Side reactions following ivermectin therapy in high density bancroftian microfilaraemics.
Kar, S.K.; Patnaik, S.; Kumaraswami, V.; Murty, R.S.N.
Acta Tropica; 1993; 55; 21-31.
Side reactions following ivermectin treatment were evaluated in sixty males with high density bancroftian microfilaremia (GM 1388 ml). Following a single oral dose of ivermectin of different strengths (20, 50, 100 or 200 m g/kg), microfilariae clearance and side reactions were monitored in a double blind fashion. Microfilaria levels fell rapidly after ivermectin administration in all dosage groups and 98% of pretreatment microfilariae was cleared after 12 h of treatment. The rate of microfilaria (mf) clearance was slower with 20 ug/kg than with the highest dose (200 m g/kg) administered. Forty six patients (77%) became amicrofilaraemic within 2 weeks of treatment. Side reactions were noted in 97% of cases. The most common reactions were fever, headache, weakness, myalgia and cough which appeared by 12 h and subsided by 72 h following treatment. The frequency and intensity of side reactions were related to pretreatment mf densities and were independent of the dose administered. Unusual side reactions were noted in a few patients with high density microfilaraemia. These included intense cough, shortness of breath, blood tinged mucoid expectoration associated with patchy pneumonitis of the lung. Itchy rashes, lymphatic nodules and raised alkaline phosphatase level were also observed in some patients. These side reactions were transient, self limiting and were not serious enough to warrant any treatment. These exaggerated unusual reactions were possibly due to allergic response of the susceptible host to rapid killing of large number of microfilarae.
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