What is the primary treatment for ivermectin toxicity?

• A. Supportive care
• B. Immediate surgical intervention
• C. Antifungal therapy
• D. Long-term antibiotic therapy

Answer: (A)

Ivermectin toxicity is handled with supportive care because there isn’t a specific antidote. The main goal is to keep the patient’s airway, breathing, and circulation stable while the drug clears from the body. That means monitoring and supporting respiration (oxygen or mechanical ventilation if there’s CNS depression or respiratory failure), giving IV fluids and treating any low blood pressure, and correcting electrolytes as needed. If seizures occur, they’re treated with appropriate anticonvulsants, and the patient is observed closely for changes in mental status.

In the early, recent-ingestion setting, activated charcoal may be considered to limit further absorption, but there’s no targeted antidote that reverses ivermectin’s effects. Antibiotics or antifungal therapy don’t address drug toxicity, and surgical intervention isn’t indicated because the issue isn’t a physical obstruction or infectious process.

So, the best approach is to provide supportive care to sustain life and let the body eliminate the drug, escalating only if organ systems become severely compromised.