Ivermectin Overdose

This content was preserved from the original amberfoundation.org page. The Amber Foundation was Dennis’ attempt to share information on feral cat care and especially treating feline mange.

WARNING For Ivermectin Users

Ivermectin is a poison. That’s how it cures mange and other parasitic diseases: it kills the parasites.

The trick is using enough poison to kill the parasites, but leave the pet unharmed. This means that Ivermectin dosage must be precisely calculated and carefully measured.

If you are considering treating your cat with Ivermectin, please consider as an alternative the best mange treatment.

Signs Of Ivermectin Poisoning

The clinical signs of Ivermectin poisoning are:

Less visible symptoms:

According to PIM 292:

Ivermectin acts on insects by potentiation of GABA-ergic neural and neuromuscular transmission but since mammals have only central GABA-ergic synapses which are to a large extent protected by the blood-brain barrier they are relatively resistant to ivermectin. Some penetration of the blood-brain barrier does occur at relatively high doses, with brain levels peaking between two and five hours after administration. Symptoms seen in a range of mammalian species are CNS depression, and consequent ataxia, as might be expected from potentiation of inhibitory GABA-ergic synapses (Hayes & Laws, 1991).

Less Worrisome Things

According to PIM 292:

At recommended doses, ivermectin does not readily penetrate the CNS of mammals, where GABA functions as a neurotransmitter. The principal peripheral neurotransmitter, acetylcholine, is unaffected by ivermectin (MSD, 1988).

When Ivermectin is used properly, there may still be some unpleasant side-effects caused by the sudden death of massive numbers of parasites: rash, itchiness.

It is thought there are no long term effects from mild overdoses.

Dangers Due To Overdose

Of the various signs of Ivermectin poisoning, not all are life-threatening. So where does the danger come from?

Respiratory Depression

According to studies on Rats and Dogs quoted in PIM 292, high doses “cause death due to respiratory depression.”

Anorexia and Dehydration

According to studies on Dogs quoted in PIM 292, continued low doses of Ivermectin caused anorexia and dehydration.

Reproductive Problems

According to PIM 292, there is no evidence of increased birth defects in humans or mares subject to normal therapeutic Ivermectin treatment. But

Ivermectin is teratogenic in rats, rabbit and mice at or near materno-toxic dose levels. The abnormalities are limited mainly to cleft palate. Mice are the most sensitive species to the effect of ivermectin with maternotoxicity at a dose of 0.2 mg/kg/day (MSD, 1988).

Treating Overdose

PIM 292:

Treatment is symptomatic and supportive in cases of overdose. Adverse effects are transient, but analgesics and antihistamines may be required. Since ivermectin is believed to enhance GABA activity in animals, it is probably wise to avoid drugs that enhance GABA activity (benzodiazepines, barbiturates, valproate, valproic acid) in patients with potentially toxic ivermectin exposure (MSD, 1988).

Supportive measures are indicated in case of life- threatening poisoning (which is rare). Analgesics and antihistamines are indicated for the treatment of adverse effects.

In case of ingestion of significant amounts of ivermectin, induce emesis using syrup of ipecac. Gastric lavage may be undertaken.

The efficacy of activated charcoal in gut decontamination following ingestion of ivermectin has not been documented and warrants investigation.

Some authors have suggested the use of picrotoxin and physostigmine as antidotal therapies. However, animal studies with these agents employing these agents as antidotes in ivermectin toxicity have been unsatisfactory and are not recommended (Iliff-Sizemore et al., 1990).

Tabulated Findings

I did a lot of research on the web. This section summarizes my findings.

WARNING: If you actually intend to use any of this information, check it with the original source. Watch out for outdated information and typographical errors!

Animals Sensitive To Ivermectin

Animals Commonly Treated With Ivermectin

Drug Interactions

Therapeutic Ivermectin Dosage For Various Animals

Dosage in mg ivermectin per kg bodyweight.

animaldoserouteusenotesreference
Cattle0.2 mg/kgS.C.G.I. roundworms, lungworms, warbles, mange mites, liceBimectin Datasheet
Reindeer0.2 mg/kgS.C.larval stages of Hypoderma TarandiBimectin Datasheet
Pigs0.3 mg/kgS.C.G.I. roundworms, lungworms, mange mites, liceBimectin Datasheet
Human, adult.150 to .200 mg/kgoral?onchocerciasis and other parasitic infectionsPIM 292
Human, children.150 mg/kgoral?onchocerciasis and other parasitic infectionsnot for children weighing less than 15 kgPIM 292
ANIMALDOSEROUTEUSENOTESREF

S.C. = subcutaneous injection

Fatal Ivermectin Dosage For Various Animals

Dosage in mg ivermectin per kg bodyweight.

animalgenderLD50 doseroutereference
Mousefemale24.6-41.6 mg/kgoralPIM 292
Mousemale11.6 mg/kgoralPIM 292
Rat young adultfemale44.3-52.8 mg/kgoralPIM 292
Rat young adultmale42.8-52.8 mg/kgoralPIM 292
Rat infantmale & female2.3 mg/kgoralPIM 292
Rat660 mg/kgdermalPIM 292
ANIMALGENDERDOSEROUTEREF

Pharmacokinetic Properties

animalroutemaximum plasma concentrationbiological half-lifereference
PigsS.C.?3.5 days5.5 daysBimectin Datasheet
HumanOral10-12 hoursPIM 292
RatI.V.1 dayPIM 292
CattleOral2.7 daysPIM 292
CattleS.C.2.9 daysPIM 292
CattleS.C.?5.5 days6 daysBimectin Datasheet
CattleTopical15.9 daysPIM 292
ANIMALROUTEMAX-PLASMAHALF-LIFEREF

S.C. = subcutaneous injection

References

I searched the web for information about Ivermectin and its side-effects. My findings are listed under: