Verify Ivermectin

Drug JSON

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{
  "slug": "ivermectin",
  "nameEn": "Ivermectin",
  "nameTh": "ไอเวอร์เมกติน",
  "class": "Antiparasitic — macrocyclic lactone (avermectin)",
  "mechanism": "ยาฆ่าพยาธิกลุ่ม macrocyclic lactone จับ glutamate-gated chloride channel ของพยาธิและแมลง ทำให้เกิด hyperpolarization อัมพาตและตาย; ในสัตว์เลี้ยงลูกด้วยนมปกติ P-glycoprotein กันไม่ให้ยาเข้าสมอง",
  "brandNamesTh": [
    "Ivomec",
    "Heartgard",
    "Iverhart"
  ],
  "indications": [
    {
      "text": "ป้องกันพยาธิหนอนหัวใจ (heartworm) ขนาดต่ำรายเดือน; รักษา demodicosis และ sarcoptic mange ด้วยขนาดสูง; ฆ่าพยาธิตัวกลมบางชนิด",
      "cites": [
        "merck-anthelmintics"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "⚠️ สุนัขที่มี MDR1 (ABCB1-1Δ) mutation — พันธุ์ Collie, Australian Shepherd, และ herding breeds — ไวต่อ ivermectin มาก: สุนัขปกติทนได้ถึง ~2,500 mcg/kg แต่ตัวที่มี mutation 2 ก็อปปี้ทนได้เพียง ~100 mcg/kg; ตรวจ MDR1 ก่อนใช้ขนาดสูง",
      "cites": [
        "wsu-mdr1"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "ความเป็นพิษต่อระบบประสาท (เดินเซ น้ำลายไหล ม่านตาขยาย ซึม ชัก โคม่า) เมื่อได้ขนาดสูงหรือในสัตว์ MDR1; ขนาดป้องกันพยาธิหนอนหัวใจปลอดภัยแม้ในสัตว์ MDR1",
      "cites": [
        "wsu-mdr1",
        "merck-anthelmintics"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Heartworm prevention",
      "route": "PO",
      "dose": "6 mcg/kg PO ทุกเดือน (ขนาดนี้ปลอดภัยแม้ในสุนัข MDR1)",
      "cites": [
        "merck-anthelmintics"
      ]
    },
    {
      "species": "canine",
      "indication": "Demodicosis / sarcoptic mange",
      "route": "PO",
      "dose": "300–600 mcg/kg PO ต่อวัน — ⚠️ ตรวจ MDR1 ก่อน; ค่อย ๆ ปรับขึ้น",
      "notes": "ขนาดสูง ห้ามในสัตว์ MDR1 ที่ยังไม่ได้ทดสอบ; ปัจจุบันนิยม isoxazoline แทนในสัตว์ MDR1",
      "cites": [
        "wsu-mdr1",
        "merck-anthelmintics"
      ]
    }
  ],
  "citations": [
    {
      "id": "merck-anthelmintics",
      "type": "textbook",
      "title": "Anthelmintics — MSD/Merck Veterinary Manual",
      "year": 2025,
      "url": "https://www.merckvetmanual.com/pharmacology/anthelmintics/anthelmintics-introduction",
      "note": "Merck antiparasitic pharmacology — macrocyclic lactone / praziquantel / pyrantel dosing. Copyrighted, cited not mirrored.",
      "cid": null
    },
    {
      "id": "wsu-mdr1",
      "type": "guideline",
      "title": "MDR1 (ABCB1-1Δ) drug sensitivities — WSU Veterinary Clinical Pharmacology Lab (PrIME)",
      "year": 2024,
      "url": "https://prime.vetmed.wsu.edu/resources/drug-sensitivities",
      "note": "Washington State University reference lab — definitive MDR1/ivermectin sensitivity thresholds (collies + herding breeds).",
      "cid": null
    },
    {
      "id": "dailymed-ivermectin",
      "type": "regulatory-database",
      "title": "Ivermectin — NLM DailyMed (FDA Structured Product Labeling)",
      "year": 2025,
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=ivermectin",
      "note": "Cross-checked source: FDA-approved labeling. Search by name returns relevant product labelings.",
      "cid": "0e8adb934b3b01c0555b452b569fe469988826413eaae8c5835d42662dc3633f"
    },
    {
      "id": "atc-P02CF01",
      "type": "guideline",
      "title": "ATC P02CF01 — Ivermectin",
      "year": 2025,
      "url": "https://www.whocc.no/atc_ddd_index/?code=P02CF01&showdescription=no",
      "note": "Cross-checked source: WHO Collaborating Centre ATC/DDD index. Authoritative drug classification.",
      "cid": "3c664bf127123852b1b6773adc2d70842b17de1a00b21c14ca8e8fc37fdd2b8e"
    },
    {
      "id": "pubchem-ivermectin",
      "type": "monograph",
      "title": "Ivermectin — PubChem search",
      "year": 2025,
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Ivermectin",
      "note": "Cross-checked source: chemical structure, identifiers, pharmacology summary. Faculty review fills exact CID.",
      "cid": "31d7f0a29aaa43a5afcec5a7bb6c9bc9d37c0690e18f075b3e61bce2bfa54306"
    },
    {
      "id": "who-eml-22",
      "type": "guideline",
      "title": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "year": 2021,
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "note": "Cross-checked source: drug appears on WHO EML — WHO recognizes its place in basic healthcare.",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb"
    }
  ],
  "mirroredFrom": [
    {
      "id": "dailymed",
      "name": "NLM DailyMed",
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=ivermectin",
      "asOfDate": "2026-05-27",
      "license": "U.S. Government work — public domain. Attribution recommended."
    },
    {
      "id": "atc",
      "name": "WHO ATC Classification",
      "url": "https://www.whocc.no/atc_ddd_index/?code=P02CF01&showdescription=no",
      "asOfDate": "2026-05-27",
      "license": "WHO publication, free for use with attribution"
    },
    {
      "id": "pubchem",
      "name": "PubChem (NIH/NLM)",
      "url": "https://pubchem.ncbi.nlm.nih.gov/#query=Ivermectin",
      "asOfDate": "2026-05-27",
      "license": "NIH/NLM public domain"
    },
    {
      "id": "who-eml",
      "name": "WHO Model List of Essential Medicines (22nd List, 2021)",
      "url": "https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02",
      "asOfDate": "2026-05-27",
      "license": "CC BY-NC-SA 3.0 IGO"
    }
  ],
  "mirrorCIDs": [
    {
      "sourceId": "dailymed",
      "cid": "0e8adb934b3b01c0555b452b569fe469988826413eaae8c5835d42662dc3633f",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "atc",
      "cid": "3c664bf127123852b1b6773adc2d70842b17de1a00b21c14ca8e8fc37fdd2b8e",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "pubchem",
      "cid": "31d7f0a29aaa43a5afcec5a7bb6c9bc9d37c0690e18f075b3e61bce2bfa54306",
      "capturedAt": "2026-05-27",
      "status": "stub"
    },
    {
      "sourceId": "who-eml",
      "cid": "71030c795c4e0c0cff56566bfc9ae4ed448eab9188ae68ce773a50d9f7fc53eb",
      "capturedAt": "2026-05-27",
      "status": "stub"
    }
  ],
  "codes": {
    "atc": {
      "code": "P02CF01",
      "name": "Ivermectin",
      "level": 5
    },
    "rxnorm": {
      "cui": "6058",
      "name": "Ivermectin"
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-05-27",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-05-27",
  "version": 1,
  "changelog": [
    {
      "version": 0,
      "date": "2026-05-27",
      "summary": "Seed entry — cross-checked from 4 authoritative sources (NLM DailyMed, WHO ATC Classification, PubChem (NIH/NLM), WHO Model List of Essential Medicines (22nd List, 2021)). ATC P02CF01 + RxNorm 6058. Thai translation + faculty review pending."
    },
    {
      "version": 1,
      "date": "2026-05-27",
      "summary": "Clinical content compiled from cited sources — heartworm prevention 6 mcg/kg, demodicosis 300–600 mcg/kg, with prominent MDR1/ABCB1 collie-sensitivity thresholds (2500 vs 100 mcg/kg) verified against Merck anthelmintics + WSU MDR1 lab. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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