伊維菌素
Ivermectin
22,23-dihydroavermectin B1a + 22,23-dihydroavermectin B1b
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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
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 |
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
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。
作用機轉
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.
藥物交互作用
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.
監測
- 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
藥物動力學
半衰期
吸收
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.
分佈
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.
代謝
Metabolized in the liver via oxidative pathways.
排除
Primarily excreted in the feces. Less than 5% of the drug (parent compound or metabolites) is excreted in the urine.
過量
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.
可用產品
劑型
- 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)
獸醫用
- 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)
人用標示
- Ivermectin Tablets: 3 mg and 6 mg (Stromectol)
- Stromectol 3 mg tablets
- Soolantra 1% cream
各地核准狀態
停藥期: cattle meat Varies by product (e.g., 49 days)
Otimectin Vet approved for cats.
Classified as POM-V (Prescription Only Medicine - Veterinarian).
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
寵物主人重要須知
- 心絲蟲預防: 當以處方的低劑量用於預防心絲蟲時,伊維菌素對所有品種的犬貓都非常安全。
- 品種敏感性: 某些牧羊犬品種(如牧羊犬、澳洲牧羊犬和喜樂蒂牧羊犬)可能帶有基因突變,使其在較高劑量下對伊維菌素極度敏感。在將此藥物用於治療毛囊蟲等疾病前,您的獸醫師可能會建議進行基因檢測。
- 毒性徵兆: 如果您的寵物在服藥後出現步態不穩、瞳孔放大、流口水、發抖、嗜睡或失明等症狀,請立即聯繫您的獸醫師。
- 操作注意事項: 如果使用大型動物的液體或膏狀產品,使用後請洗手,並避免接觸眼睛。處理藥物時請勿進食或吸菸。
- 環境安全: 請妥善處理未用完的產品。伊維菌素對魚類和水生生物具有高毒性;請勿將其丟棄於湖泊、溪流或池塘中。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠商最新仿單。
