Is ivermectin safe during pregnancy?

The Safety of Ivermectin During Pregnancy: A Complex Issue
Ivermectin, a medication widely used to treat various parasitic infections, has garnered attention for its potential use in different health contexts, including during pregnancy. However, the question of its safety for pregnant women remains contentious and complex.
Current Understanding of Ivermectin’s Safety Profile
Recent systematic reviews and meta-analyses have sought to clarify the safety of ivermectin during pregnancy. Notably, a comprehensive analysis published in *The Lancet Global Health* found no studies indicating an increased risk of abnormal birth outcomes among women who received ivermectin while pregnant 30490-5/fulltext). This suggests that, at least in some contexts, the drug may not pose significant risks to fetal development.
However, the same analysis also highlighted a critical caveat: there is insufficient evidence to definitively conclude that ivermectin is safe during pregnancy. The lack of robust data stems from the historical exclusion of pregnant women from clinical trials and mass drug administration programs, primarily due to concerns about potential teratogenic effects.
FDA Classification and Animal Studies
The U.S. Food and Drug Administration (FDA) classifies ivermectin as a Category C drug for pregnancy. This classification indicates that while animal studies have shown some evidence of teratogenicity, these effects were observed at doses that were also toxic to the mother. This raises important questions about the applicability of animal data to human pregnancy, as the doses and contexts can differ significantly.
Concerns and Recommendations
Despite some studies suggesting a lack of adverse outcomes, health authorities remain cautious. The potential risks associated with ivermectin use during pregnancy have led to recommendations against its administration in pregnant women, particularly in community-directed treatment programs for conditions like onchocerciasis. The prevailing sentiment in the medical community is one of caution, emphasizing the need for further research to establish a clearer safety profile.
Moreover, the uncertainty surrounding ivermectin’s effects on pregnancy is compounded by the lack of evidence regarding its impact on spontaneous abortions and stillbirths, with existing studies providing very low certainty of evidence.
Conclusion: A Call for Caution
In summary, while some evidence suggests that ivermectin may not significantly increase the risk of adverse pregnancy outcomes, the overall consensus is one of caution. The absence of comprehensive data necessitates a careful approach to its use in pregnant women. As research continues to evolve, healthcare providers are urged to weigh the potential benefits against the risks, ensuring that pregnant women are adequately informed about the uncertainties surrounding ivermectin use.

Which antiparasitic drugs are safe in pregnancy?

Flubendazole may be used in pregnant women, irrespective of the stage and even during the first trimester. Albendazole and mebendazole may be prescribed without any restriction during the last two trimesters of pregnancy, but they are usually administered as a second- line treatment during the first trimester.

How long does it take for ivermectin to start killing parasites?

Dermal microfilarial loads are reduced by 78% within 2 days, and by some 98% within 2 weeks of treatment, remaining at extremely low levels for about 12 months. As lowest levels of microfilariae occur well after ivermectin administration, they are not necessarily killed when plasma drug levels are highest.

What does ivermectin do to a pregnant woman?

Overall, Nicolas and colleagues’ systematic review and meta-analysis identified no studies showing evidence for excess abnormal birth outcomes in woman who received ivermectin during pregnancy.

What FDA pregnancy category is ivermectin?

Ivermectin has been assigned to pregnancy category C by the FDA. Animal studies have revealed evidence of teratogenicity, but at doses that were also maternotoxic to the pregnant female. The manufacturer considers ivermectin contraindicated during pregnancy.

Does ivermectin cross the placental barrier?

The decision was supported by evidence that P-glycoprotein in the placenta prevents avermectins (the drug family to which ivermectin belongs) from penetrating the placenta.

Is ivermectin safe for pregnant mares?

Pregnant mares should be administered ivermectin or a benzimidazole 1–3 days before foaling to prevent lactogenic transmission of Strongyloides westeri, which can cause diarrhea in young foals.

Can pregnant mares have ivermectin?

Pregnant mares should be administered ivermectin or a benzimidazole 1–3 days before foaling to prevent lactogenic transmission of Strongyloides westeri, which can cause diarrhea in young foals.

Is ivermectin safe for pregnant sows?

Safeguard (fenbendazole) and Ivermectin (Ivomec) are both safe for pregnant and nursing sows. These two medications should be given at least two weeks apart to avoid stressing the sow’s system. Ivermectin 1% injectable labeled for swine can be given orally at the dose of 0.2 ml per 10 lbs body weight.

Is it safe to give ivermectin to pregnant cows?

IVOMEC Plus controls 30 stages and species of parasites, and is also safe for use during all stages of pregnancy. Valbazen® is not safe for use in pregnant cows within the first 45 days of pregnancy.

What is pregnancy category C?

Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.