Talk:Ivermectin

USE OF IVERMECTIN IN CAMELS

In Isiolo(Kenya)there has been an outbreak of an unknown disease that is killing camels without any symptoms. The animals dying are normally very healthy, either lactating or pregnant. Since the Minstry of livestock has not been able to diagonise the problem, Farmers are trying all sorts of medicines. Some farmers have tried the IVOMEC and are claiming to have stopped the deaths.41.223.57.34 11:21, 20 May 2007 (UTC)JAMES MACHARIA KARANI P .O. BOX 277 ISIOLO e-mail adress jamesmkarani@yahoo.com

Dangerous and illegal dosing information for pet owners

I am very concerned about the content in this article that advises dog owners of how to treat their pets with Ivermectin intended for cattle. The average citizen is not skilled in calculating drug dosages or administering drugs and could easily overdose their pet dog. Also, Ivermectin should not be administered for heartworm prevention unless the dogs are known to be currently free of heartworm disease. If a pet owner reads this information and administers Ivermectin to a dog that is infected with heartworms, it would cause a massive die-off of the microfilarial lifestage, which could cause kidney failure, respiratory distress, and an acute immune reaction by the dog. Basically, people could easily kill their pets by following the advice on this page. Also, it is illegal for a non-veterinarian to use veterinary drugs off-label, such as using a drug labelled for cattle in a dog. Please, for the safety of our pets, remove this off-label dosing information from this webpage. "A little knowledge is a dangerous thing." 03:46, 10 July 2007 (UTC) Someone who cares

Thanks for pointing that out. I made the changes. --Joelmills 04:01, 10 July 2007 (UTC)

Heartgard

This article ought to mention Heartgard to explain why it redirects here. ~ Booya ^Bazooka 18:05, 10 September 2011 (UTC)

Agreed. Ivermectin is the primary ingredient in Heartgard, used to treat heartworms in dogs (and perhaps other animals). I'm not sure I like the statement early in the article that Ivermectin is sold under certain brand names in various countries, as that list is certainly not completely inclusive, and sounds brand-preferential. IrishCowboy (talk) 23:12, 23 February 2012 (UTC)

All this talk of Heartgard and no one had added it :) I've added it. Cheers. P shadoh (talk) 19:47, 10 January 2014 (UTC)

Ivermectin Approved By FDA For Lice

See http://www.medscape.org/viewarticle/758988?src=cmemp - I don't have time to re-format the "Arthropods" section of the article. Paulburnett (talk) 21:50, 5 March 2012 (UTC)

Contraindications etc

There should be information in the article on contraindications, I'll find some info and try to add a section. Thanks. 152.38.65.133 (talk) 15:53, 20 April 2012 (UTC) Hey, it's the guy from above. I just made an account, and added some information. Hopefully, I can pull some people and information and expand the section a bit more. Cfowla (talk) 16:29, 20 April 2012 (UTC)

Potentially dangerous contraindication reported in grapefruit juice in humans. Source - http://www.everydayhealth.com/drugs/ivermectin - though some are suggesting it is good to use grapefruit juice as the extension of half life is a desired effect. — Preceding unsigned comment added by 2602:306:80A3:96D0:3E07:54FF:FE35:7D81 (talk) 04:12, 15 October 2016 (UTC)

Untitled comments

Where does the high toxicity information come from? It contridicts the previous paragraph that states it low toxocity in mamammals and gives a contradictory LD50. I am removing the high toxicity paragraph. --Richard Arthur Norton (1958- ) 06:08, 12 January 2006 (UTC)

It comes from [1]. The keyword in that phrase is pure. As used, most avermectin formulations contain very little actual avermectin, thus the low toxicity. Pure--undiluted--avermectin is highly toxic. I will restore that paragraph. --Lensim 03:21, 15 January 2006 (UTC)

In the Use in Humans paragraph, you mention that Ivermectin can be used for "certain scabies". I thought there was one species of scabies -- how many species of scabies are there, and which ones are not affected by Ivermectin? Margaret now 13:41, 14 March 2007 (UTC)

The particular edit you reference was made by User:68.57.36.46. See also Scabies. Lensim 16:18, 14 March 2007 (UTC)

Since when is an iPod nano a credible unit of measurement? This wikipedia entry paid for by Steve Jobs?

"Soolantra" Ivermectin cream

As of December 23, 2014, an Ivermectin cream called Soolantra has apparently been approved by the FDA for rosacea, per this press release. This information should probably be put into the article in some form. —BarrelProof (talk) 00:27, 1 January 2015 (UTC)

Eradication vs treatment of river blindness

Per the Carter Center:

"The Carter Center's Onchocerciasis Elimination Program for the Americas (OEPA) works to end illness and transmission of onchocerciasis in Brazil, Ecuador, Guatemala, Mexico, Venezuela, and Colombia....

As of September 2015, a total of 11 foci of the 13 endemic areas have eliminated or interrupted transmission as a result of health education and mass drug administration (MDA) with Mectizan®. Colombia (2007) and Ecuador (2009) became the first countries in the world to halt river blindness transmission through health education and semiannual distribution of Mectizan..... Thanks to these achievements, the Americas region will soon permanently free itself from the threat of this debilitating disease.

http://www.cartercenter.org/health/river_blindness/oepa.html — Preceding unsigned comment added by 73.162.132.47 (talk) 18:06, 5 October 2015 (UTC)

History

We don't need a MEDRS compliant source for the inventorship of avermectin, as MEDRS covers biomedical information only. Per MEDRS:

"This guideline supports the general sourcing policy at Wikipedia:Verifiability with specific attention given to sources appropriate for biomedical content in any type of article, including alternative medicine. Sources for all other types of content – including all non-medical information in medicine-related articles – are covered by the general guideline on identifying reliable sources rather than this guideline.:

Historical details of individual contributions to research is not medical content.

Omura's webpage states:

"The discovery of avermectins was the result of a collaboration with Merck Sharp & Dohme Research Laboratories."

The Nobel Prize Committe Press release states that

"Satoshi Ōmura searched for bioactive substances from the soil and isolated a new microorganism (Streptomyces avermitilis) with remarkable properties. William C. Campbell identified the antiparasitic activity of Ōmura’s microbial culture and characterized the effective component, named Avermectin, against a variety of parasitic worms in domestic and farm animals."

Please don't tell me you are suggesting that the Nobel Committee didn't do its research and that the co-Laureate is lying.

Annual Reviews in Pharmacology and Toxicology, 1992, 32:537 unambiguously states:

"The avermectins were discovered in 1975 at Merck and Co... They are produced by a culture that originated in a Japanese soil sample sent by the Kitasato Institute"

There's your MEDRS source if you require one.

73.162.132.47 (talk) 00:20, 6 October 2015 (UTC)

One of the revisions introduced a lot of passive voice into it, but looks ok now. Are you sure about Campbell and Omura "discovering the avermectin family of compounds". I got the impression that was mostly Omura, and that Campbell did the extraction of avermectin after getting samples from Omura. Later research at Merck developed ivermectin, which is what pharmcos do, to improve properties and make something they can patent. ~ juanTamad (talk) 03:10, 6 October 2015 (UTC)

That's what I thought. I think this raises legitimate questions of the discovery process. Omura discovered Streptomyces avermitilis and its "remarkable properties". What were those remarkable properties? Campbell identified the "antimicrobial activities."

If, as the entry reads now, "Omura identified avermectin from the bacterium Streptomyces avermitilis," that means Omura did the biggest part of the discovery job. He discovered Streptomyces avermitilis and avermectin, and handed the cultures over to Campbell for isolation and purification. So if Omura had already identified the bacterium and the drug, what was left for Campbell to discover?

But here's a version that says Campbell discovered and named avermectin:

https://www.bostonglobe.com/metro/2015/10/05/nobel-winner-there-some-way-can-verify-this/87yPyykypdfOrkDLUoSFmJ/story.html

Stunned Nobel winner: ‘Is there some way I can verify this?’

By Eric Boodman and Helen Branswell

STAT

October 05, 2015

Omura, a microbiologist who specializes in isolating natural compounds, sent Merck soil samples for bacterial research. But the freeze-dried samples sat on a shelf in the microbiology department for a year.

When Campbell and his colleagues in the parasitology department later came up with a new method for testing potential compounds against parasitic worms, the soil samples were tested.

To his astonishment, the samples contained a compound that paralyzed parasitic worms. That substance was named avermectin, which was later modified and named ivermectin.

--Nbauman (talk) 04:48, 6 October 2015 (UTC)

@Nbauman: I'd like to apologize for the overheated language I used above.

I think there is some confusion in the press regarding the process, which a lot of laypeople don't understand. My understanding from the more sophisticated sources is that:

1) Omuara's group specialized in obtaining novel microorganizm cultures and testing them for biological actiivity. They identified the bacteria that produces avermectin and detected that the crude extract of these bacterial cultures killed parasites

2) This by itself, did not complete the "discovery" of avermectin. Biological actiivity in crude cultures may be due to substances that are simply biocides or for other reasons, would not work in vivo. The discovery process was completed at Merck, where the spectrum of activity of the crude extract ws demonstrated to be of interest, the activity in animal models was confirmed and the active molecules in the crude culture extract were isolated and their chemical structure determined.

It is my understanding from the Nobel Committee press release, Omura's website, and the Annual Reviews paper. You guys can decide how to handle this, I will not comment further. Again, sorry for getting so overheated.

73.162.132.47 (talk) 10:00, 6 October 2015 (UTC)

Brand names

Is there any reason for this long list of international brand names in the introduction? There are so many more important things about ivermectin than its brand name in Canada or Nepal. I would keep the one or two most common brand names in the introduction, and move the rest to a section headed "Marketing," if we include it at all.

It is sold under brand names Heartgard, Sklice[1] and Stromectol[2] in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT[3] in Nepal by Alive Pharmaceutical and Ivexterm in Mexico by Valeant Pharmaceuticals International. In Southeast Asian countries, it is marketed by Delta Pharma Ltd. under the trade name Scabo 6. While in development, it was assigned the code MK-933 by Merck.[4]

(Valeant is one of the companies that buys up small-volume drugs and raises their prices, so it might be interesting to find out whether they did the same to ivermectin.) --Nbauman (talk) 00:21, 12 October 2015 (UTC)

Infobox

I have hidden the Chemical data section of the infobox because something in there is breaklng the page and causing it to fill my browser window. It appears that {{nowrap}} templates are responsible, but I can't fix the error so I'll leave the section hidden. Cheers, Baffle gab1978 (talk) 02:42, 7 May 2016 (UTC)

User:Baffle gab1978 I am not seeing the problem. Maybe User:DePiep who is the expert in these things can help. Can you post a picture of the problem you see. Doc James (talk · contribs · email) 23:56, 7 May 2016 (UTC)

No USA FDA approved medicine for worms?

After some searches it looks like the FDA has not approved any medication for deworming in Humans in the USA. The article recommends this formula, but it can only be found available for horses, dogs and cattle. It should be discussed whether formulations for other animals can be taken by Humans as last resort and what are the dangers of doing do. — Preceding unsigned comment added by 108.30.56.204 (talk) 08:00, 3 September 2016 (UTC)

Hm. https://www.drugs.com/mtm/ivermectin.html looks like it's approved for the treatment of certain worm infections. Isn't Stromectol available in the US? --ἀνυπόδητος (talk) 07:22, 10 September 2016 (UTC)

Social Aspects Section

Perhaps a social aspects section could be added to discuss material such matters as donation of ivermectin by Merck, support for MDA by Carter Center, etc. This should be brief with link to main river blindness article (for example) as the prevention, treatment, and control of river blindness involves many other issues, such as vector control, treatment of water sources, and multiple drugs. Detailed discussion of social aspects ought to be in the river blindness article, rather than in this ivermectin article. The donations of ivermectin by Merck, support by the Gates Foundation, Carter Center, actions of WHO, national public health actions, etc are relevant. It didn't seem to me that this ought to be put in the medical uses section, though.Sbelknap (talk) 06:01, 22 December 2018 (UTC)

Bed bugs

We need a ref that ivermectin is used as a treatment. I am seeing nothing. Doc James (talk · contribs · email) 09:49, 26 December 2018 (UTC)

I've added a secondary source article in the body of the article supporting use of ivermectin for killing bedbugs.Sbelknap (talk) 21:15, 26 December 2018 (UTC)

Also, 99.9% of ivermectin use is for treating nematode infection. It seems odd that the lede begins with description of its use for arthropod infestation. Why was this change made?Sbelknap (talk) 21:18, 26 December 2018 (UTC)

The evidence supporting the use for bedbugs is very very weak. I have added some further concerns.

Among English speakers / readers of this article I would imagine lice and scabies are more common uses.

Were do you get the 99.9% figure? Doc James (talk · contribs · email) 10:20, 27 December 2018 (UTC)

The primary use in the EN speaking world would be lice and scabies both of which are very common. Doc James (talk · contribs · email) 18:45, 27 January 2019 (UTC)

Those of us who have been to places where filariasis and other nematode infestations are common discover that many of the healthcare workers prescribing and dispensing ivermectin speak English and many of the affected people speak English. Also, please understand the enormous scale of preventive treatment for nematode infestations. Through the MDP and its partners, including endemic countries, NGOs, the WHO, the United States Agency for International Development (USAID), the Department for International Development (DFID) and other donors and implementation organizations, more than 250 million people in 32 countries are reached each year for river blindness and LF. Since the inception of the program in 1987, Merck has donated more than 2.8 billion treatments for both diseases. In 2017, the Merck donation of ivermectin was expanded to provide an additional 100 million treatments per year through 2025 to support the elimination of LF globally, in countries where onchocerciasis is not endemic. Here's a link on Merck's donations: https://investors.merck.com/news/press-release-details/2017/Merck-Commemorates-30-Years-of-MECTIZAN-Donation-Program-Progress/default.aspx Sbelknap (talk) 19:08, 28 January 2019 (UTC)

River blindness affects 15.5 million. Scabies affects 204 million. Doc James (talk · contribs · email) 02:23, 30 January 2019 (UTC)

More than 350 million people will be treated this year with ivermectin for prevention/control/treatment of river blindness. Ivermectin is used for mass treatment of populations at risk for river blindness. I gave stats and link to the Merck page on this above.Sbelknap (talk) 04:52, 30 January 2019 (UTC)

Scabies is usually treated with topical permithrin or topical lindane, not ivermectin. (Arguably, ivermectin would be a better choice, but that is another issue.)Sbelknap (talk) 04:52, 30 January 2019 (UTC)

Both are common uses. Doc James (talk · contribs · email) 20:12, 30 January 2019 (UTC)

Eyes

This ref says "Importance of avoiding contact with eyes; if contact occurs, gently flush eyes with water."[2] Doc James (talk · contribs · email) 19:00, 13 February 2019 (UTC)

Price

I fail to see why we have the price in the article, let alone in the lede. Pricing is typically a NOT and POV violation. Placing it in the lede moreso. --Ronz (talk) 15:00, 7 September 2019 (UTC)

The price is an important aspect of a substance / medication. Yes of course we have a very strong lobby which wishes to suppress pricing information but we are not censored.[3] Doc James (talk · contribs · email) 11:35, 8 September 2019 (UTC)

@Doc James:Please remove it from the lede if there are no sources available to demonstrate such prominence and encyclopedic value. If there's some wide consensus that applies, identifying those discussions would help as well. --Ronz (talk) 15:22, 8 September 2019 (UTC)

Ongoing lawsuits by industry to prevent having to disclose the price in commercials. Obviously that demonstrates that they are of encyclopedic value. Doc James (talk · contribs · email) 11:57, 9 September 2019 (UTC)

Sources? --Ronz (talk) 15:49, 9 September 2019 (UTC)

[4][5] etc. Yes industry wish to hide how much medications actually cost both from the general population. Doc James (talk · contribs · email) 02:00, 12 September 2019 (UTC)

Neither mentions ivermectin, correct?

If you are trying to have an exception to NOT and POV so we start adding prices for medication articles in general, this is a poor way to try to do so. Better if you started with a medication that's notable for it's pricing. --Ronz (talk) 02:21, 12 September 2019 (UTC)

• Hi, I came here as a Third Opinion. Pursuant to MOS:LEAD, The lead section should briefly summarize the most important points covered in an article in such a way that it can stand on its own as a concise version of the article. The price of this drug is not mentioned in the article, and even if it were mentioned, I doubt it would be one of the "most important points" unless there are sources which show that this drug's pricing is unusually noteworthy. So, I would say that the price should not be in the lead. May His Shadow Fall Upon You ^Talk 18:28, 17 September 2019 (UTC)

Also came here as a Third/Fourth Opinion (since it was still open). While I'm generally a fan of MOS:LEADREL, providing prices of drugs in the intro seems to be standard across Wikipedia, as can be seen in articles from Aspirin to Xanax. The issue may be resolvable with an RfC somewhere like Template talk:Infobox drug. My own instinct would be that the price of a drug (if stable and reliably sourced) is inherently a relevant and important piece of information regardless of whether you can write a paragraph about it. ─ ReconditeRodent « talk · contribs » 00:32, 18 September 2019 (UTC)

A "standard" in this case means it was added and not removed. I've yet to find any discussion. Xanax is a GA at least, and became a GA long before the pricing was added. --Ronz (talk) 03:12, 18 September 2019 (UTC)

Perhaps the price could be suitable for an infobox, but if the purpose of a lead paragraph is to summarize the article (which it is, as per the Wikipedia Manual of Style), then it would be inappropriate for the lead paragraph to contain something which isn't in the article - regardless of how useful that information may be. Just because this error has been made on other pages doesn't mean that it should be made here. May His Shadow Fall Upon You ^Talk 14:06, 18 September 2019 (UTC)

So basically we have one opinion in each direction... Have added it to the body of the text aswell. Doc James (talk · contribs · email) 04:01, 19 September 2019 (UTC)

Welcome back. Please revert. Can you address the policies?

How about we remove it from the lede, given the lack of sources demonstrating such weight? --Ronz (talk) 17:00, 19 September 2019 (UTC)

I've gone ahead and removed from the lede. Without better sources, it's a NOT and POV vio in the lede, and questionable in the article body. --Ronz (talk) 16:59, 26 September 2019 (UTC)

It is well sourced? I can add further references... Doc James (talk · contribs · email) 23:01, 26 September 2019 (UTC)

There's absolutely nothing that demonstrates encyclopedic value. That was my initial concern and remains.

Please revert and address the policies. --Ronz (talk) 23:03, 26 September 2019 (UTC)

Price is present in medical textbooks thus making it sufficiently notable.

Also here by the US government https://data.medicaid.gov/Drug-Pricing-and-Payment/NADAC-as-of-2019-09-25/s3gx-n3zd

Yes prices are a key aspect of a medication. It often determines if an individual or country is able to access a treatment.

Every version of the British National Formulary contains the price in the UK. Doc James (talk · contribs · email) 23:06, 26 September 2019 (UTC)

That's all OR. How about reverting it from the lede, then we can have an RfC.

Can I assume you've been adding prices to other medication articles? Should we start somewhere else to address the general case of all medications? --Ronz (talk) 23:20, 26 September 2019 (UTC)

There is pricing information in a lot of articles such as IPhone_11#Price. That article on medications and procedures contain prices is common practice. Doc James (talk · contribs · email) 00:56, 27 September 2019 (UTC)

agree w/ Doc James, pricing should be included--Ozzie10aaaa (talk) 01:03, 27 September 2019 (UTC)

That article on medications and procedures contain prices is common practice If this comment was intended to further the discussion or was in response to any concerns, then I don't know what it refers to. --Ronz (talk) 16:50, 27 September 2019 (UTC)

That we have lots of secondary source that mention prices is enough to support notability. It is at least as notable as the "molecular mass" and I am not suggesting we remove that. Doc James (talk · contribs · email) 23:03, 27 September 2019 (UTC)

Nothing but OR that demonstrates encyclopedic value, nor ignoring NOPRICES. --Ronz (talk) 14:35, 28 September 2019 (UTC)

NOT says, An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention. Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention. Putting it in the article at all ignores the need for "commentary" rather than "passing mention". Putting it in the lede suggests that it is somehow related to it's notability. --Ronz (talk) 14:51, 28 September 2019 (UTC)

I'd hoped that discussions like Wikipedia_talk:WikiProject_Medicine/Archive_84#Price_of_medications would have been included, which concludes: Except in the cases where the sources note the significance of the pricing (which did have consensus), there is no consensus to add the pricing to the articles --Ronz (talk) 14:56, 28 September 2019 (UTC)

pricing, in this case(article), would benefit the reader...IMO--Ozzie10aaaa (talk) 02:31, 29 September 2019 (UTC)

Again, OR.

We have a content policy and an RfC already saying better sources are required. I take it if they were available, they would have been offered. It needs to be removed per policy, the RfC, and ONUS. Please do so. --Ronz (talk) 02:48, 29 September 2019 (UTC)

The content in questions is supported by multiple medical textbooks. These are not product reviews.

Ronz the majority of people commenting here disagree with you. Doc James (talk · contribs · email) 17:46, 29 September 2019 (UTC)

WP:CONLEVEL: Consensus among a limited group of editors, at one place and time, cannot override community consensus on a wider scale. --Ronz (talk) 22:01, 29 September 2019 (UTC)

Lots of excellent sources around pricing of this medication. Have added a bunch more. Interesting history in fact. Doc James (talk · contribs · email) 17:56, 30 September 2019 (UTC)

If you'll note, I was agreeable to including the content in the article body. I appreciate your taking time to find justification for that section of the article. However, I think you're ignoring all policy, all discussion, and the RfC still. --Ronz (talk) 18:24, 30 September 2019 (UTC)

Per Wikipedia:Prices "Wikipedia has no specific policy on presenting prices of products." Doc James (talk · contribs · email) 18:39, 30 September 2019 (UTC)

agree with Wikipedia has no specific policy on presenting prices of products--Ozzie10aaaa (talk) 18:51, 30 September 2019 (UTC)

An essay does not overrule policy. You two know better. Repeating your viewpoints gets us no where. --Ronz (talk) 19:48, 30 September 2019 (UTC)

Pricing, per policy, is not permitted in articles, with rare exceptions when the price is a significant part of something's notability or is very extensively commented on (not just mentioned). Seraphimblade ^{Talk to me} 03:17, 30 December 2019 (UTC)

If you disagree with the AN/I close you can start a discussion elsewhere. QuackGuru (talk) 12:47, 30 December 2019 (UTC)

All discussion so far supports removal: Wikipedia_talk:Manual_of_Style/Medicine-related_articles. --Ronz (talk) 17:32, 30 December 2019 (UTC)

Ah lots of discussion supports keeping it. Doc James (talk · contribs · email) 02:05, 31 December 2019 (UTC)