The standard ivermectin dosage for humans is 200 mcg per kg of body weight for strongyloidiasis and 150 mcg per kg for onchocerciasis, given as a single oral dose on an empty stomach. Your exact tablet count depends on your weight, and the FDA-approved tables make this straightforward to calculate. This guide lays out both dosage charts side by side, explains what affects absorption, and covers what to watch for after you take it.

Ivermectin Dosage Chart for Strongyloidiasis

Strongyloidiasis is a roundworm infection caused by Strongyloides stercoralis. It often goes undiagnosed for years because symptoms are mild or absent, but it can become life-threatening in immunocompromised patients. Ivermectin is the first-line treatment, and a single dose clears the infection in most people.

According to DailyMed, the recommended dose is approximately 200 mcg of ivermectin per kg of body weight, taken as a single oral dose. Using standard 3 mg tablets, the dosing breaks down as follows:

For patients over 80 kg, you calculate the dose directly: multiply your weight in kilograms by 0.2 mg (200 mcg) to get the total milligram dose needed. A person weighing 100 kg, for example, would need 20 mg total, which is about 6–7 of the standard 3 mg tablets.

One dose is usually enough. That said, DailyMed recommends follow-up stool examinations to confirm the infection is gone. In one French study conducted in a non-endemic area, some patients showed recrudescence of Strongyloides larvae up to 106 days after treatment. If that happens, retreatment is appropriate. You should have at least three stool exams over the three months following treatment.

Clinical data back up ivermectin's effectiveness here. In controlled trials, ivermectin at 170–200 mcg/kg achieved cure rates of 83–92%, significantly outperforming albendazole (which hit 45–55% in the same studies). For most adults in the 60–80 kg range, that's a 4–5 tablet single dose.

If you need a combination antiparasitic product, Bandy-Plus Tablet (ivermectin 6mg + albendazole 400mg) pairs both agents in one tablet, which some clinicians prefer for mixed or unclear parasitic infections.

Ivermectin Dosage Chart for Onchocerciasis (River Blindness)

Onchocerciasis, also called river blindness, is caused by the filarial worm Onchocerca volvulus. Ivermectin doesn't kill the adult worm, but it's highly effective against the microfilariae (the larvae), which are responsible for the skin and eye damage. The recommended dose here is slightly lower than for strongyloidiasis: 150 mcg per kg of body weight.

According to DailyMed, the dosage guidelines for onchocerciasis using 3 mg tablets are:

For retreatment, the FDA label states intervals as short as 3 months are acceptable for individual patients. In mass distribution programs, the standard interval is 12 months. The clinical evidence is impressive: a single 150 mcg/kg dose produced a 99.5% reduction in skin microfilariae count at 3 months, with that reduction maintained for up to 12 months after one dose.

You can read more about how ivermectin works mechanically and what conditions it treats in this overview of ivermectin uses and benefits.

For higher-dose protocols or patients over 80–85 kg, Ivermaxx 80 mg is available through SafeRxPills and provides a concentrated option that avoids the need for multiple smaller tablets.

How to Take Ivermectin Correctly (Timing and Food Matter)

Take ivermectin on an empty stomach with a full glass of water. This is not just a suggestion. DailyMed's pharmacokinetic data shows that taking a 30 mg dose of ivermectin after a high-fat meal increases bioavailability by approximately 2.5 times compared to taking it fasted. That sounds like it might be a good thing, but it's unpredictable and can increase the risk of side effects, especially at higher doses. The FDA-approved dosing tables are calibrated for fasted administration.

Peak plasma concentrations occur around 4 hours after taking the tablet. The plasma half-life is approximately 18 hours, meaning the drug clears your system over about 2–3 days. Ivermectin and its metabolites are excreted almost entirely in feces over about 12 days, with less than 1% going through urine.

The drug is metabolized primarily by the liver enzyme CYP3A4. If you're on any medications that inhibit or induce CYP3A4, your ivermectin levels could be higher or lower than expected. Talk to your prescriber about this before dosing.

For scabies, the dosing approach has some differences. If that's your situation, the ivermectin dosage guide for scabies covers the specifics, including why a second dose 2 weeks later is typically recommended for crusted scabies.

Side Effects: What's Common, What's Serious

Ivermectin is generally well tolerated at approved doses. The most commonly reported side effects in strongyloidiasis patients across four clinical studies (109 patients total) were dizziness (2.8%) and pruritus (2.8%). Diarrhea and nausea each occurred in 1.8% of patients. Fatigue, abdominal pain, rash, and vomiting were all reported in under 1% of patients.

Onchocerciasis treatment produces a different side effect picture, partly because of what's called the Mazzotti reaction. This is an inflammatory response triggered by the die-off of microfilariae, not the drug itself. Symptoms include itching (27.5% of patients), fever (22.6%), skin rash or edema (22.7%), and swollen lymph nodes in the groin or armpits. These typically occur in the first four days post-treatment and resolve without specific intervention in most cases. Antihistamines or aspirin are used for mild-to-moderate reactions.

Peripheral edema occurred in 3.2% of onchocerciasis patients in clinical trials, and tachycardia in 3.5%. Orthostatic hypotension was reported in 1.1%.

Serious adverse events are rare but real. Post-marketing reports include Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures, hepatitis, and elevated liver enzymes. Neurotoxicity, including confusion, disorientation, and in rare cases coma, has been reported both at recommended doses and in overdose. These neurological effects have generally resolved with supportive care and stopping the drug.

If you experience significant dizziness, confusion, or any altered consciousness after taking ivermectin, seek medical attention promptly.

Drug Interactions and Who Should Not Take Ivermectin

Ivermectin has one well-documented drug interaction you need to know about: warfarin. Post-marketing reports show that ivermectin can increase INR (a measure of blood clotting time) when taken alongside warfarin. If you're on an anticoagulant, your prescriber needs to know before you take ivermectin, and INR monitoring may be needed afterward.

The only absolute contraindication listed in the FDA label is hypersensitivity to ivermectin or any component of the formulation. If you've had a prior allergic reaction to ivermectin, don't take it again without specialist guidance.

Patients with heavy Loa loa co-infection require special caution. Ivermectin can trigger serious neurological reactions in patients with high Loa loa microfilaremia. This is primarily a concern in people who've lived in or traveled through Central African countries where Loa loa is endemic.

Because ivermectin is metabolized by CYP3A4, co-administration with strong CYP3A4 inhibitors (such as certain antifungals or HIV protease inhibitors) could raise ivermectin plasma levels. Conversely, CYP3A4 inducers like rifampin could reduce its effectiveness. Dose adjustment or timing separation may be appropriate in these cases.

There's no data to suggest ivermectin significantly inhibits other CYP450 enzymes at clinically relevant concentrations, which limits its interaction burden on other drugs you might be taking.

For a broader look at antiparasitic options, the guide to metronidazole covers another commonly used antiparasitic and anti-infective agent that's sometimes prescribed alongside ivermectin for mixed infections.

Getting Ivermectin in the USA: What You Need to Know

In the United States, ivermectin tablets are FDA-approved for treating strongyloidiasis and onchocerciasis. They are a prescription medication, meaning you need a valid prescription from a licensed US provider to obtain them legally.

Prices at US retail pharmacies for brand-name ivermectin (Stromectol) can be steep, often $50–$150 or more for a single treatment course depending on your dose and pharmacy. Generic versions are more affordable but still vary widely by location and insurance coverage.

SafeRxPills ships to US customers with a valid prescription. You can order Ivermaxx 80 mg or the combination product Bandy-Plus (ivermectin + albendazole) at significantly lower prices than typical US retail. Shipping is tracked and discreet. If you want to understand the full process before ordering, the guide to buying ivermectin online in the USA walks through everything: what to upload, how prescriptions are verified, and what delivery timelines look like.

One practical note: if you're treating strongyloidiasis, order enough for follow-up treatment before you need it. Some patients require retreatment 4–12 weeks after the initial dose if stool exams show persistent larvae. Having a second course on hand avoids delays.

Frequently Asked Questions