Drugs to avoid with ivermectin (P-gp / CYP)
Drugs to avoid with ivermectin in practice means “don’t invent a stack.” P-gp / ABCB1 inhibitors reduce efflux at the blood-brain barrier. The milligrams on the blister stay honest. Brain AUC may not.
Names that often land on counseling lists: ketoconazole, cyclosporine, quinidine, verapamil, some HIV protease inhibitors, amiodarone, clarithromycin. CYP3A4 inhibitors can raise systemic exposure on a second axis. The two stories stack.
You’re on a short macrolide for a cough? That still counts as a pump week. Write the last 14 days, not only the forever bottles. Mechanism of the pump: how does ivermectin work. AE ladder: ivermectin side effects.
Ivermectin and alcohol
Ivermectin and alcohol rarely shows as a single absolute chemical stop the way nitrates do for PDE5. The practical hold is additive CNS and balance noise — dizziness, sedation, bad judgment — on a night when you already took a systemic antiparasitic.
Skip the binge on dose night. If you drink, keep it light and don’t use alcohol to “settle” nausea. Overdose and paste stories are a different chart: ivermectin side effects.
Food as an exposure interaction
Empty stomach with water is how the mcg/kg numbers were studied. A volunteer high-fat meal at a high probe dose raised bioavailability about 2.5-fold versus fasted. That’s an interaction with exposure, not table manners.
If breakfast already landed, hold the tablet and ask the clinic — don’t stack a second swallow hours later to “fix” the fasted number. Weight math: ivermectin dosage for humans.
What to put on the table
Bring azoles, rhythm drugs, calcium-channel blockers, HIV meds, recent antibiotics, and anything labeled “avoid grapefruit” energy. Bring the alcohol plan for that night. Bring whether breakfast was greasy.
Buy path after the list is clean: where to buy ivermectin for humans.
Suspected overdose: Poison Help at 1-800-222-1222.
FAQ
What are important ivermectin interactions?
P-gp inhibitors and some CYP3A4 stacks that raise brain or systemic exposure at the same tablet count.
What drugs to avoid with ivermectin?
Ask before stacking ketoconazole, cyclosporine, quinidine, verapamil, some protease inhibitors, amiodarone, clarithromycin, and similar pump drugs.
Can I drink — ivermectin and alcohol?
Not a nitrate-style absolute in every line, but alcohol can worsen dizziness. Skip binges on dose night.
Does food count as an interaction?
Yes for exposure. Fatty meals can raise AUC about 2.5× versus fasted.
Do I stop my heart medicine myself?
No. Put both bottles in front of the clinician who owns both charts.
Why does empty stomach matter for interactions?
Food changes exposure the same way a pump drug does — fatty meals can push AUC ~2.5× versus the studied fasted water dose.
Next step: Open ivermectin side effects or ivermectin dosage for humans, or where to buy ivermectin for humans for the Rx path.