Comparative Pharmacology
Head-to-head clinical analysis: BILTRICIDE versus IVERMECTIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BILTRICIDE versus IVERMECTIN.
BILTRICIDE vs IVERMECTIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Praziquantel increases the permeability of cell membranes to calcium ions in susceptible schistosomes and other trematodes, causing sustained contraction and paralysis of the worm musculature, leading to detachment from blood vessel walls and eventual death.
Ivermectin is a macrocyclic lactone that binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, leading to increased chloride ion influx, hyperpolarization, and paralysis of the parasite. It also interacts with other ligand-gated chloride channels, such as those gated by gamma-aminobutyric acid (GABA). In mammals, these channels are largely confined to the central nervous system, but ivermectin does not readily cross the blood-brain barrier, providing a safety margin.
60 mg/kg/day orally in 3 divided doses (20 mg/kg/dose) for 1 day.
150–200 mcg/kg orally once, with repeat dose in 2 weeks for strongyloidiasis; for scabies, 200 mcg/kg orally once, repeat in 2 weeks if needed.
None Documented
None Documented
Clinical Note
moderateIvermectin + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Ivermectin."
Clinical Note
moderateIvermectin + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Ivermectin."
Clinical Note
moderateIvermectin + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Ivermectin."
Clinical Note
moderateIvermectin + Cyclosporine
Terminal elimination half-life is approximately 0.8-1.5 hours for praziquantel; clinical significance: short half-life necessitates multiple dosing for sustained antiparasitic effect.
Terminal elimination half-life is approximately 18 hours (range 12-24 hours) in healthy adults; prolonged in hepatic impairment.
Renal excretion accounts for approximately 80-90% of elimination, primarily as metabolites; biliary/fecal excretion is minor (<10%).
Primarily fecal (≥90% as unchanged drug and metabolites); renal excretion is minimal (<1% of dose). Biliary excretion contributes to fecal elimination.
Category C
Category A/B
Anthelmintic
Anthelmintic
"The metabolism of Cyclosporine can be decreased when combined with Ivermectin."