Comparative Pharmacology
Head-to-head clinical analysis: IVERMECTIN versus POVAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IVERMECTIN versus POVAN.
IVERMECTIN vs POVAN
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.
Pyrvinium pamoate inhibits oxidative metabolism and glucose uptake in susceptible helminths, leading to energy depletion and paralysis of the worm. It also binds to DNA and inhibits RNA synthesis in the parasite.
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.
Pyrantel pamoate: 11 mg/kg (maximum 1 g) orally once; repeat in 2 weeks for pinworm. For ascariasis, hookworm, trichostrongyliasis: 11 mg/kg (max 1 g) once daily for 3 days.
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 is approximately 16 hours; clinically, this supports single-dose administration with slow elimination
Primarily fecal (≥90% as unchanged drug and metabolites); renal excretion is minimal (<1% of dose). Biliary excretion contributes to fecal elimination.
Primarily fecal (90%) as unchanged drug via bile; renal excretion is minimal (<1%)
Category A/B
Category C
Anthelmintic
Anthelmintic
"The metabolism of Cyclosporine can be decreased when combined with Ivermectin."