01 Weigh first, then count the 3 mg tablets
Count three-milligram tablets against the 150 mcg/kg onchocerciasis line, not against a remembered veterinary paste or a COVID rumor. Stromectol in the US is a 3 mg human tablet. The labeled onchocerciasis swallow is about 150 mcg per kilogram as a single oral dose. That is the lock on this leaf.
Fifteen to twenty-five kilograms takes one tablet. Twenty-six to forty-four kilograms takes two. Forty-five to sixty-four takes three. Sixty-five to eighty-four takes four. At 85 kg and above the insert stops giving a tablet count and tells you to calculate 150 mcg/kg. Do not invent a 6 mg or 12 mg human tablet. Those strengths are not on the US Stromectol board.
The same insert carries a separate strongyloides weight table. It is not this 150 mcg/kg grid. Mixing the two tables on one swallow is how people either under-dose river blindness work or over-count a different infection. Read the indication on the order before you reach for tablets.
| Body weight | 3 mg tablets at 150 mcg/kg |
|---|---|
| 15-25 kg | 1 tablet |
| 26-44 kg | 2 tablets |
| 45-64 kg | 3 tablets |
| 65-84 kg | 4 tablets |
| 85 kg and above | Calculate 150 mcg/kg; do not guess a fifth tablet |
02 When a repeat 3 mg swallow is a program, not a mood
Individual oncho retreatment may be as soon as three months. Mass work is usually twelve. Strongyloides repeats after failed stools, not after a crampy Tuesday. Scabies seconds, when used, sit on a clinician's egg clock and remain off-label in the US.
Immunocompromised hosts can fail a single strongyloides pass. That is not a kitchen second count. That is a specialist. Steroid courses in the last year belong in that history. Hide them and the worm story gets uglier.
A leftover crate from last year's round is not next year's guest medicine. Weights change. Pregnancy status changes. Indication changes. Destroy or return unused stock per the program. The community-round margin repeats that hold.
Do not run a private monthly round because skin snips are not yet zero. Adult Onchocerca live on. Ivermectin hits microfilariae. Monthly swallows multiply Mazzotti burden without a labeled community rhythm.
03 Stool checks after strongyloides, eye checks after oncho
Follow-up stool examinations after a labeled strongyloides swallow are how the insert asks you to confirm eradication. Extra 3 mg tablets are not automatic when the first week still feels crampy. Immunocompromised people can fail a single pass and need a specialist, not a second kitchen count.
Onchocerciasis work watches skin microfilariae and the anterior chamber. Some patients get a transient rise in anterior-chamber counts around day 3, then a later drop. That is clinic follow-up, not a reason to redose at home because the eye itched.
Disseminated strongyloidiasis is outside the intestinal indication. Hyperinfection in a steroid-treated host is an inpatient problem. If someone is already on the prednisolone 5 mg taper and then swallows leftover ivermectin for "worms," both stories get worse. Tell both desks.
This leaf will not invent a day-14 stool kit you mail to Bordeaux. It will say: if the order was strongyloides, ask when the stools are due. If the order was oncho, ask who is watching the eye. If there was no order, stop.
04 Scabies stays off the US indication line
Scabies is not a Stromectol indication on the US insert. Clinics still use oral ivermectin for crusted or outbreak work, often with a second swallow days later, and they say off-label when they do it. This leaf will not pretend FDA signed that protocol.
If a reader landed here because a search mixed "Stromectol 3 mg" with a rash, read the two-dose scabies ink next to permethrin counseling from the person who saw the skin. Do not convert a 150 mcg/kg oncho table into a home scabies kit.
Crusted scabies is a different beast from a few burrows on a wrist. It can need repeated doses plus topical work and isolation rules. None of that is a DIY schedule from Bordeaux. Elise dates this leaf as study text, not as a dermatology visit.
05 Water only, and an empty stomach
Water only, and an empty stomach, is the Stromectol swallow rule. The pharmacokinetics section of the insert was built on fasting doses. Peak plasma of the major component sits near four hours after a 12 mg fasting study dose. Food raises exposure; that is why the how-to-take line is not "with breakfast."
If someone already ate, the honest move is to wait for the next empty window rather than push tablets through a meal and hope the mcg/kg math still holds. This leaf does not invent a gram-of-fat cutoff. It repeats the insert: empty stomach, water.
Children under 15 kg are outside the printed onchocerciasis tablet grid. That is a specialist call, not a half-tablet improvisation from this page. Write [email protected] only about wording on the leaf, never for a personal dose.
06 Two labeled infections, two different tables
Two labeled infections sit on the US Stromectol insert: intestinal (not disseminated) strongyloidiasis due to Strongyloides stercoralis, and onchocerciasis due to Onchocerca volvulus. FDA did not put scabies, head lice, or a virus on that list. Saying so is not pedantry. It keeps the 150 mcg/kg lock from being treated as a universal worm number.
Onchocerciasis work in mass programs is commonly repeated about every 12 months. For an individual patient the insert allows retreatment as soon as 3 months. That interval is about microfilariae in skin and the anterior chamber, not about inventing a weekly home course.
Strongyloides usually needs follow-up stool examinations after the single labeled swallow. Extra doses are not automatic. Immunocompromised people can fail a single pass; that is a clinic problem, not a second blister bought because a forum said so. The community-round margin walks the 12-month versus 3-month clock without reprinting this whole leaf.
07 What a US pharmacy can actually count
US boards stock the generic 3 mg human tablet. The fill strip below is literacy, not a Virena checkout. This leaf does not invent a Stromectol brand coupon or a cash story for Merck's name. If a caption on the strip cites a generic board, read it as a snapshot, not as your bag's price.
Ten tablets is a common count on coupon tables. Your weight-band math may need fewer or more than ten. Do not stretch a ten-count across two people. Do not split tablets to invent a pediatric strength.
Virena does not dispense. A Bordeaux editorial desk cannot move a US NDC. If the bag looks like a paste, a pour-on, or a 6 mg import mystery, stop and show a pharmacist the insert name Stromectol or the INN ivermectin 3 mg tablet.
3 mg x 10 (weight-band dosing in body)
Stromectol three-milligram tablet is the US label
3 mg x 10 (weight-band dosing in body)
Scabies often needs a second dose per protocol
3 mg x 10 (weight-band dosing in body)
Microfilarial syndromes need specialist oversight
3 mg x 10 (weight-band dosing in body)
Not a veterinary pour-on fill
Generic ivermectin 3 mg, ten tablets, the Virena Stromectol lock, August 2026. GoodRx lists 3 mg x 10 at $36.45 average retail and $23.76 with a coupon. Milligram-per-kilogram scabies math stays in the leaf body. Virena does not dispense.
08 The rest of the day after a 3 mg human swallow
Sit if you feel lightheaded. Drink water. Do not drive a long route if Mazzotti hypotension is a known risk for that round. Itch can be treated as the team said. It is not a license to open a second blister.
Eye pain or a sudden visual change after oncho treatment is a same-day clinic problem. Anterior-chamber microfilariae can shift in the first days. This leaf will not triage a photo. It will say go.
Stool follow-up after strongyloides is a date, not a vibe. If the lab slip is lost, call the clinic that wrote the swallow. Do not mail stool to [email protected].
Household scabies work, if that was the off-label reason, still needs cloth and contact treatment. The scabies ink is that file. Do not run a monthly oncho-style MDA because mites itch.
Alcohol does not pair with an empty-stomach rule. Save it for another day. This is not moralizing. It is how people keep the labeled swallow honest.
09 What to put in the bag the morning of a counted swallow
Bring a scale if the last weight is a guess. Bring water. Bring the insert page that matches the infection. Leave breakfast for after the hour the clinician set. Leave the veterinary paste at home. Leave the leftover 3 mg strip from a relative's scabies story in the bottle until someone matches it to a current order.
If the swallow is a community oncho round, bring identification the program asked for and any Loa-screening slip they issued. Do not pocket extra tablets "for cousins." Weight bands are personal. A 70 kg adult is four tablets on the 150 mcg/kg oncho grid. A 40 kg adolescent is two. Mixing those counts in a pocket is how a child under 15 kg gets a tablet with no printed band.
Write the time on a card. Mazzotti itch and fever can start later the same day. A card stops people from taking a second count because they "felt nothing at noon." Peak plasma in the fasting volunteer work sat near four hours. Feeling nothing at one hour is not a missed dose.
If you also take warfarin, prednisolone, or a medicine a clinic already flagged, write those names on the same card. The campaign nurse cannot guess your Bordeaux rheumatology bottle. The prednisolone leaf is a separate taper clock. Do not hide it.
Empty-stomach means empty. Tea with milk is not water only. A pastry in the queue is how exposure drifts from the fasting PK the insert used. Wait or reschedule. Do not invent a half-dose penalty.
10 Dying microfilariae, Mazzotti, and Loa loa
Dying microfilariae can stir a Mazzotti reaction: itch, rash, fever, tender nodes, joint ache, sometimes hypotension or asthma flare. It is a treatment effect in onchocerciasis, not proof the tablets were "too strong." Supportive care and timing belong to the team that diagnosed Onchocerca, especially if the eye is involved.
People who have lived in Loa loa regions need a different risk talk before ivermectin. High Loa microfilarial loads have been tied to encephalopathy after ivermectin in community programs. That is why mass work screens geography and, where programs require it, blood films. A US traveler with a forgotten Central-African chapter should not swallow a leftover 3 mg strip because a relative had scabies.
Hypersensitivity to ivermectin is a labeled stop. Pregnancy and lactation decisions sit with the prescriber against local guidance; this leaf does not write a home exception. Veterinary pour-ons and horse pastes are not Stromectol. Concentration, excipients, and dose form are wrong, and poison-control rows already exist for that mix-up.
11 What not to stack with a 3 mg human tablet
Do not stack a veterinary paste, a topical lice lotion, and a 3 mg human tablet on the same night. Concentrations differ. Excipients differ. The how-to-take for Stromectol is one counted human swallow.
Warfarin stories exist as case-level INR shifts after ivermectin in some reports. This leaf will not invent a percent. It will say: if you are anticoagulated, tell the person who writes the warfarin that ivermectin happened. Do not hide a campaign tablet.
CNS depressants are not the main ivermectin story the way they are for gabapentin. The danger here is Mazzotti hypotension and Loa encephalopathy, not a chair nap. Still, a feverish night after a round is a reason to sit down, not to drive a motorbike to the next village.
COVID leftover protocols from 2020 social posts are not on the insert. Neither is a weekly "immune" 3 mg. Those uses have already produced preventable veterinary-product poisonings. This almanac will not soften that sentence to be polite.
12 Where the 3 mg tablet goes after the swallow
Plasma concentrations after oral ivermectin run roughly with dose. In fasting adults given 12 mg (about 165 mcg/kg in those studies), mean peaks of H2B1a sat near 31 and 47 ng/mL at about four hours, with wide ranges. The plasma half-life is about 18 hours. Almost all of the dose leaves in feces over roughly 12 days. Less than 1% shows up in urine.
That fecal route is why "one extra tablet for the kidneys" is the wrong folk fix. Hepatic metabolism matters more than a creatinine story. The leaf will not invent a Child-Pugh table the insert does not print.
Binding to glutamate-gated chloride channels in invertebrates is the textbook mechanism. Humans do not run those channels the same way, which is why the therapeutic index exists - and why a megadose of a veterinary product is still a toxicology problem, not a clever hack.
| Absorption | Oral; fasting peaks near 4 hours in the 12 mg volunteer work. |
|---|---|
| Distribution | Wide tissue distribution; the insert does not give a simple Vd counseling number. |
| Metabolism | Hepatic; parent plus metabolites. |
| Excretion | Almost entirely fecal over about 12 days; urine under 1%. Half-life about 18 hours. |
13 What this leaf will not do for you
Weigh the person before you count tablets. Match the infection to the correct insert table. Keep the stomach empty. Leave scabies, Loa, and disseminated strongyloides to people who have seen the case.
Dr. Elise Moreau at Rue Sainte-Catherine 142 dates the bind. Mail [email protected] about a sentence on this page. France emergencies: 15 or 112. This site does not write a script or fill a box.
If two adults share a ten-count board, weigh both. A 90 kg person and a 58 kg person do not split five and five. The 90 kg person is already on the calculated 150 mcg/kg side of the oncho grid. The 58 kg person takes three tablets. Leftover tablets go back in the bottle, not into a child's juice. Under 15 kg the printed oncho grid is empty. That is a specialist call, not a half-tablet from this leaf.
Write the indication on a slip next to the hour. Onchocerciasis retreatment for an individual may be as soon as three months. A mass program is usually twelve. Strongyloides follow-up is a stool, not a second swallow because the first week felt crampy. Scabies, if a clinician chose it off-label, has its own second date. Mixing those three calendars is how people either under-treat mites or over-treat Onchocerca.
Keep veterinary products out of the same drawer as Stromectol 3 mg. Concentration, flavoring, and dose form are wrong. Poison-control rows already exist for horse-paste mix-ups. If the bag looks like a pour-on, stop. Ask the pharmacist to read the INN and the 3 mg strength out loud.
Travelers returning from Loa loa regions should not swallow a leftover 3 mg strip for an unrelated itch. High Loa loads have been tied to encephalopathy after ivermectin in community work. Geography is part of the how-to-take, not a trivia line. Pregnancy and very unwell adults in a queue are local protocol. Elise files the 150 mcg/kg lock. She does not staff a distribution from Sainte-Catherine.
Mail [email protected] if a sentence on this leaf disagrees with the current Stromectol insert's oncho table or the empty-stomach line. Do not mail a weight and ask for a tablet number. France emergencies: 15 or 112.