Just an FYI, ivermectin is really expensive if you search it up to buy.
Any local feed store will have it for a fraction of the cost. It’s identical other than the warnings all over saying otherw...
something else worth mentioning, it's one of a whole category of medicines. there is another one which i think is interesting because it works on much the same parasites but also has a longer lasting effect because of its fat solubility such that it also kills off quite a lot of external parasites (demodex mites, for example, also probably nits and body lice). it's a spot-on for cats and dogs, and the chemical is called moxidectin:
moxidectin is a macrocyclic lactone in the milbemycin family, related to ivermectin but with a longer half-life (23 days vs 12 hours in humans). approved by FDA in 2018 for onchocerciasis (river blindness) at a single oral dose of 8mg. also used off-label for scabies, head lice, and intestinal parasites.
key differences from ivermectin:
- **longer half-life**: ~23 days vs ~12 hours. one dose covers multiple lifecycles of most parasites. this is why it's better for scabies -- a single dose often cures what requires two doses of ivermectin a week apart.
- **lipophilic**: concentrates in fat tissue. good for tissue-dwelling parasites, means it stays in the body longer and can be detected longer
- **CNS penetration**: crosses blood-brain barrier more readily than ivermectin in mammals. this is why it's more toxic in some species (collies with MDR1 mutation are at risk). in humans with intact BBB, it's generally safe at therapeutic doses.
**reported human uses:**
- **onchocerciasis**: the approved indication. 8mg single dose, superior to ivermectin for suppressing microfilariae for longer periods. WHO has it on the essential medicines list for this.
- **scabies**: multiple case series and open-label trials. 8-12mg single dose. cure rates 80-95% in reported studies. the long half-life means it kills newly hatched mites for weeks after dosing, reducing the need for a second dose. some practitioners use it for crusted scabies when ivermectin fails.
- **head lice**: 8mg single dose, limited studies. works but permethrin is cheaper and lower risk. used for resistant cases.
- **strongyloidiasis**: off-label. 8mg single dose or 8mg repeated after a week. ivermectin is still standard but moxidectin is an alternative for refractory cases.
- **lyme / babesia**: some alternative practitioners use it in combination protocols, citing its longer half-life and activity against intracellular forms. no rigorous human trials.
**side effects**: similar to ivermectin: dizziness, nausea, headache, transient worsening of symptoms from parasite die-off (Mazzotti reaction in filariasis). more neurological side effects reported at higher doses, consistent with its higher CNS penetration.
**availability**: not widely prescribed in the US. available through compounding pharmacies. manufactured by Tarsus Pharmaceuticals for human use, also used in veterinary medicine (primarily horses, dogs, cattle). the veterinary formulation is widely available but dosing is tricky.
**the ivermectin comparison you probably want**: moxidectin is essentially ivermectin's stronger, longer cousin. if ivermectin is the mild daily driver, moxidectin is the extended-release version that hits harder and lasts longer. the risk profile is proportionally higher -- more neurotoxicity potential, more severe die-off reactions. but for resistant cases where ivermectin fails, it's the trump card.
**the scabies-specific protocol some use**: 12mg single dose, repeat after 2-3 weeks if symptoms persist. some combine with topical permethrin for crusted cases. the long half-life means you don't need the strict "repeat at exactly day 7" schedule that ivermectin requires.
moxidectin is a macrocyclic lactone in the milbemycin family, related to ivermectin but with a longer half-life (23 days vs 12 hours in humans). approved by FDA in 2018 for onchocerciasis (river blindness) at a single oral dose of 8mg. also used off-label for scabies, head lice, and intestinal parasites.
key differences from ivermectin:
- **longer half-life**: ~23 days vs ~12 hours. one dose covers multiple lifecycles of most parasites. this is why it's better for scabies -- a single dose often cures what requires two doses of ivermectin a week apart.
- **lipophilic**: concentrates in fat tissue. good for tissue-dwelling parasites, means it stays in the body longer and can be detected longer
- **CNS penetration**: crosses blood-brain barrier more readily than ivermectin in mammals. this is why it's more toxic in some species (collies with MDR1 mutation are at risk). in humans with intact BBB, it's generally safe at therapeutic doses.
**reported human uses:**
- **onchocerciasis**: the approved indication. 8mg single dose, superior to ivermectin for suppressing microfilariae for longer periods. WHO has it on the essential medicines list for this.
- **scabies**: multiple case series and open-label trials. 8-12mg single dose. cure rates 80-95% in reported studies. the long half-life means it kills newly hatched mites for weeks after dosing, reducing the need for a second dose. some practitioners use it for crusted scabies when ivermectin fails.
- **head lice**: 8mg single dose, limited studies. works but permethrin is cheaper and lower risk. used for resistant cases.
- **strongyloidiasis**: off-label. 8mg single dose or 8mg repeated after a week. ivermectin is still standard but moxidectin is an alternative for refractory cases.
- **lyme / babesia**: some alternative practitioners use it in combination protocols, citing its longer half-life and activity against intracellular forms. no rigorous human trials.
**side effects**: similar to ivermectin: dizziness, nausea, headache, transient worsening of symptoms from parasite die-off (Mazzotti reaction in filariasis). more neurological side effects reported at higher doses, consistent with its higher CNS penetration.
**availability**: not widely prescribed in the US. available through compounding pharmacies. manufactured by Tarsus Pharmaceuticals for human use, also used in veterinary medicine (primarily horses, dogs, cattle). the veterinary formulation is widely available but dosing is tricky.
**the ivermectin comparison you probably want**: moxidectin is essentially ivermectin's stronger, longer cousin. if ivermectin is the mild daily driver, moxidectin is the extended-release version that hits harder and lasts longer. the risk profile is proportionally higher -- more neurotoxicity potential, more severe die-off reactions. but for resistant cases where ivermectin fails, it's the trump card.
**the scabies-specific protocol some use**: 12mg single dose, repeat after 2-3 weeks if symptoms persist. some combine with topical permethrin for crusted cases. the long half-life means you don't need the strict "repeat at exactly day 7" schedule that ivermectin requires.
12❤️1
