伊維菌素

Ivermectin

22,23-dihydroavermectin B1a + 22,23-dihydroavermectin B1b

抗寄生蟲藥 - 巨環內酯類 (阿維菌素)POSCIMTopical狗貓小型哺乳類雪貂鳥爬蟲類馬牛豬羊山羊

別名: Heartgard · Ivomec · Equimectrin · Eqvalan · Zimectrin · Equimax · Phoenectin · Tri-Heart Plus · Panacur Plus · Stromectol · Otimectin Vet · Panomec · MK 933 · Ivermectine · Ivermectinum · Ivermectina

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

6-12 micrograms/kg PO once monthlyPO· once monthly

體重— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症	劑量	途徑	頻次	療程	地區
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.

貓

適應症	劑量	途徑	頻次	療程	地區
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.

小型哺乳類

適應症	劑量	途徑	頻次	療程	地區
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.

雪貂

適應症	劑量	途徑	頻次	療程	地區
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

鳥

適應症	劑量	途徑	頻次	療程	地區
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.

爬蟲類

適應症	劑量	途徑	頻次	療程	地區
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.

馬

適應症	劑量	途徑	頻次	療程	地區
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

牛

適應症	劑量	途徑	頻次	療程	地區
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.

豬

適應症	劑量	途徑	頻次	療程	地區
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.

羊

適應症	劑量	途徑	頻次	療程	地區
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.

山羊

適應症	劑量	途徑	頻次	療程	地區
For susceptible parasites	200 micrograms/kg SC for one dose	SC	once	—	🌎 NA

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

伊維菌素是一種典型的阿維菌素類 (avermectin) 抗寄生蟲藥物，廣泛應用於多種獸醫物種。它是一種巨環內酯類衍生物，對廣泛的線蟲和節肢動物具有高度療效。

主要臨床重點：

FDA 核准用途： 犬貓的心絲蟲預防；牛、豬、馬、馴鹿和野牛的胃腸道線蟲、肺蟲、牛皮蠅蛆、蝨子和蟎蟲治療。
標示外用途： 微絲蟲殺滅劑、緩慢殺滅成蟲療法（通常與多西環素併用），以及小動物的全身性毛囊蟲症和疥癬治療。
基因敏感性： 對於帶有 ABCB1-1Δ（原稱 MDR1） 基因突變的犬種（例如牧羊犬、澳洲牧羊犬、喜樂蒂牧羊犬、長毛惠比特犬等）需極度謹慎。這些犬隻的血腦屏障缺乏具功能的 P-醣蛋白幫浦，在用於治療疥癬或微絲蟲的常規劑量下，可能導致嚴重甚至致命的中樞神經系統毒性。
毒性概況： 在低劑量的心絲蟲預防用藥下通常是安全的（即使是 MDR1 突變犬隻），但在高劑量或與 P-醣蛋白抑制劑併用時，神經毒性風險會顯著增加。

作用機制

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.

安全性與警告

禁忌症

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

不良反應

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

注意事項

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.

藥物相互作用

Benzodiazepines

Effects may be potentiated by ivermectin; concurrent use is not advised.

Ketamine

Avoid ivermectin in reptiles within 10 days of ketamine administration.

SpinosadMajor

Increased risk of neurotoxicity; do not use with high extra-label doses of ivermectin.

Amiodarone