Ivermectin tablets are usually taken as a single dose and most people tolerate them well. This guide covers the side effects to expect, the ones that need a doctor, and the warning signs of taking too much.

Common side effects of ivermectin tablets

• dizziness
• nausea, diarrhoea or stomach pain
• tiredness or lack of energy
• itching or a mild rash

These are usually mild and pass within a day or two.

Reactions to dying parasites

When ivermectin is used for river blindness (onchocerciasis), the body can react to the parasites as they die. This is called the Mazzotti reaction. It can cause itching, fever, swollen glands, joint pain and, less often, a drop in blood pressure that makes you dizzy when you stand up. Lie down if you feel faint and tell your doctor.

Serious side effects: get medical help

• a severe skin rash with blistering or peeling
• yellowing of the skin or eyes, or dark urine
• confusion, extreme sleepiness or difficulty walking
• seizures
• swelling of the face, lips or throat, or difficulty breathing

Overdose warning signs

Most ivermectin overdoses in the US have involved animal products or taking more than prescribed. Signs include:

• nausea, vomiting and diarrhoea
• confusion, drowsiness or hallucinations
• unsteady walking, tremor
• blurred vision
• low blood pressure, seizures or coma

If you think someone has taken too much, call Poison Control on 1-800-222-1222, or 911 if they are very drowsy, having a seizure or struggling to breathe.

Medicines that interact with ivermectin

• Warfarin: there are reports of a raised INR (increased bleeding risk), so your INR may need checking.
• Sedatives such as benzodiazepines or barbiturates: tell your doctor if you take these.
• Some medicines that change how the liver breaks down drugs, including certain HIV medicines, antifungals and ciclosporin. Your pharmacist can check your list.

Side effects of ivermectin lotion and cream

The lotion used for head lice and the cream used for rosacea are applied to the skin, so very little reaches the bloodstream. Possible effects include eye irritation, redness, burning, dry skin or dandruff. Keep them away from the eyes.

See also: what ivermectin is used for, and what it doesn’t treat.

More in our Lice and Parasites guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Ivermectin is an antiparasitic medicine. It has been used for decades to treat certain worm infections, and it has saved millions of people from river blindness. It also became one of the most searched medicines during the COVID-19 pandemic. This guide explains what ivermectin does and doesn’t do, based on the evidence.

What ivermectin is approved to treat

In the US, ivermectin comes in three forms, each for different conditions:

• Tablets (prescription): approved for strongyloidiasis (a threadworm infection of the intestine) and onchocerciasis (river blindness). Doctors also prescribe them for some other parasitic infections, including scabies, particularly severe (crusted) scabies.
• 0.5% lotion (Sklice, over the counter): for head lice in adults and children aged 6 months and over. See our guide to head lice treatment.
• 1% cream (Soolantra, prescription): for the bumps and spots of rosacea.

How ivermectin tablets are taken

• A doctor works out the dose from your body weight. It is often a single dose, sometimes repeated.
• Tablets are taken on an empty stomach with water.
• Depending on the infection, you may need follow-up stool tests to check the treatment worked.

Because the right dose and the need for a repeat dose depend on the infection and on your weight, ivermectin tablets need a prescription and a diagnosis.

What about COVID-19?

Several large randomised trials, including ACTIV-6, TOGETHER and PRINCIPLE, tested ivermectin in people with COVID-19. They found it did not speed up recovery or reduce hospital admissions compared with a placebo. The FDA has not authorised or approved ivermectin to prevent or treat COVID-19.

Never use animal ivermectin

Ivermectin products for horses, cattle and dogs are much more concentrated and are made for animals that weigh far more than a person. US poison centres have reported people needing hospital treatment after taking them, with confusion, seizures, very low blood pressure and coma. Never take a veterinary product.

Check with a doctor first if you

• are pregnant or breastfeeding
• have liver disease
• take warfarin or other regular medicines
• have lived in or travelled to Central or West Africa. Ivermectin can cause serious reactions in people with a heavy Loa loa (eye worm) infection, so doctors test for it first.
• want to treat a child who weighs less than 15 kg (33 lb)

Side effects

Most people have no side effects or mild ones such as dizziness, nausea or itching. Read our full guide to ivermectin side effects, interactions and overdose warning signs.

More in our Lice and Parasites guide: all our articles on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Motion sickness is especially common in children aged 2 to 12. A car journey can quickly turn into nausea, pale skin, sweating and vomiting. The good news: a few simple habits prevent most episodes, and many children grow out of it.

Why children get car sick

Motion sickness happens when the eyes and the balance system in the inner ear send the brain different signals. A child sitting low in the back seat, looking at a book or screen, sees a still scene while their inner ear feels every turn and bump.

Prevention tips

• Help them look out of the front window, at the horizon, rather than out of the side windows. A middle back seat, raised booster (where age-appropriate and safe) can help them see ahead.
• No screens or books while the car is moving. Try audiobooks, music or games like I-spy instead.
• Keep the car cool and let in fresh air.
• A light, plain snack before the trip is better than an empty stomach or a big, greasy meal.
• Take regular breaks on long drives, and travel at nap time for younger children if you can.
• Drive smoothly: gentle braking and cornering help.

Medicine for motion sickness

• Dimenhydrinate (Dramamine) can be used in children 6 to 11 at ½ to 1 tablet every 6 to 8 hours, no more than 3 tablets in 24 hours. Give the first dose 30 to 60 minutes before travel.
• For children under 6, ask a doctor or pharmacist before giving any motion sickness medicine.
• It can cause drowsiness. In some children it causes excitability instead.

If your child feels sick

• Stop the car when it’s safe and let them get some fresh air.
• Have them lie back, close their eyes, and keep their head still.
• Offer small sips of cold water.
• Keep sick bags, wipes and a change of clothes within reach.

When to see a doctor

See a doctor if your child has dizziness, headaches or vomiting when they’re not travelling, if symptoms continue long after the journey, or if they show signs of dehydration.

Also see our guide to motion sickness in adults.

More in our Travel Health guide: all our articles and products on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Every over-the-counter (OTC) medicine sold in the US carries a Drug Facts label in the same format. Knowing how to read it helps you choose the right product, take the right dose, and avoid mistakes such as taking the same ingredient twice.

1. Active ingredient

This is the medicine that does the work, with the amount in each tablet or dose, for example “Loratadine 10 mg”. Different brands often contain the same active ingredient: Claritin and Alavert are both loratadine 10 mg.

Tip: before taking two products together, compare their active ingredients. Taking the same ingredient from two products is one of the most common ways people take too much.

2. Purpose

What kind of medicine it is, such as “antihistamine”, “anti-diarrhoeal” or “laxative”.

3. Uses

The symptoms or conditions the product is approved to treat. If your symptoms aren’t listed, ask a pharmacist before using it.

4. Warnings

The most important section. It tells you:

• Do not use if you have certain conditions or allergies
• Ask a doctor before use if you have certain health problems
• Ask a doctor or pharmacist before use if you take certain other medicines
• When using this product: side effects to expect, such as drowsiness
• Stop use and ask a doctor if certain things happen, or symptoms last too long
• Advice for pregnancy and breastfeeding, and to keep it out of reach of children

5. Directions

How much to take, how often, and the maximum in 24 hours, usually set out by age group. Use the measuring device that comes with liquid medicines, not a kitchen spoon.

6. Other information, inactive ingredients and questions

How to store the product, the fillers, colours and flavours (useful if you have allergies), and a phone number for questions.

Before you buy or take any OTC medicine

• Check the expiry date and that the packaging is sealed.
• Tell your pharmacist about any other medicines, vitamins or supplements you take.
• Be extra careful with medicines for children, older adults, and during pregnancy.

Browse our guides on allergies, digestive health and travel health.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.

Sneezing, a runny nose and a scratchy throat could be a cold or an allergy. They feel similar, but they have different causes and respond to different treatments, so it’s worth knowing which one you have.

The key differences

• Itchy eyes, nose or throat: very common with allergies, uncommon with colds.
• Fever and body aches: possible with a cold (usually mild), never caused by allergies.
• Mucus: allergies usually cause clear, watery mucus. With a cold it often thickens and may turn yellow or green.
• How it starts: allergy symptoms start soon after contact with a trigger like pollen or pets. A cold builds over a day or two.
• How long it lasts: a cold usually clears in 7 to 10 days. Allergies last as long as you’re exposed, which can be weeks during pollen season.
• Timing: allergies often follow a pattern, such as every spring, outdoors, or around a pet. Colds are more common in autumn and winter.

Treating allergies

Non-drowsy antihistamines such as Zyrtec, Claritin and Allegra block the histamine behind allergy symptoms. They work best taken daily through the season. See which one to choose.

Treating a cold

Colds are caused by viruses, so antihistamines and antibiotics won’t cure them. Rest, fluids and time are the main treatment. Pain relievers can ease aches and a sore throat, and saline sprays or steam can help a blocked nose.

See a doctor if

• Symptoms last more than 10 days, or get better then worse again
• You have a high fever, severe headache or facial pain
• You have wheezing or shortness of breath
• Allergy symptoms aren’t controlled by antihistamines

More in our Allergies guide: all our articles and products on this topic in one place.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read the label before using any medicine.