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The following safety information highlights essential warnings and precautions for the use of this medication. It is crucial to understand these risks and consult with your healthcare provider if you have any questions or concerns.

• Severe Allergic Reaction (Mazzotti Reaction): In rare cases, individuals using ivermectin (Stromectol) for the treatment of river blindness may experience a severe allergic response known as the Mazzotti reaction. This occurs due to the immune system's reaction to the elimination of parasitic worms. Symptoms may include rash, fever, joint pain, stomach upset, and swollen lymph nodes. If untreated, this reaction can be life-threatening. Seek immediate medical attention if these symptoms occur.

• Brain and Nervous System Issues: There is a rare risk for those treating river blindness, especially if also infected with the African eye worm, of experiencing neurological problems such as severe drowsiness, confusion, or even coma. These symptoms typically resolve after discontinuing ivermectin (Stromectol), but they require prompt medical attention to prevent potentially life-threatening complications.

Common side effects:

• Headache
• Dizziness
• Nausea
• Diarrhea
• Muscle pain

Less common but important to monitor:

• Fatigue
• Weakness
• Spinning sensation
• Tremors
• Abdominal pain
• Constipation
• Vomiting

Serious side effects:

• Neck or back pain
• Swelling in the face, arms, hands, or feet
• Chest pain
• Rapid heartbeat
• Drowsiness
• Confusion
• Seizures
• Severe rash
• Itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Difficulty breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Warfarin

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Phenobarbital
• Butalbital
• Clonazepam
• Lorazepam
• Sodium oxybate (GHB)
• Valproic Acid