Coronavirus (COVID-19) – Special Notice For All Members

Stromectol is the original brand name for human ivermectin, a broad-spectrum antiparasitic that has transformed care for several neglected tropical diseases and dermatologic infestations. This all-new, uniquely written guide explains when Stromectol is appropriate, how it works, the right way to dose it for different conditions, how to minimize risks, what to know about resistance, and how to access it legally and safely – including through accredited telemedicine and licensed pharmacies.

1) Quick Snapshot & Why It Matters

2) Mechanism: Why Ivermectin Targets Parasites (Not People)

Ivermectin binds to glutamate-gated chloride channels found in invertebrate nerve and muscle cells. This increases chloride influx, hyperpolarizes cell membranes, and leads to parasite paralysis and death. Mammals do not possess these channels in the same way; in addition, the blood-brain barrier restricts ivermectin’s access to central nervous system targets, which underpins its safety at therapeutic doses.

• Parasites affected: Many nematodes and arthropods (mites/lice). Activity against adult worms may be limited in some diseases; often it sterilizes/adversely affects microfilariae, reducing transmission.
• Speed: Oral tablet reaches clinically meaningful levels quickly; symptom relief in scabies and lice often begins within 24-72 hours.
• Topical vs oral: Topical ivermectin (e.g., 1% cream) is for skin conditions like certain forms of rosacea; it is not a substitute for oral therapy in systemic parasitoses.

3) Indications: On-Label, Global Use, and Select Off-Label

Regulatory approvals vary, but human ivermectin is broadly used for:

• Onchocerciasis (river blindness) – mass drug administration (MDA) and individual treatment.
• Strongyloidiasis – intestinal threadworm (including hyperinfection in immunosuppressed patients, under specialist care).
• Scabies – classic and crusted (Norwegian) scabies, institutional outbreaks, treatment failures to topical agents.
• Pediculosis (head lice) – for refractory cases or when topicals fail; combined strategies may be used.
• Lymphatic filariasis – in combination with albendazole or diethylcarbamazine (depending on region and program protocols).
• Other nematode infections (select, off-label) – ascariasis, trichuriasis, cutaneous larva migrans, gnathostomiasis (specialist guidance).
• Dermatology (topical 1% cream) – inflammatory lesions of papulopustular rosacea (separate product; not Stromectol tablets).

4) Formulations & Human-Only Products

5) Dosing by Condition (with Examples & Tables)

Ivermectin dosing is typically weight-based and expressed in micrograms per kilogram (mcg/kg). Take with water on an empty stomach unless told otherwise by your prescriber. Follow local guidelines and clinician instructions.

5.1 Strongyloidiasis (intestinal threadworm)

• Adults: 200 mcg/kg orally once; a second identical dose may be given after 2 weeks based on testing and clinical course.
• Immunosuppressed or disseminated disease: Specialist management; repeated dosing and combination therapy may be required.

5.2 Scabies

• Classic scabies: 200 mcg/kg orally; repeat in 7-14 days (two doses total). Combine with topical permethrin if severe or in outbreak settings.
• Crusted (Norwegian) scabies: Multiple doses (e.g., days 1, 2, 8, 9, 15), plus topical keratolytics and permethrin; infectious-disease/dermatology input advised.
• Household/close contacts: Treat simultaneously to prevent reinfestation, even if asymptomatic, per public health advice.

5.3 Onchocerciasis (river blindness)

• Standard: 150 mcg/kg orally, typically once yearly for many years in endemic regions (per program protocols).
• Individual care: Dosing intervals may vary; ophthalmology or tropical medicine follow-up recommended.

5.4 Lice (pediculosis)

• Resistant/recurrent lice: 200 mcg/kg orally; repeat in 7 days. Consider adjunctive topical agents and combing strategies.

5.5 Dosing calculator (example table)

Approximate tablet counts using 3 mg tablets (round per prescriber’s guidance):

6) Special Populations: Kids, Elderly, Pregnancy, Comorbidities

• Children: Generally used in children ≥15 kg (≈33 lb). Below this threshold, safety data are limited; specialist guidance required.
• Elderly: Usually well tolerated, but monitor hydration, concomitant meds, and skin integrity (in scabies). Dose by actual body weight.
• Pregnancy: Discuss risks/benefits with an obstetric specialist; ivermectin is generally avoided in the first trimester unless benefits clearly outweigh risks. Programmatic decisions in endemic areas may differ.
• Breastfeeding: Ivermectin appears in low levels in breastmilk. Some guidelines avoid breastfeeding for 7 days after a dose; individualize with clinician.
• Hepatic/renal impairment: Use with caution; data are limited. Consider dose adjustments and closer monitoring.
• Immunosuppression: Strongyloides hyperinfection can be life-threatening; management should be specialist-led with repeated dosing and follow-up testing.

7) Side Effects, Contraindications & Overdose Response

Common side effects

• Gastrointestinal: nausea, diarrhea, abdominal discomfort.
• Neurologic: dizziness, mild headache, fatigue.
• Dermatologic: pruritus, rash – often related to parasite die-off.

Reactions to dying microfilariae (Mazzotti-type)

Especially in onchocerciasis: fever, pruritus, arthralgia, lymphadenitis, hypotension, tachycardia. Typically self-limited; symptomatic management may include antihistamines or short corticosteroid courses as directed by specialists.

Serious (uncommon) events

• Severe allergic reaction (anaphylaxis) – rare.
• Marked hypotension, confusion, visual disturbances – seek urgent care.
• Severe cutaneous reactions (very rare) – stop drug and seek care.

Contraindications & cautions

• Known hypersensitivity to ivermectin or formulation excipients.
• Use extreme caution if CNS barrier disorders are suspected (rare genetic transporter issues) – specialist care.
• Co-endemic infections (e.g., Loa loa) may require screening in some African regions before mass treatment to avoid serious adverse events.

Overdose

Symptoms: profound dizziness, vomiting, tremor, confusion, seizures, hypotension, respiratory depression (rare). Management is supportive in a medical setting:

1. Call emergency services immediately.
2. Airway, breathing, circulation – monitor continuously.
3. Activated charcoal early if appropriate; seizure control with benzodiazepines under medical care.
4. No specific human antidote; supportive care is mainstay.

8) Drug Interactions & What to Avoid

Ivermectin has relatively few clinically significant interactions but caution is warranted:

9) Resistance, Programmatic Use & Public-Health Context

Ivermectin is central to global programs targeting onchocerciasis and lymphatic filariasis. Widespread use raises important stewardship questions:

• Parasite susceptibility: Most targeted parasites remain sensitive, but program monitoring is essential to detect shifts in response over time.
• Mass Drug Administration (MDA): Repeated annual or semiannual dosing reduces microfilarial loads and transmission; success depends on coverage, adherence, and integration with vector control.
• Co-endemic hazards: In areas with Loa loa, high microfilarial loads may precipitate serious reactions; screening strategies and tailored protocols are used.
• Diagnostics: Post-treatment testing (e.g., stool, serology, skin snips) guides additional dosing for some infections; follow clinician advice.

10) Stromectol vs Generics & Alternative Therapies

11) Telemedicine: Getting a Legitimate Prescription

• Use established platforms with licensed clinicians practicing in your jurisdiction.
• Expect a real consultation: symptoms, exposure history, travel, diagnostics, comorbidities, pregnancy status, medicine list.
• Diagnosis drives therapy: scabies, strongyloidiasis, onchocerciasis, lice – each requires its own plan.
• Receive written dosing instructions and advice for contacts, decontamination (for scabies/lice), and follow-up testing if applicable.
• Good services will not supply ivermectin without assessing medical need or will refer you to in-person care if needed.

12) Buying Stromectol Online Safely & Legally

1. Start with a valid prescription. Many countries require one for human ivermectin tablets.
2. Choose a licensed online pharmacy. Look for national accreditation or recognized seals; verify an address and phone number you can call.
3. Avoid “no prescription” websites. These are often illegal and frequently sell counterfeits or veterinary products.
4. Check the product: Human-labeled ivermectin, correct strength, lot number, and expiry. Packaging should be intact.
5. Use secure payment and tracked shipping. Keep all confirmations and receipts.
6. Report suspected counterfeits to your regulator and prescriber; do not use questionable tablets.

13) Legal Status & Import Considerations

14) Practice Scenarios (Mini Case Studies)

15) FAQ: 15 Practical Questions Answered

1. How fast will Stromectol work?
   Many notice relief from itching (scabies/lice) within 24-72 hours; full resolution can take 1-2 weeks as skin heals.
2. Do I always need a second dose?
   Scabies and lice typically require a repeat dose 7-14 days later. Strongyloides often needs a second dose after 2 weeks; follow testing and clinical advice.
3. Can I take it with food?
   Commonly given on an empty stomach with water; your clinician may individualize this advice.
4. Can pregnant people take ivermectin?
   Generally avoided in early pregnancy unless benefits clearly outweigh risks. Discuss with an obstetric specialist.
5. Is itching after treatment normal?
   Yes, post-treatment itch is common for scabies as the skin recovers; antihistamines/emollients may help.
6. Can I drink alcohol?
   Best avoided during therapy to limit dizziness and interactions.
7. Why not use my pet’s ivermectin?
   Veterinary products are unsafe for humans (concentration/excipients). Use human prescriptions only.
8. What if I miss my second dose?
   Contact your clinician; you’ll likely be advised to take it as soon as possible and adjust timing of follow-up.
9. Will it cure onchocerciasis?
   It reduces microfilariae and transmission; repeated dosing over years is used programmatically; specialist care is needed for individuals.
10. What about crusted scabies?
    Requires multiple doses plus intensive topical therapy and infection control; seek specialist management.
11. Does ivermectin kill eggs (nits)?
    Oral ivermectin has limited ovicidal activity; hence the need for repeat dosing and combing/environmental measures.
12. Any lab tests needed?
    For strongyloidiasis, stool/serology may confirm clearance. Onchocerciasis programs use specialized assessments. Routine labs aren’t typically required for simple scabies.
13. Can children use ivermectin?
    Commonly used ≥15 kg with weight-based dosing. Below that, use only with specialist advice.
14. What side effects should prompt urgent care?
    Severe allergic reaction, fainting/hypotension, visual changes, confusion, severe rash, or breathing problems.
15. How do I avoid getting scabies again?
    Treat all close contacts together, decontaminate linens and clothing (hot wash/dry), and follow public health instructions.

16) Safe Use Checklist & Closing Notes

Medical & Legal Notice: This is an educational overview and not a substitute for professional medical advice. Always consult a licensed healthcare provider for diagnosis and treatment. Laws and pharmacy regulations vary by country and change over time; verify local requirements before obtaining prescription medicines online. In case of suspected overdose or severe reaction, call emergency services immediately.

© This document is a newly authored, unique text prepared for informational use.

Dear Members,

Governor Larry Hogan on April 24th introduced the Maryland Strong: Roadmap to Recovery, which provides a safe, effective, and gradual approach to reopening the state as it continues to combat the COVID-19 pandemic.

The Roadmap rests on four building blocks that needed to be firmly in place before the state can consider lifting restrictions:

• Expanded testing capacity
• Increased hospital surge capacity
• Ramping up supply of PPE
• Robust contact tracing operation

We understand that contact tracing programs, while not new in public health, will be conducted on a scale not previously experienced as we fight COVID-19. We are committed to answering your questions about the process.

Learn more about Contract Tracing and what it means for you.

Your health and well-being are our highest priorities. We are monitoring this situation closely and communicating with medical professionals, the Maryland Department of Health (MDH), and other government agencies to stay on top of this evolving situation.

Information is changing rapidly. Please visit the Centers for Disease Control and Prevention (CDC) website to keep up with the latest details, tips, and symptoms.

Currently, there is not a vaccine available for COVID-19, but University of Maryland Health Partners will cover testing for coronavirus and any treatment if your test is positive.

As with any illness, call your doctor if you are feeling sick. You should also call your doctor if you experience symptoms of coronavirus—fever, cough, and trouble breathing—or if you think you may have been exposed to the virus.