Ivermectina
Ivermectin
22,23-dihydroavermectin B1a + 22,23-dihydroavermectin B1b
También conocido como: Heartgard · Ivomec · Equimectrin · Eqvalan · Zimectrin · Equimax · Phoenectin · Tri-Heart Plus · Panacur Plus · Stromectol · Otimectin Vet · Panomec · MK 933 · Ivermectine · Ivermectinum · Ivermectina
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a preventative for heartworm | 6-12 micrograms/kg PO once monthly | PO | once monthly | — | 🌎 NA |
| As a preventative for heartworm | Minimum dosage of 6 micrograms/kg (0.006 mg/kg) PO per month. | PO | per month | — | 🌎 NA |
| As a microfilaricide | 6-12 micro-grams/kg PO once a month | PO | once a month | — | 🌎 NA |
| As an adulticide or pre-adulticide for heartworm (with doxycycline) | 6-14 micrograms/kg PO once every 15 days for 6 months | PO | once every 15 days | 6 months | 🌎 NA |
| For generalized demodicosis | Day 1: 100 micrograms/kg PO q24h, Day 4: 200 micrograms/kg PO q24h, Day 7: 300 micrograms/kg; continue to increase by 100 micro-grams/kg every 3rd day until reach target dose of 600 micrograms/kg PO daily | PO | q24h | 1-2 months after 2 negative skin scrapes | 🌎 NA |
| For demodicosis (alternative protocol) | Start at a trial dose of 0.05 mg/kg (50 micrograms/kg) day 1. Then increase the dose to 0.12 mg/kg for the next week... go up to 0.2 mg/kg for the next 3 days, and then increase the dose weekly by 0.1 mg/kg until you reach 0.6 mg/kg. | PO | daily | 2 months past negative scrapings | 🌎 NA |
| As scabicide | 300-400 micrograms/kg PO or SC once weekly for weeks. | PO/SC | once weekly | for weeks | 🌎 NA |
| For treatment of parasitic lung disease (Capillaria spp.) | 0.2 mg/kg PO once | PO | once | — | 🌎 NA |
| For Oslerus osleri | 0.4 mg/kg SC once | SC | once | — | 🌎 NA |
| For Eucoleus boehmi | 0.2 mg/kg PO once | PO | once | — | 🌎 NA |
| For Pneumonyssoides caninum | 0.2 mg/kg SC once | SC | once | — | 🌎 NA |
- As a microfilaricide: To kill third, fourth, and young fifth stage larvae. Alternatively, 50 micrograms/kg for rapid kill (higher risk of adverse effects).
- As an adulticide or pre-adulticide for heartworm (with doxycycline): Used in combination with doxycycline 10 mg/kg PO once daily for 30 days.
- For generalized demodicosis: Do not use in ABCB1-1Δ susceptible breeds unless tested normal/normal.
- As scabicide: Beware in sensitive breeds.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a preventative for heartworm | 0.024 mg/kg (24 micrograms/kg) PO every 30-45 days | PO | every 30-45 days | — | 🌎 NA |
| For Aelurostrongylus abstrusus | 0.4 mg/kg SC once | SC | once | — | 🌎 NA |
| Ear mites | 1 mg/g ear gel | topical | Not specified | Not specified | 🌍 EU |
- As a preventative for heartworm: Also controls hookworms at this dosage.
- Ear mites: Otimectin Vet. Do not use in kittens under 16 weeks.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Rabbits: For Sarcoptes scabiei, Notoedres cati | 0.3-0.4 mg/kg SC, repeat in 14 days. | SC | repeat in 14 days | — | 🌎 NA |
| Rabbits: For ear mites (Psoroptes) | 0.2-0.44 mg/kg PO, SC repeat in 8-18 days | PO/SC | repeat in 8-18 days | — | 🌎 NA |
| Rabbits: For treatment of ear mites | 200 micrograms/kg SC and repeated in two weeks. | SC | repeated in two weeks | — | 🌎 NA |
| Rodents and lagomorphs: For treatment of sarcoptoid and some fur mites | 200-250 micrograms/kg SC. | SC | once | — | 🌎 NA |
| Mice, Rats, Gerbils, Guinea pigs, Chinchillas | 200 micrograms/kg SC or PO every 7 days for 3 weeks | SC/PO | every 7 days | 3 weeks | 🌎 NA |
| Hamsters | 200-500 micrograms/kg SC or PO every 14 days for 3 weeks | SC/PO | every 14 days | 3 weeks | 🌎 NA |
| Guinea pigs for Trixacarus caviae mites | 500 micrograms/kg SC, repeated at 14 and 28 days. | SC | repeated at 14 and 28 days | — | 🌎 NA |
- Rabbits: For treatment of ear mites: All rabbits in colony should be treated.
Hurones
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For prevention of heartworm disease | 0.02 mg/kg PO monthly | PO | monthly | — | 🌎 NA |
| To treat heartworm disease using the very slow protocol | 50 micrograms PO once a month. | PO | once a month | — | 🌎 NA |
Aves
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For ascarids, Capillaria, Knemidocoptes pilae | Inject 220 micrograms/kg IM; Amazons: 0.1 mg IM; Macaws: 0.2 mg IM; Finches: 0.02 mg | IM | once | — | 🌎 NA |
| For most species | 200 micrograms/kg IM or orally; repeat in 10-14 days. | IM/PO | repeat in 10-14 days | — | 🌎 NA |
| Budgerigars | 0.01 mL of diluted product (see above) IM or PO | IM/PO | once | — | 🌎 NA |
| For most species | 200 micrograms/kg (0.2 mg/kg) SC; dilute using propylene glycol. | SC | once | — | 🌎 NA |
| Ratites | 200 micrograms/kg PO, IM or SC. | PO/IM/SC | once | — | 🌎 NA |
- For ascarids, Capillaria, Knemidocoptes pilae: Dilute to a 2 mg/mL concentration or dilute bovine prep 1:4 with propylene glycol.
- Ratites: Has efficacy against Chandlerella quiscali in emus.
Reptiles
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For most nematodes, ectoparasites (Lizards, snakes, alligators) | 0.2 mg/kg (200 micrograms/kg) IM, SC, or PO once; repeat in 2 weeks. | IM/SC/PO | repeat in 2 weeks | — | 🌎 NA |
- For most nematodes, ectoparasites (Lizards, snakes, alligators): A third treatment can be given if still positive. Toxic to chelonians, indigo snakes, skinks.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For susceptible parasites | 200 micrograms/kg (0.2 mg/kg) PO using oral paste or oral liquid | PO | once | — | 🌎 NA |
| For lice and mange | 0.2 mg/kg PO; 0.2 mg/kg PO at 4 day intervals | PO | at 4 day intervals | — | 🌎 NA |
| As a larvicidal for arterial stages of S. vulgaris | 0.2 mg/kg once | PO | once | — | 🌎 NA |
Ganado
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For susceptible parasites | 200 micrograms/kg SC. | SC | once | — | 🌎 NA |
| For psoroptic mange | 200 mg/kg IM | IM | once | — | 🌎 NA |
| For susceptible parasites | 200 micrograms/kg (0.2 mg/kg) SC under the loose skin in front of or behind the shoulder | SC | once | — | 🌎 NA |
- For susceptible parasites: Doses greater than 10 mL should be given at two separate sites.
- For psoroptic mange: Note: Reference was written before approval of the SC labeled bovine product; isolate from other cattle for at least 5 days after treatment.
Cerdos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For susceptible parasites | 300 micrograms/kg (0.3 mg/kg) SC in the neck immediately behind the ear | SC | once | — | 🌎 NA |
| For general control of endo- and ectoparasites in potbellied pigs | 300 micro-grams/kg SC or IM once for internal parasites and repeated in 10-14 days for external parasites | SC/IM | once, repeat in 10-14 days | — | 🌎 NA |
- For general control of endo- and ectoparasites in potbellied pigs: Only partially effective against whipworms.
Ovejas
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For nasal bot infection | 200 micrograms/kg | SC/PO | once | — | 🌎 NA |
| For susceptible parasites | 200 micrograms/kg SC for one dose | SC | once | — | 🌎 NA |
| For adjunctive treatment of meningeal worm (Parelaphostrongylus tenuis) | 0.3 mg/kg SC once daily for 5 days | SC | once daily | 5 days | 🌎 NA |
| Camelids: For susceptible parasites | 0.2 mg/kg PO or SC for one dose | PO/SC | once | — | 🌎 NA |
| Camelids: For GI helminths | 0.2 mg/kg PO once. | PO | once | — | 🌎 NA |
| Camelids: For adjunctive treatment of meningeal worm | 0.3 mg/kg SC once daily for 5 days. | SC | once daily | 5 days | 🌎 NA |
- For adjunctive treatment of meningeal worm (Parelaphostrongylus tenuis): Given with fenbendazole (50 mg/kg PO once daily for 5 days).
- Camelids: For adjunctive treatment of meningeal worm: Given with fenbendazole. Camelids very susceptible to GI ulcers; give prophylaxis.
Cabras
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| For susceptible parasites | 200 micrograms/kg SC for one dose | SC | once | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La ivermectina es un agente antiparasitario prototipo de las avermectinas ampliamente utilizado en múltiples especies veterinarias. Es un derivado de la lactona macrocíclica altamente eficaz contra un amplio espectro de nematodos y artrópodos.
Aspectos clínicos destacados:
- Usos aprobados por la FDA: Prevención de la dirofilariosis en perros y gatos; tratamiento de nematodos gastrointestinales, gusanos pulmonares, larvas de moscas, piojos y ácaros en ganado bovino, porcino, equino, renos y bisontes.
- Usos fuera de etiqueta (Extra-Label): Microfilaricida, adulticida de acción lenta (a menudo combinado con doxiciclina) y tratamiento para la demodicosis generalizada y la sarna en animales pequeños.
- Sensibilidad genética: Se requiere extrema precaución en razas susceptibles a la mutación ABCB1-1Δ (anteriormente MDR1) (p. ej., Collies, Pastores Australianos, Pastores de Shetland, Whippets de pelo largo). Estos perros carecen de una bomba de glicoproteína P funcional en la barrera hematoencefálica, lo que provoca una toxicidad grave y potencialmente mortal en el SNC a las dosis comúnmente utilizadas para la sarna o las microfilarias.
- Perfil de toxicidad: Generalmente segura a dosis bajas para la prevención de la dirofilariosis (incluso en perros con MDR1), pero el riesgo de neurotoxicidad aumenta significativamente a dosis más altas o cuando se combina con inhibidores de la glicoproteína P.
Mecanismo de acción
Ivermectin exerts its antiparasitic effect by binding selectively and with high affinity to glutamate-gated chloride channels which occur in invertebrate nerve and muscle cells.
- Primary Mechanism: Binds to glutamate-gated chloride channels → increases cell membrane permeability to chloride ions → hyperpolarization of the nerve or muscle cell → flaccid paralysis and death of the parasite.
- Secondary Mechanism: Enhances the release of gamma-aminobutyric acid (GABA) at presynaptic neurons. GABA acts as an inhibitory neurotransmitter → blocks post-synaptic stimulation → paralysis.
Pharmacology Pearl: Because flukes (trematodes) and tapeworms (cestodes) do not utilize GABA as a peripheral nerve transmitter and lack glutamate-gated chloride channels, ivermectin is completely ineffective against these parasites. Mammals generally lack glutamate-gated chloride channels, and mammalian GABA receptors are confined to the CNS, which ivermectin does not readily cross (unless the P-glycoprotein pump is defective or overwhelmed), providing a wide margin of safety.
Seguridad y advertencias
Contraindicaciones
- Foals less than 4 months old (manufacturer recommendation)
- Puppies less than 6 weeks old
- Breeds susceptible to ABCB1-1Δ (MDR1) mutation at high doses (unless tested normal)
- Chelonians (turtles, tortoises)
- Indigo snakes
- Skinks
- Lactating dairy animals (no milk withdrawal established)
- Females of breeding age (cattle/swine, per label)
- Dogs with the MDR1 (ABCB1) gene mutation (unless using strictly at low heartworm preventative doses)
- Chelonians (turtles and tortoises) - causes fatal flaccid paralysis
- Kittens under 16 weeks of age (for topical ear gel)
- Use of concentrated livestock formulations in small animals
Efectos adversos
- Horses: Ventral midline swelling and pruritus (hypersensitivity to dying Onchocerca microfilariae)
- Dogs: Shock-like reaction (when used as microfilaricide), depression, hypothermia, vomiting
- Dogs (MDR1/Toxicity): Ataxia, lethargy, hypersalivation, mydriasis, tremors, seizures, blindness, coma
- Cats: Agitation, vocalization, anorexia, mydriasis, rear limb paresis, tremors, disorientation, blindness
- Cattle: Paralysis/staggering or salivation/bloat (if Hypoderma bovis larvae are killed in vital areas), injection site swelling
- Birds: Lethargy, anorexia, death (especially in finches and budgerigars)
- Neurotoxicity (ataxia, tremors, mydriasis, blindness, coma, death) - especially in MDR1-mutant dogs
- Bradycardia
Precauciones
MDR1 Gene Mutation Warning: Ivermectin is actively transported out of the CNS by the P-glycoprotein pump. Dogs with the ABCB1-1Δ (formerly MDR1) mutation have a defective pump, allowing ivermectin to accumulate in the brain, causing severe neurotoxicity. Always test susceptible breeds (Collies, Shelties, Australian Shepherds, Long-haired Whippets, 'white feet' breeds) before using extra-label high doses. Heartworm preventative doses are generally safe.
- Species Sensitivities: Highly toxic to chelonians (turtles/tortoises), indigo snakes, and skinks. Finches and budgerigars are highly sensitive.
- Cattle Grubs: Treating cattle for Hypoderma bovis when larvae are migrating through the spinal canal or esophagus can cause severe host reactions (paralysis or bloat) due to larval death in vital areas.
- Food Animal Withdrawal: Strict adherence to slaughter withdrawal times is required. Not approved for lactating dairy animals.
- Administration: Injectable products for cattle and swine are for SC use only; do not administer IM or IV.
Interacciones farmacológicas
Effects may be potentiated by ivermectin; concurrent use is not advised.
Avoid ivermectin in reptiles within 10 days of ketamine administration.
Increased risk of neurotoxicity; do not use with high extra-label doses of ivermectin.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
Strong P-glycoprotein inhibitor; should never be used with ivermectin in dogs.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
P-glycoprotein inhibitor; increases risk of ivermectin CNS toxicity.
Monitorización
- Clinical efficacy (resolution of parasites, negative skin scrapes, etc.)
- Adverse effects/toxicity (especially neurologic signs: ataxia, mydriasis, tremors)
- MDR1 (ABCB1) genotype (prior to use in susceptible breeds)
- Neurological signs (ataxia, mydriasis, tremors)
- Resolution of parasitic infection
Farmacocinética
Vida media
Absorción
In simple-stomached animals, up to 95% absorbed after oral administration. Ruminants only absorb 1/4-1/3 of a dose due to rumen inactivation. SC administration has greater bioavailability, but oral dosing is absorbed more rapidly. Bioavailability is lower in cats than in dogs.
Distribución
Well distributed to most tissues. Does not readily penetrate the CSF in normal animals, minimizing toxicity. Dogs with the ABCB1-1Δ (MDR1) gene defect allow more ivermectin into the CNS. Volume of distribution: Cattle 0.45-2.4 L/kg; Dogs 2.4 L/kg; Swine 4 L/kg; Sheep 4.6 L/kg.
Metabolismo
Metabolized in the liver via oxidative pathways.
Eliminación
Primarily excreted in the feces. Less than 5% of the drug (parent compound or metabolites) is excreted in the urine.
Sobredosis
Clinical Signs of Toxicity:
- Dogs: Vomiting, ataxia, lethargy, tachycardia, hypersalivation, mydriasis, tremors, and seizures. In non-sensitive breeds, signs rarely occur at ≤ 1 mg/kg. Mydriasis occurs at 2.5 mg/kg, tremors at 5 mg/kg, severe tremors/ataxia at 10 mg/kg. LD50 is 80 mg/kg. In MDR1-sensitive breeds, severe signs can develop within 4 hours at much lower doses.
- Cats: Agitation, vocalization, anorexia, mydriasis, rear limb paresis, tremors, disorientation, blindness, head pressing, wall climbing. Margin of safety is narrower in kittens (signs seen at 300 mcg/kg).
- Large Animals: Horses show visual impairment, depression, ataxia at 2 mg/kg. Cattle show ataxia and listlessness at 8 mg/kg. Swine show lethargy, ataxia, tremors, lateral recumbency at 30 mg/kg.
Treatment:
- Decontamination: Emptying the gut should be considered for recent massive oral ingestions. Repeated doses of activated charcoal are advised to interrupt enterohepatic recirculation.
- Supportive Care: Symptomatic and supportive therapy for CNS, GI, and cardiovascular effects.
- Advanced Therapy: Intravenous Lipid Emulsion (IVFE) therapy has been used successfully to facilitate clearance of ivermectin due to its highly lipophilic nature.
Productos disponibles
Formulaciones
- Injection
- Oral Liquid
- Oral Tablets
- Chewable Tablets
- Oral Solution (Drench)
- Bolus
- Medicated Feed Premix
- Topical Pour-on
- Otic Suspension
- Injectable: 10 mg/ml (licensed for farm animals)
- Topical: 1 mg/g ear gel (for cats)
- Oral: Pastes and drenches (farm animals)
Veterinario
- Ivermectin for Injection: 10 mg/mL (1%) and 2.7 mg/mL (0.27%)
- Ivermectin Oral Paste: 1.87%
- Ivermectin Liquid: 1% (10 mg/mL)
- Ivermectin Oral Tablets/Chewables: 68 mcg, 136 mcg, 272 mcg (Dogs); 55 mcg, 165 mcg (Cats)
- Ivermectin Oral Solution (Drench): 0.08%
- Ivermectin SR Bolus: 1.72 gram
- Ivermectin Medicated feeds: 0.6%, 0.02%, 0.1%
- Ivermectin Topical Pour-on: 5 mg/mL
- Combination products with Clorsulon, Pyrantel, Praziquantel, or Fenbendazole
- Otic suspension (Acarexx)
- Otimectin Vet 1 mg/g ear gel
- Various 10 mg/ml injectables (licensed for farm animals)
- Various oral pastes and drenches (licensed for farm animals)
Etiquetado para humanos
- Ivermectin Tablets: 3 mg and 6 mg (Stromectol)
- Stromectol 3 mg tablets
- Soolantra 1% cream
Estado regulador
Tiempos de retirada: cattle meat Varies by product (e.g., 49 days)
Otimectin Vet approved for cats.
Classified as POM-V (Prescription Only Medicine - Veterinarian).
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Ivermectin is photolabile in solution; protect from light. Store products at room temperature (15-30°C) unless otherwise specified. The 1% oral solution is stable at 1:20 and 1:40 dilutions with water for 72 hours when stored in a tight container at room temperature and protected from light.
Información para el cliente
Información importante para los propietarios de mascotas
- Prevención de la dirofilariosis: Cuando se utiliza a las dosis bajas prescritas para la prevención de la dirofilariosis, la ivermectina es extremadamente segura para todas las razas de perros y gatos.
- Sensibilidad racial: Ciertas razas de pastoreo (como Collies, Pastores Australianos y Pastores de Shetland) pueden tener una mutación genética que los hace altamente sensibles a la ivermectina a dosis más altas. Su veterinario puede recomendar una prueba genética antes de usar este medicamento para afecciones como la sarna.
- Signos de toxicidad: Contacte a su veterinario inmediatamente si su mascota muestra signos de tambaleo, pupilas dilatadas, babeo, temblores, letargo o ceguera después de recibir este medicamento.
- Precauciones de manipulación: Si utiliza productos líquidos o en pasta para animales grandes, lávese las manos después de su uso y evite el contacto con los ojos. No coma ni fume mientras manipula el producto.
- Seguridad ambiental: Deseche los productos no utilizados con cuidado. La ivermectina es altamente tóxica para los peces y los organismos acuáticos; no la deseche en lagos, arroyos o estanques.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.
