Soil-transmitted helminths infect well over a billion people worldwide. Ivermectin is highly effective against some of them and distinctly weaker against others, and knowing which is which matters more than any dosing detail. Choosing the wrong drug for the wrong worm is the most common reason deworming fails.
Strongyloides stercoralis (threadworm) — ivermectin is first-line and FDA-approved, achieving parasitological cure in roughly 80 to 95 percent of cases. Nothing else performs comparably.
Ascaris lumbricoides (roundworm) — excellent activity, with cure rates commonly above 90 percent from a single dose.
Enterobius vermicularis (pinworm) — effective, though mebendazole and albendazole are more commonly used first.
Trichuris trichiura (whipworm) — ivermectin alone performs poorly. Cure rates from monotherapy are low, and this is a well-documented limitation rather than a marginal one.
Hookworm (Necator americanus, Ancylostoma duodenale) — also poor as monotherapy. Albendazole is substantially better here.
This is precisely why deworming programmes increasingly use ivermectin combined with albendazole. The combination covers the gaps each drug leaves: trials of ivermectin plus albendazole against whipworm show markedly higher cure rates than either drug alone.
Ivermectin has no useful activity against tapeworms (Taenia species) or against flukes such as Schistosoma. These require praziquantel, which works by an entirely different mechanism. Taking ivermectin for a tapeworm will simply not work.
For strongyloidiasis the regimen is 200 mcg/kg once daily for two consecutive days. For ascariasis and most other susceptible intestinal worms, a single dose of 150 to 200 mcg/kg is typical, sometimes repeated after two weeks. Absorption improves substantially when taken with food.
See the full dosage guide for weight-based calculations.
Stool microscopy is the usual check, but larval and egg shedding is intermittent and often scanty, so a single negative sample does not exclude infection. Multiple samples over several days give a far more reliable answer. For strongyloidiasis, serology should also decline substantially over 6 to 12 months after successful treatment.
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View products and pricingNo. It is excellent against Strongyloides and roundworm, weak against whipworm and hookworm, and has no useful activity at all against tapeworms or flukes, which need praziquantel.
Because their weaknesses differ. Ivermectin is weak against whipworm and hookworm while albendazole covers those better, and albendazole is weak against Strongyloides where ivermectin excels. Trials of the combination against whipworm show markedly higher cure rates than either alone.
No. Tapeworms and flukes require praziquantel, which works by a completely different mechanism. Ivermectin will not clear a tapeworm infection.
Stool microscopy, but repeated over several days rather than once, because shedding is intermittent. For Strongyloides, serology should also fall substantially over 6 to 12 months.