Comparative Pharmacology
Head-to-head clinical analysis: IVERMECTIN versus PIPERAZINE CITRATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IVERMECTIN versus PIPERAZINE CITRATE.
IVERMECTIN vs PIPERAZINE CITRATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Piperazine citrate acts as a gamma-aminobutyric acid (GABA) receptor agonist in nematodes, causing hyperpolarization of nerve membranes and flaccid paralysis of the worm, which is then expelled by normal peristalsis. It does not affect mammalian neuromuscular junctions due to differences in GABA receptor sensitivity.
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.
Adults: 3.5 g orally once daily for 2 days; may repeat after 1 week 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 18 hours (range 12-24 hours) in healthy adults; prolonged in hepatic impairment.
Terminal elimination half-life: 2-4 hours in patients with normal renal function; may be prolonged in renal impairment.
Primarily fecal (≥90% as unchanged drug and metabolites); renal excretion is minimal (<1% of dose). Biliary excretion contributes to fecal elimination.
Primarily renal (60-70% unchanged); biliary/fecal elimination accounts for 10-20% of the dose.
Category A/B
Category C
Anthelmintic
Anthelmintic
"The metabolism of Cyclosporine can be decreased when combined with Ivermectin."