of Ivermectin can be increased when it is combined with Desloratadine.
DexamethasoneThe serum concentration of Ivermectin can be decreased when it is combined with Dexamethasone.
DexamethasoneThe serum concentration of Dexamethasone can be increased when it is combined with Ivermectin.
DextromethorphanThe serum concentration of Ivermectin can be increased when it is combined with Dextromethorphan.
DiazepamThe serum concentration of Diazepam can be increased when it is combined with Ivermectin.
DiclofenacThe serum concentration of Ivermectin can be increased when it is combined with Diclofenac.
DicoumarolIvermectin may increase the anticoagulant activities of Dicoumarol.
DiethylstilbestrolThe serum concentration of Diethylstilbestrol can be increased when it is combined with Ivermectin.
DigitoxinThe serum concentration of Digitoxin can be increased when it is combined with Ivermectin.
DigoxinThe serum concentration of Ivermectin can be decreased when it is combined with Digoxin.
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Ivermectin.
DihydroergotamineThe metabolism of Ivermectin can be decreased when combined with Dihydroergotamine.
DihydrotestosteroneThe serum concentration of Dihydrotestosterone can be increased when it is combined with Ivermectin.
DiltiazemThe metabolism of Ivermectin can be decreased when combined with Diltiazem.
DiltiazemThe serum concentration of Diltiazem can be increased when it is combined with Ivermectin.
DipyridamoleThe serum concentration of Ivermectin can be increased when it is combined with Dipyridamole.
DocetaxelThe serum concentration of Docetaxel can be increased when it is combined with Ivermectin.
DomperidoneThe serum concentration of Domperidone can be increased when it is combined with Ivermectin.
DoxazosinThe serum concentration of Ivermectin can be increased when it is combined with Doxazosin.
DoxepinThe serum concentration of Ivermectin can be increased when it is combined with Doxepin.
DoxorubicinThe serum concentration of Ivermectin can be decreased when it is combined with Doxorubicin.
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Ivermectin.
DoxycyclineThe metabolism of Ivermectin can be decreased when combined with Doxycycline.
DronabinolThe serum concentration of Ivermectin can be increased when it is combined with Dronabinol.
DronedaroneThe metabolism of Ivermectin can be decreased when combined with Dronedarone.
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Ivermectin.
EfavirenzThe serum concentration of Ivermectin can be decreased when it is combined with Efavirenz.
ElbasvirThe serum concentration of Ivermectin can be increased when it is combined with Elbasvir.
EletriptanThe serum concentration of Eletriptan can be increased when it is combined with Ivermectin.
EltrombopagThe serum concentration of Ivermectin can be increased when it is combined with Eltrombopag.
EnalaprilThe serum concentration of Ivermectin can be increased when it is combined with Enalapril.
EnzalutamideThe serum concentration of Ivermectin can be increased when it is combined with Enzalutamide.
EpinastineThe serum concentration of Epinastine can be increased when it is combined with Ivermectin.
ErgonovineThe serum concentration of Ivermectin can be increased when it is combined with Ergonovine.
ErgotamineThe serum concentration of Ivermectin can be increased when it is combined with Ergotamine.
ErlotinibThe serum concentration of Erlotinib can be increased when it is combined with Ivermectin.
ErythromycinThe metabolism of Ivermectin can be decreased when combined with Erythromycin.
ErythromycinThe serum concentration of Erythromycin can be increased when it is combined with Ivermectin.
Eslicarbazepine acetateThe serum concentration of Ivermectin can be decreased when it is combined with Eslicarbazepine acetate.
EstradiolThe serum concentration of Estradiol can be increased when it is combined with Ivermectin.
EstramustineThe serum concentration of Ivermectin can be increased when it is combined with Estramustine.
EstriolThe serum concentration of Ivermectin can be decreased when it is combined with Estriol.
EstriolThe serum concentration of Estriol can be increased when it is combined with Ivermectin.
EstroneThe serum concentration of Ivermectin can be decreased when it is combined with Estrone.
EstroneThe serum concentration of Estrone can be increased when it is combined with Ivermectin.
Ethinyl EstradiolThe serum concentration of Ethinyl Estradiol can be increased when it is combined with Ivermectin.
Ethyl biscoumacetateIvermectin may increase the anticoagulant activities of Ethyl biscoumacetate.
EtoposideThe serum concentration of Ivermectin can be increased when it is combined with Etoposide.
EtravirineThe serum concentration of Ivermectin can be decreased when it is combined with Etravirine.
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Ivermectin.
EzetimibeThe serum concentration of Ezetimibe can be increased when it is combined with Ivermectin.
FelodipineThe serum concentration of Ivermectin can be increased when it is combined with Felodipine.
FentanylThe serum concentration of Ivermectin can be increased when it is combined with Fentanyl.
FesoterodineThe serum concentration of Fesoterodine can be increased when it is combined with Ivermectin.
FexofenadineThe serum concentration of Fexofenadine can be increased when it is combined with Ivermectin.
FidaxomicinThe serum concentration of Fidaxomicin can be increased when it is combined with Ivermectin.
FluconazoleThe metabolism of Ivermectin can be decreased when combined with Fluconazole.
FluoxetineThe serum concentration of Ivermectin can be increased when it is combined with Fluoxetine.
FlupentixolThe serum concentration of Ivermectin can be increased when it is combined with Flupentixol.
FluphenazineThe serum concentration of Ivermectin can be increased when it is combined with Fluphenazine.
FlurazepamThe serum concentration of Ivermectin can be increased when it is combined with Flurazepam.
Fluticasone furoateThe serum concentration of Fluticasone furoate can be increased when it is combined with Ivermectin.
FluvoxamineThe metabolism of Ivermectin can be decreased when combined with Fluvoxamine.
FosamprenavirThe metabolism of Ivermectin can be decreased when combined with Fosamprenavir.
FosaprepitantThe serum concentration of Ivermectin can be increased when it is combined with Fosaprepitant.
FosphenytoinThe metabolism of Ivermectin can be increased when combined with Fosphenytoin.
Fusidic AcidThe serum concentration of Ivermectin can be increased when it is combined with Fusidic Acid.
GefitinibThe serum concentration of Gefitinib can be increased when it is combined with Ivermectin.
GemcitabineThe serum concentration of Gemcitabine can be increased when it is combined with Ivermectin.
GenisteinThe serum concentration of Ivermectin can be increased when it is combined with Genistein.
GlyburideThe serum concentration of Ivermectin can be increased when it is combined with Glyburide.
GlycerolThe serum concentration of Ivermectin can be increased when it is combined with Glycerol.
Gramicidin DThe serum concentration of Ivermectin can be increased when it is combined with Gramicidin D.
GrazoprevirThe serum concentration of Grazoprevir can be increased when it is combined with Ivermectin.
GrepafloxacinThe serum concentration of Grepafloxacin can be increased when it is combined with Ivermectin.
HaloperidolThe serum concentration of Ivermectin can be increased when it is combined with Haloperidol.
HydrocortisoneThe serum concentration of Hydrocortisone can be increased when it is combined with Ivermectin.
HydroxychloroquineThe serum concentration of Ivermectin can be decreased when it is combined with Hydroxychloroquine.
IbuprofenThe serum concentration of Ibuprofen can be increased when it is combined with Ivermectin.
IdelalisibThe serum concentration of Ivermectin can be increased when it is combined with Idelalisib.
ImatinibThe metabolism of Ivermectin can be decreased when combined with Imatinib.
ImatinibThe serum concentration of Imatinib can be increased when it is combined with Ivermectin.
ImipramineThe serum concentration of Ivermectin can be increased when it is combined with Imipramine.
IndacaterolThe serum concentration of Indacaterol can be increased when it is combined with Ivermectin.
IndinavirThe serum concentration of Ivermectin can be decreased when it is combined with Indinavir.
IndinavirThe serum concentration of Indinavir can be increased when it is combined with Ivermectin.
IndomethacinThe serum concentration of Ivermectin can be increased when it is combined with Indomethacin.
IrinotecanThe serum concentration of Irinotecan can be increased when it is combined with Ivermectin.
IsavuconazoniumThe metabolism of Ivermectin can be decreased when combined with Isavuconazonium.
IsradipineThe metabolism of Ivermectin can be decreased when combined with Isradipine.
ItraconazoleThe serum concentration of Ivermectin can be increased when it is combined with Itraconazole.
IvacaftorThe serum concentration of Ivermectin can be increased when it is combined with Ivacaftor.
KetamineThe serum concentration of Ivermectin can be increased when it is combined with Ketamine.
KetazolamThe serum concentration of Ketazolam can be increased when it is combined with Ivermectin.
KetoconazoleThe serum concentration of Ivermectin can be increased when it is combined with Ketoconazole.
LamivudineThe serum concentration of Lamivudine can be increased when it is combined with Ivermectin.
LamotrigineThe serum concentration of Lamotrigine can be increased when it is combined with Ivermectin.
LansoprazoleThe serum concentration of Ivermectin can be increased when it is combined with Lansoprazole.
LapatinibThe serum concentration of Ivermectin can be increased when it is combined with Lapatinib.
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Ivermectin.
LenalidomideThe serum concentration of Lenalidomide can be increased when it is combined with Ivermectin.
LenvatinibThe serum concentration of Lenvatinib can be increased when it is combined with Ivermectin.
LevetiracetamThe serum concentration of Levetiracetam can be increased when it is combined with Ivermectin.
LevofloxacinThe serum concentration of Levofloxacin can be increased when it is combined with Ivermectin.
LevomilnacipranThe serum concentration of Levomilnacipran can be increased when it is combined with Ivermectin.
LevothyroxineThe serum concentration of Ivermectin can be decreased when it is combined with Levothyroxine.
LidocaineThe serum concentration of Ivermectin can be increased when it is combined with Lidocaine.
LinagliptinThe serum concentration of Linagliptin can be increased when it is combined with Ivermectin.
LiothyronineThe serum concentration of Ivermectin can be decreased when it is combined with Liothyronine.
LiotrixThe serum concentration of Ivermectin can be decreased when it is combined with Liotrix.
LisinoprilThe serum concentration of Ivermectin can be increased when it is combined with Lisinopril.
LomitapideThe serum concentration of Ivermectin can be increased when it is combined with Lomitapide.
LoperamideThe serum concentration of Ivermectin can be increased when it is combined with Loperamide.
LopinavirThe serum concentration of Ivermectin can be increased when it is combined with Lopinavir.
LoratadineThe serum concentration of Ivermectin can be increased when it is combined with Loratadine.
LosartanThe serum concentration of Ivermectin can be increased when it is combined with Losartan.
LovastatinThe metabolism of Ivermectin can be decreased when combined with Lovastatin.
LuliconazoleThe serum concentration of Ivermectin can be increased when it is combined with Luliconazole.
LumacaftorThe serum concentration of Ivermectin can be decreased when it is combined with Lumacaftor.
MannitolThe serum concentration of Mannitol can be increased when it is combined with Ivermectin.
MaprotilineThe serum concentration of Ivermectin can be increased when it is combined with Maprotiline.
MebendazoleThe serum concentration of Ivermectin can be increased when it is combined with Mebendazole.
MefloquineThe serum concentration of Ivermectin can be increased when it is combined with Mefloquine.
Megestrol acetateThe serum concentration of Ivermectin can be increased when it is combined with Megestrol acetate.
MeprobamateThe serum concentration of Ivermectin can be increased when it is combined with Meprobamate.
MethadoneThe serum concentration of Ivermectin can be increased when it is combined with Methadone.
MethotrexateThe serum concentration of Methotrexate can be increased when it is combined with Ivermectin.
MethylprednisoloneThe serum concentration of Methylprednisolone can be increased when it is combined with Ivermectin.
MetoprololThe serum concentration of Ivermectin can be increased when it is combined with Metoprolol.
MibefradilThe serum concentration of Ivermectin can be increased when it is combined with Mibefradil.
MiconazoleThe serum concentration of Ivermectin can be increased when it is combined with Miconazole.
MidazolamThe serum concentration of Ivermectin can be decreased when it is combined with Midazolam.
MidazolamThe serum concentration of Midazolam can be increased when it is combined with Ivermectin.
MifepristoneThe metabolism of Ivermectin can be decreased when combined with Mifepristone.
MirabegronThe serum concentration of Mirabegron can be increased when it is combined with Ivermectin.
MitomycinThe serum concentration of Ivermectin can be increased when it is combined with Mitomycin.
MitotaneThe serum concentration of Ivermectin can be decreased when it is combined with Mitotane.
MitoxantroneThe serum concentration of Ivermectin can be decreased when it is combined with Mitoxantrone.
MitoxantroneThe serum concentration of Mitoxantrone can be increased when it is combined with Ivermectin.
ModafinilThe serum concentration of Ivermectin can be decreased when it is combined with Modafinil.
MorphineThe serum concentration of Ivermectin can be increased when it is combined with Morphine.
Mycophenolate mofetilThe serum concentration of Mycophenolate mofetil can be increased when it is combined with Ivermectin.
NadololThe serum concentration of Nadolol can be increased when it is combined with Ivermectin.
NafcillinThe serum concentration of Ivermectin can be decreased when it is combined with Nafcillin.
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Ivermectin.
NaloxoneThe serum concentration of Naloxone can be increased when it is combined with Ivermectin.
NaltrexoneThe serum concentration of Ivermectin can be increased when it is combined with Naltrexone.
NaringeninThe serum concentration of Ivermectin can be increased when it is combined with Naringenin.
NefazodoneThe serum concentration of Ivermectin can be decreased when it is combined with Nefazodone.
NelfinavirThe serum concentration of Ivermectin can be decreased when it is combined with Nelfinavir.
NelfinavirThe serum concentration of Nelfinavir can be increased when it is combined with Ivermectin.
NeostigmineThe serum concentration of Ivermectin can be increased when it is combined with Neostigmine.
NetupitantThe serum concentration of Ivermectin can be increased when it is combined with Netupitant.
NevirapineThe metabolism of Ivermectin can be decreased when combined with Nevirapine.
NicardipineThe serum concentration of Ivermectin can be increased when it is combined with Nicardipine.
NifedipineThe serum concentration of Ivermectin can be decreased when it is combined with Nifedipine.
NifedipineThe serum concentration of Nifedipine can be increased when it is combined with Ivermectin.
NilotinibThe metabolism of Ivermectin can be decreased when combined with Nilotinib.
NilotinibThe serum concentration of Nilotinib can be increased when it is combined with Ivermectin.
NintedanibThe serum concentration of Nintedanib can be increased when it is combined with Ivermectin.
NisoldipineThe serum concentration of Ivermectin can be increased when it is combined with Nisoldipine.
NitrazepamThe serum concentration of Ivermectin can be increased when it is combined with Nitrazepam.
NitrendipineThe serum concentration of Ivermectin can be increased when it is combined with Nitrendipine.
NizatidineThe serum concentration of Nizatidine can be increased when it is combined with Ivermectin.
NorethisteroneThe serum concentration of Ivermectin can be decreased when it is combined with Norethisterone.
OlanzapineThe serum concentration of Olanzapine can be increased when it is combined with Ivermectin.
OlaparibThe metabolism of Ivermectin can be decreased when combined with Olaparib.
OmbitasvirThe serum concentration of Ombitasvir can be increased when it is combined with Ivermectin.
OmeprazoleThe serum concentration of Ivermectin can be increased when it is combined with Omeprazole.
OsimertinibThe serum concentration of Ivermectin can be increased when it is combined with Osimertinib.
P-NitrophenolThe serum concentration of Ivermectin can be increased when it is combined with P-Nitrophenol.
PaclitaxelThe serum concentration of Ivermectin can be increased when it is combined with Paclitaxel.
PalbociclibThe serum concentration of Ivermectin can be increased when it is combined with Palbociclib.
Palmitic AcidThe serum concentration of Ivermectin can be increased when it is combined with Palmitic Acid.
PanobinostatThe serum concentration of Panobinostat can be increased when it is combined with Ivermectin.
PantoprazoleThe serum concentration of Ivermectin can be increased when it is combined with Pantoprazole.
ParoxetineThe serum concentration of Ivermectin can be increased when it is combined with Paroxetine.
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Ivermectin.
PentobarbitalThe metabolism of Ivermectin can be increased when combined with Pentobarbital.
PerindoprilThe serum concentration of Ivermectin can be increased when it is combined with Perindopril.
PhenindioneIvermectin may increase the anticoagulant activities of Phenindione.
PhenobarbitalThe serum concentration of Ivermectin can be decreased when it is combined with Phenobarbital.
PhenobarbitalThe serum concentration of Phenobarbital can be increased when it is combined with Ivermectin.
PhenprocoumonIvermectin may increase the anticoagulant activities of Phenprocoumon.
PhenytoinThe metabolism of Ivermectin can be increased when combined with Phenytoin.
PhenytoinThe serum concentration of Phenytoin can be increased when it is combined with Ivermectin.
PimozideThe serum concentration of Ivermectin can be increased when it is combined with Pimozide.
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Ivermectin.
Platelet Activating FactorThe serum concentration of Ivermectin can be decreased when it is combined with Platelet Activating Factor.
PomalidomideThe serum concentration of Pomalidomide can be increased when it is combined with Ivermectin.
PonatinibThe serum concentration of Ponatinib can be increased when it is combined with Ivermectin.
PosaconazoleThe serum concentration of Ivermectin can be increased when it is combined with Posaconazole.
PravastatinThe serum concentration of Pravastatin can be increased when it is combined with Ivermectin.
PrazosinThe serum concentration of Ivermectin can be increased when it is combined with Prazosin.
PrednisoloneThe serum concentration of Prednisolone can be increased when it is combined with Ivermectin.
PrednisoneThe serum concentration of Prednisone can be increased when it is combined with Ivermectin.
PrimaquineThe serum concentration of Ivermectin can be decreased when it is combined with Primaquine.
PrimidoneThe metabolism of Ivermectin can be increased when combined with Primidone.
ProbenecidThe serum concentration of Ivermectin can be increased when it is combined with Probenecid.
ProgesteroneThe serum concentration of Ivermectin can be decreased when it is combined with Progesterone.
ProgesteroneThe serum concentration of Progesterone can be increased when it is combined with Ivermectin.
PromethazineThe serum concentration of Ivermectin can be increased when it is combined with Promethazine.
PropafenoneThe serum concentration of Ivermectin can be increased when it is combined with Propafenone.
PropranololThe serum concentration of Propranolol can be increased when it is combined with Ivermectin.
ProtriptylineThe serum concentration of Ivermectin can be increased when it is combined with Protriptyline.
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Ivermectin.
QuercetinThe serum concentration of Ivermectin can be increased when it is combined with Quercetin.
QuetiapineThe serum concentration of Quetiapine can be increased when it is combined with Ivermectin.
QuinacrineThe serum concentration of Ivermectin can be increased when it is combined with Quinacrine.
QuinidineThe serum concentration of Ivermectin can be increased when it is combined with Quinidine.
QuinineThe serum concentration of Ivermectin can be increased when it is combined with Quinine.
RanitidineThe serum concentration of Ivermectin can be increased when it is combined with Ranitidine.
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Ivermectin.
ReboxetineThe serum concentration of Ivermectin can be increased when it is combined with Reboxetine.
RegorafenibThe serum concentration of Ivermectin can be increased when it is combined with Regorafenib.
ReserpineThe serum concentration of Ivermectin can be decreased when it is combined with Reserpine.
ReserpineThe serum concentration of Reserpine can be increased when it is combined with Ivermectin.
RifabutinThe metabolism of Ivermectin can be increased when combined with Rifabutin.
RifampicinThe serum concentration of Ivermectin can be decreased when it is combined with Rifampicin.
RifampicinThe serum concentration of Rifampicin can be increased when it is combined with Ivermectin.
RifapentineThe metabolism of Ivermectin can be increased when combined with Rifapentine.
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Ivermectin.
RilpivirineThe serum concentration of Ivermectin can be increased when it is combined with Rilpivirine.
RisperidoneThe serum concentration of Risperidone can be increased when it is combined with Ivermectin.
RitonavirThe serum concentration of Ivermectin can be decreased when it is combined with Ritonavir.
RitonavirThe serum concentration of Ritonavir can be increased when it is combined with Ivermectin.
RivaroxabanThe serum concentration of Rivaroxaban can be increased when it is combined with Ivermectin.
RolapitantThe serum concentration of Ivermectin can be increased when it is combined with Rolapitant.
RomidepsinThe serum concentration of Romidepsin can be increased when it is combined with Ivermectin.
Salicylic acidThe serum concentration of Salicylic acid can be increased when it is combined with Ivermectin.
SaquinavirThe serum concentration of Ivermectin can be decreased when it is combined with Saquinavir.
SaquinavirThe serum concentration of Saquinavir can be increased when it is combined with Ivermectin.
ScopolamineThe serum concentration of Ivermectin can be increased when it is combined with Scopolamine.
SelegilineThe serum concentration of Ivermectin can be increased when it is combined with Selegiline.
SelexipagThe serum concentration of Selexipag can be increased when it is combined with Ivermectin.
SertralineThe serum concentration of Ivermectin can be increased when it is combined with Sertraline.
SildenafilThe metabolism of Ivermectin can be decreased when combined with Sildenafil.
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Ivermectin.
SiltuximabThe serum concentration of Ivermectin can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Ivermectin can be increased when it is combined with Simeprevir.
SimvastatinThe serum concentration of Ivermectin can be increased when it is combined with Simvastatin.
SirolimusThe serum concentration of Ivermectin can be decreased when it is combined with Sirolimus.
SitagliptinThe serum concentration of Sitagliptin can be increased when it is combined with Ivermectin.
SofosbuvirThe serum concentration of Sofosbuvir can be increased when it is combined with Ivermectin.
SorafenibThe serum concentration of Sorafenib can be increased when it is combined with Ivermectin.
SparfloxacinThe serum concentration of Sparfloxacin can be increased when it is combined with Ivermectin.
SphingosineThe serum concentration of Sphingosine can be increased when it is combined with Ivermectin.
SpironolactoneThe serum concentration of Ivermectin can be increased when it is combined with Spironolactone.
St. John's WortThe serum concentration of Ivermectin can be decreased when it is combined with St. John's Wort.
StaurosporineThe serum concentration of Ivermectin can be increased when it is combined with Staurosporine.
StiripentolThe serum concentration of Ivermectin can be increased when it is combined with Stiripentol.
StreptozocinThe serum concentration of Ivermectin can be decreased when it is combined with Streptozocin.
SulfinpyrazoneThe serum concentration of Ivermectin can be increased when it is combined with Sulfinpyrazone.
SulfisoxazoleThe metabolism of Ivermectin can be decreased when combined with Sulfisoxazole.
SumatriptanThe serum concentration of Ivermectin can be increased when it is combined with Sumatriptan.
SunitinibThe serum concentration of Ivermectin can be increased when it is combined with Sunitinib.
TacrineThe serum concentration of Ivermectin can be increased when it is combined with Tacrine.
TacrolimusThe serum concentration of Ivermectin can be decreased when it is combined with Tacrolimus.
TacrolimusThe serum concentration of Tacrolimus can be increased when it is combined with Ivermectin.
TamoxifenThe serum concentration of Ivermectin can be decreased when it is combined with Tamoxifen.
TamoxifenThe serum concentration of Tamoxifen can be increased when it is combined with Ivermectin.
Taurocholic AcidThe serum concentration of Taurocholic Acid can be increased when it is combined with Ivermectin.
Technetium Tc-99m sestamibiThe serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Ivermectin.
TelaprevirThe metabolism of Ivermectin can be decreased when combined with Telaprevir.
TelaprevirThe serum concentration of Telaprevir can be increased when it is combined with Ivermectin.
TelithromycinThe metabolism of Ivermectin can be decreased when combined with Telithromycin.
TelmisartanThe serum concentration of Ivermectin can be increased when it is combined with Telmisartan.
TemsirolimusThe serum concentration of Temsirolimus can be increased when it is combined with Ivermectin.
TerazosinThe serum concentration of Ivermectin can be increased when it is combined with Terazosin.
TerfenadineThe serum concentration of Ivermectin can be increased when it is combined with Terfenadine.
TeriflunomideThe serum concentration of Ivermectin can be increased when it is combined with Teriflunomide.
TesmilifeneThe serum concentration of Ivermectin can be decreased when it is combined with Tesmilifene.
TestosteroneThe serum concentration of Ivermectin can be increased when it is combined with Testosterone.
TicagrelorThe serum concentration of Ticagrelor can be increased when it is combined with Ivermectin.
TiclopidineThe metabolism of Ivermectin can be decreased when combined with Ticlopidine.
TimololThe serum concentration of Timolol can be increased when it is combined with Ivermectin.
TocilizumabThe serum concentration of Ivermectin can be decreased when it is combined with Tocilizumab.
TolvaptanThe serum concentration of Tolvaptan can be increased when it is combined with Ivermectin.
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Ivermectin.
ToremifeneThe serum concentration of Toremifene can be increased when it is combined with Ivermectin.
Trastuzumab emtansineThe serum concentration of Trastuzumab emtansine can be increased when it is combined with Ivermectin.
TrazodoneThe serum concentration of Ivermectin can be decreased when it is combined with Trazodone.
TrifluoperazineThe serum concentration of Ivermectin can be increased when it is combined with Trifluoperazine.
TriflupromazineThe serum concentration of Ivermectin can be increased when it is combined with Triflupromazine.
TrimethoprimThe serum concentration of Ivermectin can be decreased when it is combined with Trimethoprim.
TrimipramineThe serum concentration of Ivermectin can be increased when it is combined with Trimipramine.
TroleandomycinThe serum concentration of Ivermectin can be increased when it is combined with Troleandomycin.
UlipristalThe serum concentration of Ulipristal can be increased when it is combined with Ivermectin.
UmeclidiniumThe serum concentration of Umeclidinium can be increased when it is combined with Ivermectin.
VecuroniumThe serum concentration of Vecuronium can be increased when it is combined with Ivermectin.
VenlafaxineThe metabolism of Ivermectin can be decreased when combined with Venlafaxine.
VenlafaxineThe serum concentration of Venlafaxine can be increased when it is combined with Ivermectin.
VerapamilThe metabolism of Ivermectin can be decreased when combined with Verapamil.
VerapamilThe serum concentration of Verapamil can be increased when it is combined with Ivermectin.
VinblastineThe serum concentration of Ivermectin can be decreased when it is combined with Vinblastine.
VinblastineThe serum concentration of Vinblastine can be increased when it is combined with Ivermectin.
VincristineThe serum concentration of Vincristine can be increased when it is combined with Ivermectin.
VincristineThe serum concentration of Ivermectin can be decreased when it is combined with Vincristine.
VinorelbineThe serum concentration of Ivermectin can be increased when it is combined with Vinorelbine.
VismodegibThe serum concentration of Vismodegib can be increased when it is combined with Ivermectin.
VoriconazoleThe metabolism of Ivermectin can be decreased when combined with Voriconazole.
WarfarinIvermectin may increase the anticoagulant activities of Warfarin.
ZidovudineThe serum concentration of Zidovudine can be increased when it is combined with Ivermectin.
ZimelidineThe serum concentration of Ivermectin can be increased when it is combined with Zimelidine.
ZiprasidoneThe metabolism of Ivermectin can be decreased when combined with Ziprasidone.
Food Interactions
  • When administered with a high fat meal, the bioavailability is increased 2.5 times.

Targets

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
agonist
General Function:
Gaba-gated chloride ion channel activity
Specific Function:
Component of the heteropentameric receptor for GABA, the major inhibitory neurotransmitter in the vertebrate brain. Functions also as histamine receptor and mediates cellular responses to histamine. Functions as receptor for diazepines and various anesthetics, such as pentobarbital; these are bound at a separate allosteric effector binding site. Functions as ligand-gated chloride channel.
Gene Name:
GABRB3
Uniprot ID:
P28472
Molecular Weight:
54115.04 Da
References
  1. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
  2. Feng XP, Hayashi J, Beech RN, Prichard RK: Study of the nematode putative GABA type-A receptor subunits: evidence for modulation by ivermectin. J Neurochem. 2002 Nov;83(4):870-8. [PubMed:12421359 ]
  3. Berman HM, Westbrook J, Feng Z, Gilliland G, Bhat TN, Weissig H, Shindyalov IN, Bourne PE: The Protein Data Bank. Nucleic Acids Res. 2000 Jan 1;28(1):235-42. [PubMed:10592235 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
agonist
General Function:
Transmitter-gated ion channel activity
Specific Function:
The glycine receptor is a neurotransmitter-gated ion channel. Binding of glycine to its receptor increases the chloride conductance and thus produces hyperpolarization (inhibition of neuronal firing).
Gene Name:
GLRA3
Uniprot ID:
O75311
Molecular Weight:
53799.775 Da
References
  1. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [PubMed:17016423 ]
  2. Yates DM, Wolstenholme AJ: An ivermectin-sensitive glutamate-gated chloride channel subunit from Dirofilaria immitis. Int J Parasitol. 2004 Aug;34(9):1075-81. [PubMed:15313134 ]
  3. McCavera S, Rogers AT, Yates DM, Woods DJ, Wolstenholme AJ: An ivermectin-sensitive glutamate-gated chloride channel from the parasitic nematode Haemonchus contortus. Mol Pharmacol. 2009 Jun;75(6):1347-55. doi: 10.1124/mol.108.053363. Epub 2009 Mar 31. [PubMed:19336526 ]
  4. Berman HM, Westbrook J, Feng Z, Gilliland G, Bhat TN, Weissig H, Shindyalov IN, Bourne PE: The Protein Data Bank. Nucleic Acids Res. 2000 Jan 1;28(1):235-42. [PubMed:10592235 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrateinhibitor
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:
ABCB1
Uniprot ID:
P08183
Molecular Weight:
141477.255 Da
References
  1. Schwab D, Fischer H, Tabatabaei A, Poli S, Huwyler J: Comparison of in vitro P-glycoprotein screening assays: recommendations for their use in drug discovery. J Med Chem. 2003 Apr 24;46(9):1716-25. [PubMed:12699389 ]
  2. Pouliot JF, L'Heureux F, Liu Z, Prichard RK, Georges E: Reversal of P-glycoprotein-associated multidrug resistance by ivermectin. Biochem Pharmacol. 1997 Jan 10;53(1):17-25. [PubMed:8960059 ]
  3. Nagy H, Goda K, Fenyvesi F, Bacso Z, Szilasi M, Kappelmayer J, Lustyik G, Cianfriglia M, Szabo G Jr: Distinct groups of multidrug resistance modulating agents are distinguished by competition of P-glycoprotein-specific antibodies. Biochem Biophys Res Commun. 2004 Mar 19;315(4):942-9. [PubMed:14985103 ]
  4. Schinkel AH, Wagenaar E, van Deemter L, Mol CA, Borst P: Absence of the mdr1a P-Glycoprotein in mice affects tissue distribution and pharmacokinetics of dexamethasone, digoxin, and cyclosporin A. J Clin Invest. 1995 Oct;96(4):1698-705. [PubMed:7560060 ]
  5. Jani M, Makai I, Kis E, Szabo P, Nagy T, Krajcsi P, Lespine A: Ivermectin interacts with human ABCG2. J Pharm Sci. 2011 Jan;100(1):94-7. doi: 10.1002/jps.22262. Epub 2010 Jun 22. [PubMed:20574995 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Transporter activity
Specific Function:
Mediates export of organic anions and drugs from the cytoplasm. Mediates ATP-dependent transport of glutathione and glutathione conjugates, leukotriene C4, estradiol-17-beta-o-glucuronide, methotrexate, antiviral drugs and other xenobiotics. Confers resistance to anticancer drugs. Hydrolyzes ATP with low efficiency.
Gene Name:
ABCC1
Uniprot ID:
P33527
Molecular Weight:
171589.5 Da
References
  1. Lespine A, Dupuy J, Orlowski S, Nagy T, Glavinas H, Krajcsi P, Alvinerie M: Interaction of ivermectin with multidrug resistance proteins (MRP1, 2 and 3). Chem Biol Interact. 2006 Feb 25;159(3):169-79. Epub 2005 Dec 27. [PubMed:16384552 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Organic anion transmembrane transporter activity
Specific Function:
Mediates hepatobiliary excretion of numerous organic anions. May function as a cellular cisplatin transporter.
Gene Name:
ABCC2
Uniprot ID:
Q92887
Molecular Weight:
174205.64 Da
References
  1. Lespine A, Dupuy J, Orlowski S, Nagy T, Glavinas H, Krajcsi P, Alvinerie M: Interaction of ivermectin with multidrug resistance proteins (MRP1, 2 and 3). Chem Biol Interact. 2006 Feb 25;159(3):169-79. Epub 2005 Dec 27. [PubMed:16384552 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
High-capacity urate exporter functioning in both renal and extrarenal urate excretion. Plays a role in porphyrin homeostasis as it is able to mediates the export of protoporhyrin IX (PPIX) both from mitochondria to cytosol and from cytosol to extracellular space, and cellular export of hemin, and heme. Xenobiotic transporter that may play an important role in the exclusion of xenobiotics from t...
Gene Name:
ABCG2
Uniprot ID:
Q9UNQ0
Molecular Weight:
72313.47 Da
References
  1. Jani M, Makai I, Kis E, Szabo P, Nagy T, Krajcsi P, Lespine A: Ivermectin interacts with human ABCG2. J Pharm Sci. 2011 Jan;100(1):94-7. doi: 10.1002/jps.22262. Epub 2010 Jun 22. [PubMed:20574995 ]
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Drug created on June 13, 2005 07:24 / Updated on August 30, 2016 02:13