Ivermectin oral tablet interactions: Alcohol, medications, and other factors

Ivermectin interactions with other drugs

Before you start treatment with ivermectin tablets, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether ivermectin interacts with supplements, herbs, or vitamins, see the “Ivermectin and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of ivermectin drug interactions in humans. Keep in mind this table doesn’t include all drugs that may interact with ivermectin. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid ivermectin  

In some cases, factors or conditions could prevent your doctor from prescribing ivermectin due to the risk of harm. These are known as contraindications. Below are the contraindications of ivermectin.

Note: Before you start treatment with ivermectin, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe ivermectin.

Having had an allergic reaction to ivermectin or any of its ingredients

If you have had an allergic reaction to ivermectin or any of its ingredients, your doctor will likely not prescribe ivermectin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Ivermectin interaction with alcohol 

There are no known interactions between ivermectin and alcohol. However, if you drink alcohol, your doctor may advise you to avoid or limit it during ivermectin treatment.

This is because drinking alcohol while taking the drug may worsen some of ivermectin’s side effects. For example, you may experience:

• nausea
• vomiting
• dizziness
• sleepiness

If you consume alcohol during ivermectin treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking ivermectin, talk with your doctor.

Drug interactions in depth 

Here’s a closer look at certain drug interactions of ivermectin.

Warfarin

Taking ivermectin with warfarin can increase the effect and risk of side effects of warfarin. Warfarin is a blood thinner. Ivermectin has blood-thinning effects as well. So, combining these drugs can enhance the blood-thinning effects and increase your risk of unwanted bleeding.

Steps you or your doctor may take

Tell your doctor if you take warfarin before starting ivermectin. They may lower your dosage of warfarin or choose an alternative treatment altogether. If you are taking ivermectin and warfarin together, your doctor will likely monitor your international normalized ratio (INR, a type of test that measures how thin your blood is) more frequently. Tell your doctor right away if you develop any unusual bleeding symptoms, such as a bloody nose, bleeding gums, or bloody stool or urine.

Mirabegron (Myrbetriq)

Combining mirabegron and ivermectin can increase the risk of side effects of ivermectin. This is because mirabegron blocks the activity of an enzyme (protein) that’s involved in breaking down ivermectin in your body. If this enzyme is blocked, ivermectin may not be broken down as quickly as usual. This can lead to the drug building up in your body, which can increase your risk of side effects of ivermectin.

Steps you or your doctor may take

Let your doctor know if you take mirabegron before you start taking ivermectin. They may prescribe a lower dose of ivermectin to lower the risk of side effects.

Certain antifungals

Combining ivermectin with certain antifungals can increase the risk of side effects of ivermectin. Some antifungals slow down the activity of an enzyme that helps break down ivermectin in your system. This can cause ivermectin to build up in your body, which increases your risk of side effects from the drug.

Here are some antifungals that may interact with ivermectin:

• posaconazole (Noxafil)
• ketoconazole (Nizoral, others)
• itraconazole (Sporanox, others)

Steps you or your doctor may take

Before starting ivermectin, tell your doctor if you take any antifungal medications. They may prescribe a lower dosage of ivermectin than usual, or they may recommend a different treatment altogether.

Ivermectin and other interactions

Ivermectin may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with ivermectin. Keep in mind that the following information does not include all other possible ivermectin interactions.

Ivermectin interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Ivermectin interactions with herbs

There are no specific reports of herbs interacting with ivermectin. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during ivermectin treatment.

Ivermectin interactions with vitamins

There are no specific reports of vitamins interacting with ivermectin. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with ivermectin.

Ivermectin interactions with food

There were no reports of food interactions with ivermectin. If you’d like to learn more about eating certain foods during treatment with ivermectin, talk with your doctor.

Ivermectin interactions with vaccines

There aren’t any known interactions between ivermectin and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Ivermectin interactions with lab tests

Ivermectin isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

IVERMECTIN INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with ivermectin. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with ivermectin. The impact of cannabis may affect how well you stick to your ivermectin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Ivermectin and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with ivermectin. Before you take this drug, be sure to talk with your doctor about your health history. Ivermectin may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with ivermectin include:

• Liver problems: Ivermectin can cause liver problems. If you have existing liver issues, this drug may worsen your condition. Your doctor can help determine if it’s safe for you to take ivermectin.
• Asthma: Ivermectin may worsen asthma. Although this didn’t occur in studies of the drug, it has been reported after the drug came on the market. If you have asthma, let your doctor know. They can discuss whether it’s safe to start treatment with ivermectin.
• Immune system condition: If you have a condition that weakens your immune system, such as HIV, ivermectin may not work as effectively as it should. Let your doctor know if you have an immune system condition. They can determine whether you need extra doses of ivermectin for your infection.
• Seizures: Ivermectin may cause seizures. While this didn’t occur in studies of the drug, it has been reported by people who have taken the drug after it was approved. If you have a history of seizures, talk with your doctor about whether ivermectin is safe for you.
• Allergic reaction: If you’ve had an allergic reaction to ivermectin or any of its ingredients, your doctor will likely not prescribe ivermectin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be a better option for you.
• Breastfeeding: It’s not known whether it’s safe to use ivermectin while breastfeeding. Ivermectin can pass into breast milk in small amounts, but it isn’t known what effects ivermectin has on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using ivermectin. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
• Pregnancy: You should not take ivermectin while pregnant. There haven’t been studies to determine if ivermectin is safe during pregnancy. However, animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting ivermectin. They can advise you on the right treatment plan for you.

Preventing interactions  

You can take certain steps to help prevent interactions with ivermectin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the ivermectin label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If ivermectin doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with ivermectin by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.