Details of the Drug

General Information of Drug (ID: DMDBX5F)

Drug Name
Ivermectin
Synonyms I 8898; Ivexterm (TN); MK-933; Mectizan (TN); Stromectol (TN)
Indication
Disease Entry ICD 11 Status REF
Intestinal strongyloidiasis due to nematode parasite 1F6B Approved [1]
Onchocerciasis 1F6A Approved [2]
Strongyloidiasis N.A. Approved [3]
Coronavirus Disease 2019 (COVID-19) 1D6Y Phase 2/3 [4]
Therapeutic Class
Antiprotozoal Agents
Affected Organisms
Parasitic nematodes and other roundwormsHead lice
ATC Code
D11AX22: Ivermectin
D11AX: Other dermatologicals
D11A: OTHER DERMATOLOGICAL PREPARATIONS
D11: OTHER DERMATOLOGICAL PREPARATIONS
D: DERMATOLOGICALS
P02CF01: Ivermectin
P02CF: Avermectines
P02C: ANTINEMATODAL AGENTS
P02: ANTHELMINTICS
P: ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS
Drug Type
Small molecular drug
Structure
3D MOL is unavailable 2D MOL
#Ro5 Violations (Lipinski): 2 Molecular Weight (mw) 875.1
Logarithm of the Partition Coefficient (xlogp) 4.1
Rotatable Bond Count (rotbonds) 8
Hydrogen Bond Donor Count (hbonddonor) 3
Hydrogen Bond Acceptor Count (hbondacc) 14
ADMET Property
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 1: high solubility and high permeability [5]
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 0.17141 micromolar/kg/day [6]
Water Solubility
The ability of drug to dissolve in water is measured as 4 mg/mL [5]
Adverse Drug Reaction (ADR)
ADR Term Variation Related DOT DOT ID REF
Cell-mediated cytotoxicity Not Available ABCC3 OTC3IJV4 [7]
Cell-mediated cytotoxicity Not Available ABCC2 OTJSIGV5 [7]
Chemical Identifiers
Formula
C48H74O14
IUPAC Name
(1R,4S,5'S,6R,6'R,8R,10E,12S,13S,14E,16E,20R,21R,24S)-6'-[(2S)-butan-2-yl]-21,24-dihydroxy-12-[(2R,4S,5S,6S)-5-[(2S,4S,5S,6S)-5-hydroxy-4-methoxy-6-methyloxan-2-yl]oxy-4-methoxy-6-methyloxan-2-yl]oxy-5',11,13,22-tetramethylspiro[3,7,19-trioxatetracyclo[15.6.1.14,8.020,24]pentacosa-10,14,16,22-tetraene-6,2'-oxane]-2-one
Canonical SMILES
CC[C@H](C)[C@@H]1[C@H](CC[C@@]2(O1)C[C@@H]3C[C@H](O2)C/C=C(/[C@H]([C@H](/C=C/C=C/4\\CO[C@H]5[C@@]4([C@@H](C=C([C@H]5O)C)C(=O)O3)O)C)O[C@H]6C[C@@H]([C@H]([C@@H](O6)C)O[C@H]7C[C@@H]([C@H]([C@@H](O7)C)O)OC)OC)\\C)C
InChI
InChI=1S/C48H74O14/c1-11-25(2)43-28(5)17-18-47(62-43)23-34-20-33(61-47)16-15-27(4)42(26(3)13-12-14-32-24-55-45-40(49)29(6)19-35(46(51)58-34)48(32,45)52)59-39-22-37(54-10)44(31(8)57-39)60-38-21-36(53-9)41(50)30(7)56-38/h12-15,19,25-26,28,30-31,33-45,49-50,52H,11,16-18,20-24H2,1-10H3/b13-12+,27-15+,32-14+/t25-,26-,28-,30-,31-,33+,34-,35-,36-,37-,38-,39-,40+,41-,42-,43+,44-,45+,47+,48+/m0/s1
InChIKey
AZSNMRSAGSSBNP-XPNPUAGNSA-N
Cross-matching ID
PubChem CID
6321424
ChEBI ID
CHEBI:63941
CAS Number
71827-03-7
UNII
8883YP2R6D
DrugBank ID
DB00602
TTD ID
D09YHJ
VARIDT ID
DR00147
INTEDE ID
DR0899
ACDINA ID
D00340
Combinatorial Drugs (CBD) Click to Jump to the Detailed CBD Information of This Drug
Repurposed Drugs (RPD) Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Onchocerca Glutamate-gated chloride channel (Onchoc GluCl) TTSNVHO Q25634_ONCVO Activator [8]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Multidrug resistance-associated protein 1 (ABCC1) DTSYQGK MRP1_HUMAN Substrate [9]
P-glycoprotein 1 (ABCB1) DTUGYRD MDR1_HUMAN Substrate [10]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 3A4 (CYP3A4)
Main DME 		DE4LYSA CP3A4_HUMAN Substrate [11]

Drug Off-Target (DOT)
DOT Name DOT ID UniProt ID Interaction REF
(3R)-3-hydroxyacyl-CoA dehydrogenase (HSD17B8) OTX1DWEF DHB8_HUMAN Gene/Protein Processing [12]
(E2-independent) E3 ubiquitin-conjugating enzyme FATS (C10ORF90) OT6DNZC4 CJ090_HUMAN Gene/Protein Processing [12]
(E3-independent) E2 ubiquitin-conjugating enzyme OTHGS2VA UBE2O_HUMAN Gene/Protein Processing [12]
1,4-alpha-glucan-branching enzyme (GBE1) OTK2N05B GLGB_HUMAN Gene/Protein Processing [12]
1-acyl-sn-glycerol-3-phosphate acyltransferase epsilon (AGPAT5) OTNY3VMD PLCE_HUMAN Gene/Protein Processing [12]
1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase beta-3 (PLCB3) OT0OMDEM PLCB3_HUMAN Gene/Protein Processing [12]
1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase delta-1 (PLCD1) OT6WFVXZ PLCD1_HUMAN Gene/Protein Processing [12]
1-phosphatidylinositol 4,5-bisphosphate phosphodiesterase gamma-1 (PLCG1) OTSBQR6D PLCG1_HUMAN Gene/Protein Processing [12]
10 kDa heat shock protein, mitochondrial (HSPE1) OT7JSZLB CH10_HUMAN Gene/Protein Processing [12]
116 kDa U5 small nuclear ribonucleoprotein component (EFTUD2) OT3X7QG2 U5S1_HUMAN Gene/Protein Processing [12]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Ivermectin (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Arn-509 DMT81LZ Moderate Accelerated clearance of Ivermectin due to the transporter induction by Arn-509. Acute myeloid leukaemia [2A60] [13]
Dronedarone DMA8FS5 Moderate Decreased metabolism of Ivermectin caused by Dronedarone mediated inhibition of CYP450 enzyme. Angina pectoris [BA40] [14]
Posaconazole DMUL5EW Moderate Decreased metabolism of Ivermectin caused by Posaconazole mediated inhibition of CYP450 enzyme. Aspergillosis [1F20] [13]
Clarithromycin DM4M1SG Moderate Decreased metabolism of Ivermectin caused by Clarithromycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [13]
Troleandomycin DMUZNIG Moderate Decreased metabolism of Ivermectin caused by Troleandomycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [13]
Telithromycin DMZ4P3A Moderate Decreased metabolism of Ivermectin caused by Telithromycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [15]
Lapatinib DM3BH1Y Moderate Decreased metabolism of Ivermectin caused by Lapatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [16]
Tucatinib DMBESUA Moderate Decreased metabolism of Ivermectin caused by Tucatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [13]
Mifepristone DMGZQEF Moderate Decreased metabolism of Ivermectin caused by Mifepristone mediated inhibition of CYP450 enzyme. Cushing syndrome [5A70] [17]
Ivacaftor DMZC1HS Moderate Decreased metabolism of Ivermectin caused by Ivacaftor mediated inhibition of CYP450 enzyme. Cystic fibrosis [CA25] [18]
MK-8228 DMOB58Q Moderate Decreased metabolism of Ivermectin caused by MK-8228 mediated inhibition of CYP450 enzyme. Cytomegaloviral disease [1D82] [19]
Aprepitant DM053KT Moderate Decreased metabolism of Ivermectin caused by Aprepitant mediated inhibition of CYP450 enzyme. Depression [6A70-6A7Z] [20]
Oxcarbazepine DM5PU6O Moderate Increased metabolism of Ivermectin caused by Oxcarbazepine mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [21]
Stiripentol DMMSDOY Moderate Decreased metabolism of Ivermectin caused by Stiripentol mediated inhibition of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [22]
Rufinamide DMWE60C Moderate Increased metabolism of Ivermectin caused by Rufinamide mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [13]
Itraconazole DMCR1MV Moderate Decreased metabolism of Ivermectin caused by Itraconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [13]
Ketoconazole DMPZI3Q Moderate Decreased metabolism of Ivermectin caused by Ketoconazole mediated inhibition of CYP450 enzyme. Fungal infection [1F29-1F2F] [13]
Boceprevir DMBSHMF Moderate Decreased metabolism of Ivermectin caused by Boceprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [23]
Telaprevir DMMRV29 Moderate Decreased metabolism of Ivermectin caused by Telaprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [24]
Rifapentine DMCHV4I Moderate Increased metabolism of Ivermectin caused by Rifapentine mediated induction of CYP450 enzyme. HIV-infected patients with tuberculosis [1B10-1B14] [25]
Delavirdine DM3NF5G Moderate Decreased metabolism of Ivermectin caused by Delavirdine mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Fosamprenavir DM4W9B3 Moderate Decreased metabolism of Ivermectin caused by Fosamprenavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Cobicistat DM6L4H2 Moderate Decreased metabolism of Ivermectin caused by Cobicistat mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Efavirenz DMC0GSJ Moderate Increased metabolism of Ivermectin caused by Efavirenz mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [26]
Saquinavir DMG814N Moderate Decreased metabolism of Ivermectin caused by Saquinavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Etravirine DMGV8QU Moderate Increased metabolism of Ivermectin caused by Etravirine mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [27]
Amprenavir DMLMXE0 Moderate Decreased metabolism of Ivermectin caused by Amprenavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Darunavir DMN3GCH Moderate Decreased metabolism of Ivermectin caused by Darunavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [28]
Atazanavir DMSYRBX Moderate Decreased metabolism of Ivermectin caused by Atazanavir mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [13]
Conivaptan DM1V329 Moderate Decreased metabolism of Ivermectin caused by Conivaptan mediated inhibition of CYP450 enzyme. Hypo-osmolality/hyponatraemia [5C72] [29]
Brigatinib DM7W94S Moderate Increased metabolism of Ivermectin caused by Brigatinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [30]
PF-06463922 DMKM7EW Moderate Increased metabolism of Ivermectin caused by PF-06463922 mediated induction of CYP450 enzyme. Lung cancer [2C25] [31]
Selpercatinib DMZR15V Moderate Decreased metabolism of Ivermectin caused by Selpercatinib mediated inhibition of CYP450 enzyme. Lung cancer [2C25] [13]
Idelalisib DM602WT Moderate Decreased metabolism of Ivermectin caused by Idelalisib mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [32]
IPI-145 DMWA24P Moderate Decreased metabolism of Ivermectin caused by IPI-145 mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [33]
Exjade DMHPRWG Moderate Decreased metabolism of Ivermectin caused by Exjade mediated inhibition of CYP450 enzyme. Mineral absorption/transport disorder [5C64] [34]
Nilotinib DM7HXWT Moderate Decreased clearance of Ivermectin due to the transporter inhibition by Nilotinib. Myeloproliferative neoplasm [2A20] [35]
Dasatinib DMJV2EK Moderate Decreased metabolism of Ivermectin caused by Dasatinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [36]
Modafinil DMYILBE Minor Increased metabolism of Ivermectin caused by Modafinil mediated induction of CYP450 enzyme. Narcolepsy [7A20] [37]
Rucaparib DM9PVX8 Moderate Decreased metabolism of Ivermectin caused by Rucaparib mediated inhibition of CYP450 enzyme. Ovarian cancer [2C73] [38]
Abametapir DM2RX0I Moderate Decreased metabolism of Ivermectin caused by Abametapir mediated inhibition of CYP450 enzyme. Pediculosis [1G00] [39]
Lefamulin DME6G97 Moderate Decreased metabolism of Ivermectin caused by Lefamulin mediated inhibition of CYP450 enzyme. Pneumonia [CA40] [40]
Lonafarnib DMGM2Z6 Moderate Decreased metabolism of Ivermectin caused by Lonafarnib mediated inhibition of CYP450 enzyme. Premature ageing appearance [LD2B] [41]
Enzalutamide DMGL19D Moderate Increased metabolism of Ivermectin caused by Enzalutamide mediated induction of CYP450 enzyme. Prostate cancer [2C82] [42]
Temsirolimus DMS104F Moderate Increased plasma concentrations of Ivermectin and Temsirolimus due to competitive inhibition of the same metabolic pathway. Renal cell carcinoma [2C90] [43]
Telotristat ethyl DMDIYFZ Moderate Increased metabolism of Ivermectin caused by Telotristat ethyl mediated induction of CYP450 enzyme. Small intestine developmental anomaly [DA90] [13]
Larotrectinib DM26CQR Moderate Decreased metabolism of Ivermectin caused by Larotrectinib mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [17]
Armodafinil DMGB035 Minor Increased metabolism of Ivermectin caused by Armodafinil mediated induction of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [37]
LEE011 DMMX75K Moderate Decreased metabolism of Ivermectin caused by LEE011 mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [44]
Pitolisant DM8RFNJ Moderate Increased metabolism of Ivermectin caused by Pitolisant mediated induction of CYP450 enzyme. Somnolence [MG42] [13]
Fostamatinib DM6AUHV Moderate Decreased clearance of Ivermectin due to the transporter inhibition by Fostamatinib. Thrombocytopenia [3B64] [45]
Sirolimus DMGW1ID Moderate Increased plasma concentrations of Ivermectin and Sirolimus due to competitive inhibition of the same metabolic pathway. Transplant rejection [NE84] [43]
Tacrolimus DMZ7XNQ Moderate Increased plasma concentrations of Ivermectin and Tacrolimus due to competitive inhibition of the same metabolic pathway. Transplant rejection [NE84] [43]
⏷ Show the Full List of 53 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
Kyselina citronova E00014 311 Acidulant; Antioxidant; Buffering agent; Complexing agent; Flavoring agent
Butylhydroxyanisole E00308 24667 Antimicrobial preservative; Antioxidant
Carmellose sodium E00625 Not Available Disintegrant
Magnesium stearate E00208 11177 lubricant
Silicon dioxide E00670 Not Available Anticaking agent; Opacifying agent; Viscosity-controlling agent
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Ivermectin 3 mg tablet 3 mg Oral Tablet Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 2373).
2 FDA Approved Drug Products from FDA Official Website. 2019. Application Number: (NDA) 202736
3 Ivermectin FDA Label
4 ClinicalTrials.gov (NCT04351347) The Efficacy of Ivermectin and Nitazoxanide in COVID-19 Treatment. U.S. National Institutes of Health.
5 BDDCS applied to over 900 drugs
6 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
7 ADReCS-Target: target profiles for aiding drug safety research and application. Nucleic Acids Res. 2018 Jan 4;46(D1):D911-D917. doi: 10.1093/nar/gkx899.
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10 MDR1-deficient genotype in Collie dogs hypersensitive to the P-glycoprotein substrate ivermectin. Eur J Pharmacol. 2003 Jan 24;460(2-3):85-91.
11 Identification of cytochrome P4503A4 as the major enzyme responsible for the metabolism of ivermectin by human liver microsomes. Xenobiotica. 1998 Mar;28(3):313-21.
12 Quantitative proteomics reveals a broad-spectrum antiviral property of ivermectin, benefiting for COVID-19 treatment. J Cell Physiol. 2021 Apr;236(4):2959-2975. doi: 10.1002/jcp.30055. Epub 2020 Sep 22.
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26 Product Information. Sustiva (efavirenz). DuPont Pharmaceuticals, Wilmington, DE.
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