Ophthalmologic Manifestations of Onchocerciasis Medication

Updated: Oct 16, 2014
  • Author: Debora E Garcia-Zalisnak, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Antiparasitic agents

Ivermectin

Semisynthetic, broad-spectrum antiparasitic agent isolated from Streptomyces avermitilis. It is a mixture of 5-O demethyl-22,23-dihydroavermectin A (90%) and 5-O demethyl-25-de (1-methylpropyl)-22,23-dihydro-25- (1-methylethyl) avermectin A1a (10%).

Selectively binds to glutamate-gated chloride ion channels in muscles and nerve cells of the invertebrate. Increased permeability of cell membrane to chloride ions leads to hyperpolarization of the nerve or muscle cell, paralysis, and death of the parasite.

Active against various life-cycle stages of many nematodes, including microfilariae of O volvulus but has no effect on adult worm.

Metabolized in liver. Plasma half-life is 16 hours, 99% excreted in feces and 1% in urine. Available as 6 mg tab for oral administration. Given as single dose of 12 mg (two 6 mg tab) or 150 mcg/kg.

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Antibiotic, Tetracycline Derivative

Doxycycline

Tetracycline antibiotic who binds to the 30S ribosomal subunit in the mRNA translation complex therefore inhibiting tRNA to join the mRNA ribosome complex. In O. volvulus, it interferes with microfilarial embryogenesis. It has modes activity against adult works, decreasing them by 50%-60%. It also kills the endosymbiont Wolbachia.

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