Ivermectin Dosage Chart for Adults: US Medical Reference Guide (2026)
- Dr. Ryan Heals, Pharm.D.
- May 14
- 10 min read
Ivermectin is one of the most important antiparasitic medicines in the world. Discovered in the late 1970s, FDA-approved for human use since 1987, and listed on the WHO Model List of Essential Medicines, it has been safely administered to hundreds of millions of people globally. In the United States, it is a prescription-only medication used to treat two primary FDA-approved indications — strongyloidiasis (intestinal threadworm) and onchocerciasis (river blindness) — as well as several widely practiced off-label uses including scabies, head lice, and emerging antiparasitic cancer protocols.
The most important thing to understand about Ivermectin dosing is this: the dose is never fixed. It is always calculated based on the patient's body weight in kilograms, using a standard of micrograms of drug per kilogram of body weight (mcg/kg). The correct dose for a 60 kg (132 lb) adult is different from the correct dose for a 90 kg (198 lb) adult — and getting this right matters for both safety and effectiveness.
This complete 2026 US Medical Reference Guide provides the full Ivermectin dosage chart for adults by body weight, covering both FDA-approved indications and commonly used off-label applications, explains how to calculate your dose correctly, covers the key dosing rules, and explains where to buy the correct Ivermectin strength in the USA.
At TheMedicineKart, we stock Ivermectin in six strengths — 6mg, 12mg, 15mg, 20mg, 25mg (as Febentel Plus), and 40mg — sourced from WHO-GMP certified manufacturers, with USA-to-USA delivery and 50% off your first order using code MK50. Browse at www.themedicinekart.com/anti-worm
What Is Ivermectin and How Does It Work?
Ivermectin is a macrocyclic lactone antiparasitic drug originally developed for veterinary use in 1975 and approved for human use by the FDA in 1987. It works by binding to glutamate-gated chloride ion channels in the nerve and muscle cells of parasitic invertebrates — causing permanent channel opening, hyperpolarization of the parasite's nerve membranes, and ultimately paralysis and death of the parasite. Human cells do not have the same channel structure, which is why Ivermectin is selectively toxic to parasites and not to the patient at therapeutic doses.
Quick reference:
Detail | Information |
Drug Class | Macrocyclic lactone antiparasitic |
FDA Approval | 1987 (Stromectol brand) |
Standard Dose | 150–200 mcg/kg body weight |
Available Strengths | 3 mg (brand); 6 mg, 12 mg, 15 mg, 20 mg, 40 mg (generics) |
FDA-Approved Indications | Strongyloidiasis, Onchocerciasis |
Common Off-Label Uses | Scabies, head lice (pediculosis), filariasis, antiparasitic cancer protocols |
WHO Essential Medicine | Yes |
Prescription Required | Yes — in the United States |
Dosing Basis | Always weight-based — mcg per kg of body weight |
Take With | Water, on an empty stomach (unless protocol specifies otherwise) |
How to Calculate Your Ivermectin Dose — Step by Step
Ivermectin dosing is straightforward once you understand the formula. Here is exactly how to calculate it:
Step 1:
Convert your body weight to kilograms
If you know your weight in pounds, divide by 2.2.
Example: 154 lbs ÷ 2.2 = 70 kg
Step 2:
Multiply your weight in kg by the mcg/kg dose for your indication
Example for strongyloidiasis (200 mcg/kg):
70 kg × 200 mcg/kg = 14,000 mcg
Step 3:
Convert mcg to mg
14,000 mcg ÷ 1,000 = 14 mg
Step 4:
Select the tablet strength that delivers your calculated dose
14 mg = one Ivermectin 12mg tablet + one 3mg tablet (or one Ivermectin 15mg tablet)
This is exactly how your doctor calculates your dose. Never guess — always calculate based on your actual current body weight.
Ivermectin Dosage Chart — Strongyloidiasis (200 mcg/kg)
Strongyloidiasis is an intestinal infection caused by the parasitic worm Strongyloides stercoralis. It is the primary FDA-approved indication for oral Ivermectin and the indication that uses the higher 200 mcg/kg standard dose.
Body Weight (kg) | Body Weight (lbs) | Dose Required | Recommended Tablet |
15–24 kg | 33–53 lbs | 3 mg | 1 × 3 mg tablet |
25–35 kg | 55–77 lbs | 6 mg | 1 × 6 mg tablet |
36–50 kg | 79–110 lbs | 9 mg | 1.5 × 6 mg tablet |
51–65 kg | 112–143 lbs | 12 mg | 1 × 12 mg tablet |
66–79 kg | 145–174 lbs | 15 mg | 1 × 15 mg tablet |
80–99 kg | 176–218 lbs | 18–20 mg | 1 × 20 mg tablet |
100–110 kg | 220–242 lbs | 20–22 mg | 1 × 20 mg + 1 × 3 mg |
Over 110 kg | Over 242 lbs | Calculate 200 mcg/kg | 1 × 40 mg tablet or combination |
Schedule:
Single dose on Day 1. A follow-up stool examination 1–4 weeks after treatment is recommended to confirm clearance. In immunocompromised patients (e.g., HIV-positive), repeat dosing every 2 weeks may be required as the infection can be more persistent.
Ivermectin Dosage Chart — Onchocerciasis (150 mcg/kg)
Onchocerciasis (river blindness) is caused by the parasitic worm Onchocerca volvulus, transmitted by blackfly bites. It is the second FDA-approved indication for oral Ivermectin and uses a lower 150 mcg/kg dose.
Body Weight (kg) | Body Weight (lbs) | Dose Required | Recommended Tablet |
15–25 kg | 33–55 lbs | 3 mg | 1 tablet (3 mg) |
26–44 kg | 57–97 lbs | 6 mg | 2 × 3 mg tablets |
45–64 kg | 99–141 lbs | 9 mg | 3 × 3 mg tablets |
65–84 kg | 143–185 lbs | 12 mg | 4 × 3 mg tablets / 1 × 12 mg tablet |
85 kg or more | 187 lbs or more | 150 mcg/kg calculated | Calculate precisely |
Schedule:
Single dose. Treatment may be repeated every 3–12 months, or as frequently as every 6 months for patients with heavy ocular infection, until the adult worm population dies naturally (typically 10–15 years). Note: Ivermectin kills the microfilariae (larvae) but not adult Onchocerca worms, which is why long-term repeat dosing is required.
Ivermectin Dosage Chart — Scabies (200 mcg/kg, Off-Label)
Scabies is one of the most common off-label uses of Ivermectin in the United States and is the indication most frequently searched by US patients. While not officially FDA-approved for scabies (the FDA removed it from the scabies indication in its most recent label update), it is widely used and recommended in clinical practice guidelines for scabies — particularly for crusted scabies, household outbreaks, and patients who cannot apply topical treatments.
Body Weight (kg) | Body Weight (lbs) | Dose (200 mcg/kg) | Tablet |
25–35 kg | 55–77 lbs | 6 mg | 1 × 6 mg |
36–50 kg | 79–110 lbs | 9 mg | 1.5 × 6 mg |
51–65 kg | 112–143 lbs | 12 mg | 1 × 12 mg |
66–79 kg | 145–174 lbs | 15 mg | 1 × 15 mg |
80–99 kg | 176–218 lbs | 18–20 mg | 1 × 20 mg |
Over 100 kg | Over 220 lbs | 20–22 mg | 1 × 20 mg + supplement |
Schedule for standard scabies:
- Dose 1: Day 1
- Dose 2: Day 8 or Day 14 (essential — kills newly hatched mites from eggs present at first dose)
Schedule for crusted (Norwegian) scabies:
- Multiple doses: Days 1, 2, 8, 9, 15, 22, and 29
- Combined with topical permethrin or benzyl benzoate
- Medical supervision required throughout
Ivermectin Dosage — Cancer Protocol Reference (Off-Label)
This section covers the off-label dosing used in antiparasitic cancer protocols — specifically the Joe Tippens Protocol, the Dr. William Makis Protocol, and the ISOM Framework. These are investigational uses and are not FDA-approved for cancer. All cancer protocol dosing requires medical supervision.
Protocol | Ivermectin Dose | Example (70 kg adult) | Schedule |
Joe Tippens (original) | Not included | — | N/A |
Joe Tippens (updated 2026) | 25 mg | Fixed 25 mg | 6 days per week |
Makis Standard | 0.5–1 mg/kg/day | 35–70 mg daily | Daily with fatty meal |
Makis Intermediate | 1–1.5 mg/kg/day | 70–105 mg daily | Daily continuous |
Makis Aggressive | 1.5–2 mg/kg/day | 105–140 mg daily | Daily — medical supervision |
For cancer protocols, TheMedicineKart provides:
- Ivermectin 12mg — standard adult dose for most protocol levels
- Ivermectin 20mg — for adults 80–100 kg on standard protocol
- Ivermectin 40mg — for higher doses or adults over 100 kg
- Febentel Plus (Fenbendazole 500mg + Ivermectin 25mg) — covers the updated Joe Tippens 2026 combined protocol in one tablet
Standard Dosing Rules — How to Take Ivermectin Correctly
These rules apply to all FDA-approved and off-label oral Ivermectin use:
Take on an empty stomach with a full glass of water (approximately 8 oz / 240 ml). The FDA-approved prescribing information states Ivermectin should be taken on an empty stomach. Food generally reduces absorption — the exception is cancer protocols, where a high-fat meal is specifically recommended to increase bioavailability (see below).
Exception for cancer protocols: Both Fenbendazole and Ivermectin are fat-soluble (lipophilic) drugs. For off-label cancer protocol use, taking Ivermectin with a high-fat meal can increase oral bioavailability by up to 2–2.5-fold, significantly increasing the systemic drug concentration. This is why cancer protocol users are advised to take Ivermectin with a fatty meal — the opposite of the antiparasitic instruction.
Do not take more than one dose per 24 hours for antiparasitic indications.
Store at room temperature (59–86°F / 15–30°C), protected from light and moisture.
Do not crush or chew extended-release or film-coated tablets unless specifically instructed.
Never take veterinary Ivermectin formulations — products like Ivomec pour-on are formulated for animals and contain concentrations that are not safe for human use.
Which Ivermectin Strength Do I Need?
This is the most practical question. Here is how to match your calculated dose to the correct TheMedicineKart product:
Calculated Dose | Body Weight Range | Best Product at TheMedicineKart |
6 mg | 30–35 kg (66–77 lbs) | Ivermectin 6 mg |
9 mg | 45–50 kg (99–110 lbs) | Ivermectin 6 mg × 1.5 tablets |
12 mg | 60–65 kg (132–143 lbs) | Ivermectin 12 mg |
15 mg | 75–79 kg (165–174 lbs) | Ivermectin 15 mg |
18–20 mg | 90–100 kg (198–220 lbs) | Ivermectin 20 mg |
25 mg | Protocol fixed dose | Febentel Plus (includes FBZ 500 mg) |
40 mg | High dose / over 100 kg | Ivermectin 40 mg |
All Ivermectin products at TheMedicineKart are sourced from WHO-GMP certified pharmaceutical manufacturers and are pharmaceutical-grade human tablets — not veterinary formulations. Use code MK50 for 50% off your first order. Free shipping on orders above $199. USA-to-USA delivery in 4 business days.
Browse the full Ivermectin range at www.themedicinekart.com/anti-worm
Side Effects and Safety Information
Ivermectin at FDA-approved antiparasitic doses has a well-documented favorable safety profile, supported by decades of use and mass drug administration programs treating hundreds of millions of people globally.
Common side effects (primarily related to parasite die-off — Mazzotti reaction — not direct drug toxicity):
- Temporary worsening of itching — especially with scabies (mites dying rapidly)
- Headache — usually mild and resolves within 24 hours
- Dizziness — particularly if taken without food; more common at higher doses
- Nausea and stomach discomfort — mild and transient
- Fatigue — uncommon; typically resolves within 1–2 days
- Swollen lymph nodes — more common in onchocerciasis treatment (Mazzotti reaction)
- Fever — part of the Mazzotti die-off reaction in onchocerciasis; managed with antihistamines and aspirin
Serious but rare:
- Neurological effects — confusion, loss of coordination, tremors, and vision changes have been reported rarely, particularly in patients with blood-brain barrier disorders or at very high doses. Seek immediate care if any neurological symptoms develop.
- Severe Mazzotti reaction — in heavy onchocerciasis infections, the rapid death of large numbers of microfilariae can cause significant systemic inflammation. Managed with corticosteroids, antihistamines, and fluids.
Who should not take Ivermectin:
- Children weighing less than 15 kg — safety not established
- Pregnant women — not recommended; insufficient human safety data; permethrin is the preferred scabies treatment during pregnancy
- Patients with concurrent Loa loa (loiasis) infection — extremely important: high Loa loa microfilariae levels combined with Ivermectin can trigger fatal neurological reactions including encephalopathy. Patients from regions where Loa loa is endemic (Central and West Africa) should be screened before Ivermectin use.
- Patients with conditions affecting the blood-brain barrier (meningitis, African trypanosomiasis with CNS involvement) — Ivermectin may penetrate the brain at higher concentrations
Drug interactions:
- Warfarin — Ivermectin may increase anticoagulant effect; INR monitoring recommended
- CYP3A4 inhibitors (ketoconazole, ritonavir) — may increase Ivermectin blood levels; use with caution
- Medications that increase blood-brain barrier permeability — increase neurological risk
Ivermectin in the USA — Price Reality Check
Ivermectin is a prescription drug in the United States. At US retail pharmacies without insurance, the cost can be significant — particularly for the higher doses used in antiparasitic cancer protocols requiring daily use.
Source | Ivermectin 12 mg Price | Monthly Cost (Daily Use) |
US Retail Pharmacy (Brand Stromectol) | $50–$100/tablet | Not practical daily |
US Pharmacy Generic | $5–$15/tablet | $150–$450/month |
US Compounders (restricted since 2025) | $3–$6/tablet | $90–$180/month |
TheMedicineKart (with code MK50) | As low as $0.50–$1/tablet | $15–$30/month |
TheMedicineKart sources Ivermectin directly from WHO-GMP certified Indian pharmaceutical manufacturers — the same manufacturing standard required for pharmaceutical export to the USA, UK, and EU. The dramatically lower price reflects the elimination of US wholesale, distribution, and retail pharmacy chain markup — not any difference in quality or potency.
For antiparasitic protocol users requiring daily Ivermectin, TheMedicineKart's pricing makes consistent long-term use financially accessible in a way that US pharmacy prices simply do not.
Frequently Asked Questions
How do I calculate the correct Ivermectin dose for my weight?
The standard dose for most antiparasitic indications is 200 mcg/kg for strongyloidiasis and scabies, and 150 mcg/kg for onchocerciasis. To calculate: convert your weight to kg (divide pounds by 2.2), then multiply by the mcg/kg standard for your indication, then convert mcg to mg (divide by 1,000). For example: a 70 kg adult with strongyloidiasis needs 70 × 200 = 14,000 mcg = 14 mg of Ivermectin. Always have your physician verify your calculation before taking the dose.
What is the difference between Ivermectin 6mg, 12mg, 15mg, 20mg, and 40mg?
All strengths contain the same active drug — Ivermectin — at different milligram doses to allow precise weight-based dosing. The 6mg tablet covers adults up to approximately 35 kg. The 12mg tablet covers most standard adult doses for strongyloidiasis and scabies (51–65 kg). The 15mg tablet covers adults 66–79 kg. The 20mg covers adults 80–100 kg. The 40mg is used for adults over 100 kg or for higher-dose antiparasitic cancer protocols. At TheMedicineKart, all six strengths are available at 50% off with code MK50.
Should I take Ivermectin with food or on an empty stomach?
For FDA-approved antiparasitic indications — strongyloidiasis, onchocerciasis, scabies — take Ivermectin on an empty stomach with a full glass of water. Food reduces absorption for standard antiparasitic dosing. The exception is off-label cancer protocols: both Ivermectin and Fenbendazole are fat-soluble drugs whose bioavailability increases significantly when taken with a high-fat meal. If using Ivermectin as part of a cancer protocol, your integrative physician will likely specify taking it with a fatty meal.
How many doses of Ivermectin do I need for scabies?
For standard (non-crusted) scabies, two doses are required — one on Day 1 and a second on Day 8 or Day 14. The second dose is essential because Ivermectin kills live mites but not their eggs. The second dose eliminates newly hatched mites before they can reproduce and restart the infestation. For crusted (Norwegian) scabies, multiple doses are required over 4 weeks (typically Days 1, 2, 8, 9, 15, 22, and 29) in combination with topical treatment.
Is Ivermectin safe to take long-term for cancer protocols?
At standard antiparasitic doses (150–200 mcg/kg once or twice), Ivermectin has an excellent safety profile. For the higher daily doses used in some cancer protocols (0.5–2 mg/kg/day), long-term safety data in humans is limited. The most important monitoring requirements for long-term higher-dose Ivermectin use are: liver function panel (AST, ALT, bilirubin) every 4–6 weeks, complete blood count every 4–6 weeks, and regular neurological assessment. Always use under medical supervision for any long-term or high-dose protocol.
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