Not related to COVID-19, but relevant in terms of pharmacokinetics in children. Ivermectin is considered contraindicated in children under 5 years and under 15kg, this peer reviewed study finds safe and effective dosages for treating parasites.
Some excerpts from the Discussion section:
Ivermectin is an increasingly important drug for prevention and treatment of neglected tropical diseases and scabies[14–16]. Recently, the repurposing of ivermectin for the control of malaria has been identified as a public health priority due to its mosquitocidal activity[17]. For many of these diseases, in particular scabies, young children in resource poor settings are especially vulnerable to infection and associated secondary complications. Therefore, improving access to ivermectin for these children is important for public health. This study identified a dosing strategy (i.e. a dose of 3 mg) for children aged 2 to 4 years that achieves comparable drug exposure to children aged over 4 years. Our results are similar to a prospective pharmacokinetic study of children in Cote d’Ivoire that recommended a dose of 3 mg in children weighing 10 to 15 kg[13,18]. We propose that our simulated dose of 3 mg can now be prospectively evaluated to determine safety and efficacy in children aged 2 to 4 years and weighing 10 to 15 kg.
The primary safety concern of ivermectin treatment in young children is the risk of neurotoxicity. However, a review of nine studies where ivermectin was administered to children aged less than five years and weighing less than 15 kg (107 patients in total) found no serious drug-related adverse effects associated with ivermectin use with doses between 150 and 200 μg/kg[6,24–32]. Furthermore, in a cohort of 170 infants and children aged between one and 64 months treated with ivermectin at a mean dose of 223 μg/kg, no serious adverse effects were reported[33]. Ivermectin has a large therapeutic window. A study of adults that evaluated doses 10 times the recommended dose of 200 μg/kg reported no neurotoxicity[34]. Furthermore, two large trials of mass drug administration of oral ivermectin to 21,444 and 14,556 adults and children have shown that ivermectin is not associated with serious adverse events[15,35]. For children aged less than five years who typically cannot swallow tablets, the tablet can be administered dispersed or crushed[36]. However, if an ethanol-based solution is used, a previous study reported up to double the bioavailability of ivermectin (AUC ratio 1.08–2.29)[37]
Using population pharmacokinetic modelling, we identified a dosing strategy for ivermectin in children aged 2 to 4 years and weighing less than 15 kg—a dose of 3 mg in children weighing 10 to 15 kg. Young children in resource-poor settings are at especially high risk of infection with multiple parasites susceptible to ivermectin, including scabies, and an appropriate dosing strategy has the potential to confer substantial health benefits for this high-risk population.
[-] Haitchpeasauce | 2 points | Dec 08 2020 10:40:47
Not related to COVID-19, but relevant in terms of pharmacokinetics in children. Ivermectin is considered contraindicated in children under 5 years and under 15kg, this peer reviewed study finds safe and effective dosages for treating parasites.
Some excerpts from the Discussion section:
Ivermectin is an increasingly important drug for prevention and treatment of neglected tropical diseases and scabies[14–16]. Recently, the repurposing of ivermectin for the control of malaria has been identified as a public health priority due to its mosquitocidal activity[17]. For many of these diseases, in particular scabies, young children in resource poor settings are especially vulnerable to infection and associated secondary complications. Therefore, improving access to ivermectin for these children is important for public health. This study identified a dosing strategy (i.e. a dose of 3 mg) for children aged 2 to 4 years that achieves comparable drug exposure to children aged over 4 years. Our results are similar to a prospective pharmacokinetic study of children in Cote d’Ivoire that recommended a dose of 3 mg in children weighing 10 to 15 kg[13,18]. We propose that our simulated dose of 3 mg can now be prospectively evaluated to determine safety and efficacy in children aged 2 to 4 years and weighing 10 to 15 kg.
The primary safety concern of ivermectin treatment in young children is the risk of neurotoxicity. However, a review of nine studies where ivermectin was administered to children aged less than five years and weighing less than 15 kg (107 patients in total) found no serious drug-related adverse effects associated with ivermectin use with doses between 150 and 200 μg/kg[6,24–32]. Furthermore, in a cohort of 170 infants and children aged between one and 64 months treated with ivermectin at a mean dose of 223 μg/kg, no serious adverse effects were reported[33]. Ivermectin has a large therapeutic window. A study of adults that evaluated doses 10 times the recommended dose of 200 μg/kg reported no neurotoxicity[34]. Furthermore, two large trials of mass drug administration of oral ivermectin to 21,444 and 14,556 adults and children have shown that ivermectin is not associated with serious adverse events[15,35]. For children aged less than five years who typically cannot swallow tablets, the tablet can be administered dispersed or crushed[36]. However, if an ethanol-based solution is used, a previous study reported up to double the bioavailability of ivermectin (AUC ratio 1.08–2.29)[37]
Using population pharmacokinetic modelling, we identified a dosing strategy for ivermectin in children aged 2 to 4 years and weighing less than 15 kg—a dose of 3 mg in children weighing 10 to 15 kg. Young children in resource-poor settings are at especially high risk of infection with multiple parasites susceptible to ivermectin, including scabies, and an appropriate dosing strategy has the potential to confer substantial health benefits for this high-risk population.
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[-] converter-bot | 1 points | Dec 08 2020 10:41:01
15.0 kg is 33.04 lbs
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