One strength. The strongyloides table does the counting
Plot the lock before anyone talks about a cart. Human ivermectin tablets in the United States are 3 mg. Stromectol's strongyloidiasis dose is a single oral amount meant to deliver about 200 mcg per kilogram. The FDA table turns weight bands into tablet counts. That is the only arithmetic this page will sell.
Stromectol 3 mg tablets at the labelled 200 mcg/kg strongyloidiasis lock
| Body weight | 3 mg tablets |
|---|---|
| 15-24 kg | 1 tablet |
| 25-35 kg | 2 tablets |
| 36-50 kg | 3 tablets |
| 51-65 kg | 4 tablets |
| 66-79 kg | 5 tablets |
| 80 kg and over | 200 mcg/kg, rounded by the prescriber |
Nearest published cash board: generic 3 mg x 10, GoodRx $36.45 average retail / $23.76 coupon (updated 03 August 2026).
Ivermectin 3 mg tablets, the only US tablet strength, locked here to the strongyloidiasis 200 mcg/kg schedule, marked September 2026. Weight bands above follow the Stromectol prescribing table. Onchocerciasis uses 150 mcg/kg and a different count. GoodRx lists 3 mg x 10 at $36.45 average retail and $23.76 with a coupon. Ask the window to price the counted course, not a leftover bottle. GoodRx stays in this caption. Each link is that pharmacy only. Advena does not dispense. Prescription required. Not a viral home remedy.
Fifteen to 24 kg takes one tablet. Twenty-five to 35 kg takes two. Thirty-six to 50 kg takes three. Fifty-one to 65 kg takes four. Sixty-six to 79 kg takes five. At 80 kg and above the prescriber calculates 200 mcg/kg and rounds. Those bands are Merck's Table 1, not a forum spreadsheet.
In general the label says extra doses are unnecessary. Follow-up stools still have to prove the larvae are gone. A French non-endemic series saw larvae come back as late as day 106. The PI therefore wants at least three stool exams over the next three months, using a concentration method such as Baermann, because larvae per gram can be scarce. Recrudescence means retreatment, not a bigger guessed pile on day two.
Buying Stromectol 3 mg online is still a prescription event. A legitimate US pharmacy prices the counted course. Coupon boards stay in the weight-card caption, including the 03 August 2026 GoodRx line for a ten-count bottle. Ask the window to price the tablets you were actually prescribed. Advena does not dispense. [email protected] is a sheet mailbox.
Chloride channels in the worm, a barrier in the host
Ivermectin is a mixture of at least 90% 22,23-dihydroavermectin B1a and less than 10% B1b. The formulas are C48H74O14 and C47H72O14. Weights 875.10 and 861.07. It comes from Streptomyces avermitilis avermectins. The powder is white to yellowish-white, melts near 155 C, insoluble in water, freely soluble in methanol.
The class binds glutamate-gated chloride channels on invertebrate nerve and muscle. Chloride floods in. The cell hyperpolarizes. The parasite paralyses and dies. GABA-gated chloride channels can be touched too. Mammals either lack those glutamate channels or bind avermectins weakly, and ivermectin does not readily cross the human blood-brain barrier. That triad is the safety story at labelled human doses.
Activity is stage-limited. Against Onchocerca volvulus it hits tissue microfilariae, not the adult in the nodule. Against Strongyloides stercoralis it hits intestinal stages. The indication language follows those limits. Nodulectomy can still matter in onchocerciasis because adults keep shedding microfilariae after a microfilaricidal swallow.
Stromectol tablets are white, round, flat, bevel-edged, coded MSD on one side and 32 on the other. Inactive ingredients: microcrystalline cellulose, pregelatinized starch, magnesium stearate, butylated hydroxyanisole, and anhydrous citric acid. Store below 30 C. That description is a human NDC, not a livestock jug.
River blindness uses 150 mcg/kg and does not kill the adult
Merck Table 2. Different bands from the 200 mcg/kg strongyloides lock.
In a placebo-controlled adult study, a single 150 mcg/kg dose cut the geometric mean skin microfilariae count by 83.2% at day 3 and 99.5% at 3 months. A reduction over 90% held out to 12 months. Some patients had more microfilariae in the anterior chamber at day 3, then better counts than placebo at 3 and 6 months. A pediatric open study in ages 6-13 (17-41 kg) showed similar skin drops out to a year.
STROMECTOL has no activity against adult Onchocerca. Adults live in nodules that are often not palpable. That is why retreatment is usual and why nodulectomy still appears in the note. Do not steal this page's title lock by counting an onchocerciasis course on the 200 mcg/kg grid. Wrong table, wrong tablet number.
Viral claims and veterinary jugs fail the same bench
Human tablets are approved at specific doses for some parasitic worms. Topicals cover lice and rosacea. Animal pour-on, injectable, paste, chewable, and drench products are approved for those species. They are concentrated differently and carry excipients that were not cleared for people. FDA has recorded hospitalizations after self-dosing with horse paste.
The Stromectol overdose section is explicit about veterinary exposure by mouth, lung, injection, or skin. Common reports: rash, edema, headache, dizziness, asthenia, nausea, vomiting, diarrhea. Also listed: seizure, ataxia, dyspnea, abdominal pain, paresthesia, urticaria, contact dermatitis. Support is fluids, airway, and pressors if blood pressure falls. There is no casual 'I used the livestock math and scaled it down' conversion.
Omura and Campbell's avermectin work later took a Nobel, and mass onchocerciasis programs still run on 150 mcg/kg. That history does not launder a viral claim. The longer myth walk is ivermectin uses and myths. Dr. Lena Hofer takes the questions below.
Empty stomach with water. A fatty meal more than doubles exposure
After single 12 mg doses in fasting volunteers (mean about 165 mcg/kg), mean peak H2B1a levels were 46.6 ng/mL in one study and 30.6 ng/mL in the other, near four hours. Ranges were wide. Plasma concentrations track dose. The plasma half-life is about 18 hours.
Those food numbers are why the administration line is not casual. The labelled human tablet is taken fasted. A high-fat breakfast is a different exposure. Do not 'take it with dinner to be kind to the stomach' unless a prescriber is deliberately chasing a different bioavailability.
Warfarin is the postmarketing interaction the PI bothers to name: rare INR rises when the two are combined. That is a bench check, not a trivia line. If someone is already anti-coagulated, the counted 3 mg course still needs a clinician who will look at the next INR, not a cart checkout.
Cure rates were measured against albendazole and thiabendazole
| Comparator study | Ivermectin cure | Comparator cure |
|---|---|---|
| Albendazole, international | 24/26 (92%) | 12/22 (55%) |
| Albendazole, WHO study | 126/152 (83%) | 67/149 (45%) |
| Thiabendazole, international | 9/14 (64%) | 13/15 (87%) |
| Thiabendazole, US studies | 14/14 (100%) | 16/17 (94%) |
The indication is intestinal, nondisseminated Strongyloides stercoralis. Quoted single-dose 200 mcg/kg cure bands in the indication text run 64-100%. That spread is why stool follow-up is part of the lock, not an optional lab.
Immunocompromised hosts, including people with HIV, may need repeated courses. The PI says adequate controlled studies have not defined the best regimen. Some clinicians repeat at two-week intervals. Cure may not be reachable. Extra-intestinal disease is hard to control; monthly suppression is sometimes used. None of that is a DIY calendar copied from a strongyloides forum.
A bacterial gut infection is a different lock. Do not treat an unclear diarrhea with leftover ivermectin, and do not reach for ciprofloxacin as a worm substitute. Species first. Then the tablet count.
Under 15 kg is unestablished. Pregnancy is Category C
Safety and effectiveness below 15 kg have not been established. Do not invent a half-tablet 'pediatric Stromectol' from a weight app. Geriatric trials did not enroll enough people over 65 to split responses. Treat an older adult cautiously because liver, kidney, heart, and other drugs pile up.
Ivermectin was teratogenic in mice, rats, and rabbits at repeated doses of 0.2, 8.1, and 4.5 times the maximum recommended human 200 mcg/kg dose on a mg/m2 basis. Cleft palate appeared in all three species. Clubbed forepaws also appeared in rabbits. Effects sat at or near maternotoxic doses. There are no adequate well-controlled studies in pregnant women. The PI says do not use in pregnancy because safety is not established.
The drug appears in human milk in low concentrations. Treat a breastfeeding mother only when delay is worse for her than the possible newborn risk. That is a named clinician's weighing, not a cart rule.
Off-label scabies and other parasite uses exist in clinics. They are not this title lock and they are not a reason to swallow livestock paste. Topical ivermectin for rosacea (Soolantra) and lotion for head lice (Sklice) are different products with different labels. Do not convert a cream percent into a 3 mg tablet count.
Mazzotti, Loa loa, and the strongyloides adverse list
Bench flags before a 3 mg count is issued
- Hypersensitivity to any component - contraindication
- Onchocerciasis Mazzotti-type reactions from dying microfilariae, plus possible drug effects
- Sowda (hyperreactive onchodermatitis) - more edema and skin flare after microfilaricides
- Loa loa co-infection - rare encephalopathy, including fatal cases; screen after West or Central Africa exposure
- Strongyloidiasis trial AEs (109 patients, 170-200 mcg/kg): dizziness 2.8%, pruritus 2.8%, diarrhea 1.8%, nausea 1.8%
Onchocerciasis trials in 963 adults (100-200 mcg/kg) saw Mazzotti worsening in the first four days: pruritus 27.5%, skin edema or rash 22.7%, fever 22.6%, inguinal node tenderness 13.9%, inguinal enlargement 12.6%, axillary enlargement 11.0%, arthralgia or synovitis 9.3%. Facial edema 1.2%, peripheral edema 3.2%, orthostatic hypotension 1.1%, tachycardia 3.5% were called drug-related at or above 1%. Headache and myalgia were common overall but rarely attributed to the drug.
Loa loa warnings are specific. Pain in the neck or back, red eye, conjunctival hemorrhage, dyspnea, incontinence, trouble standing, confusion, seizures, or coma have been reported in heavily co-infected people. Pretreatment assessment and close follow-up are the PI's words. They are not optional travel trivia.
Strongyloidiasis patients should not be talked into expecting Mazzotti. That pattern belongs to onchocerciasis. Lab notes in the 109-patient strongyloides set included ALT or AST rises in 2% and a leukocyte drop in 3%. Postmarketing across indications adds orthostatic hypotension, asthma worsening, SJS, TEN, seizures, hepatitis, and bilirubin or enzyme rises.
Issue a counted human course, then schedule the stools
A finished Stromectol sheet names the indication, the kg, the 3 mg count, and the empty-stomach instruction. For strongyloidiasis it also names the stool follow-up window. For onchocerciasis it names retreatment and the adult-worm limit. For anyone with Loa loa exposure it names the screen.
A ten-count bottle sitting in a drawer is not a viral kit. A foreign 6 mg or 12 mg 'ivermectin tablet' is not the US lock. If the story is pinworm in a US household, this is the wrong parasite page; use Emverm. Advena Med does not fill. A prescriber who can weigh the person still has to write the script.