Compounded Ivermectin Capsules: Precision Dosing, Evolving Research, and How To Obtain Safely

In today’s era of personalized medicine, compounded ivermectin capsules stand at the crossroads of precision pharmacology and patient-specific care. Ivermectin, a broad-spectrum antiparasitic that has transformed global health since the 1980s, remains one of the most studied and utilized medications worldwide.

At Restorative Compounding Pharmacy + Wellness, we prepare pharmaceutical-grade, patient-specific ivermectin capsules under valid prescriptions in our state-licensed 503A facility, following USP <795> and Michigan Board of Pharmacy regulations.

What Are Compounded Ivermectin Capsules?

Compounded ivermectin capsules are custom formulations prepared when the standard commercial tablets—typically available in 3 mg or 6 mg strengths—do not meet a patient’s dosing or formulation needs. Each capsule is made from USP-grade ivermectin active pharmaceutical ingredient (API), precisely weighed, blended with a hypoallergenic filler, and encapsulated to deliver accurate, reproducible dosing.

This customization benefits pediatric, geriatric, and veterinary patients or anyone requiring unique dosing precision and excipient control. Compounded versions also allow alternative strengths such as 1 mg, 9 mg, 12 mg, or higher, while excluding potential allergens like lactose, dyes, or corn.

How Ivermectin Works

Ivermectin is a semi-synthetic derivative of avermectin B1, discovered in the soil bacterium Streptomyces avermitilis—a discovery that earned the 2015 Nobel Prize in Physiology or Medicine.

It works by binding selectively to glutamate-gated chloride channels in the nerve and muscle cells of invertebrates, causing paralysis and death of the parasite. Mammalian cells lack these channels, and ivermectin does not readily cross the human blood-brain barrier, which accounts for its strong safety record.

Oral bioavailability improves when taken with fat; peak plasma levels occur in about four hours, and the half-life averages 18 hours. It is excreted primarily through feces with minimal renal elimination.

FDA-Approved and Established Uses

Human Medicine

• Strongyloidiasis: 200 mcg/kg single oral dose

• Onchocerciasis (River Blindness): 150 mcg/kg every 6–12 months

• Scabies and Lice: Oral or topical use, particularly when topicals fail

• Rosacea and Demodicosis: Reduces Demodex mite density and inflammation

Veterinary Applications
Used for heartworm prevention, mange, and intestinal parasites in dogs, cats, horses, and livestock (species-specific dosing required; human and veterinary formulations should never be interchanged).

Emerging Research and Investigational Areas (2025 Update)

More than 3.7 billion doses of ivermectin have been distributed globally, prompting research into broader potential effects.

Laboratory studies suggest ivermectin may inhibit the importin α/β1 transport protein used by some viruses for nuclear entry (Caly et al., Antiviral Research, 2020). Other research indicates possible modulation of NF-κB and STAT3 inflammatory pathways (Heidary & Ghahramani, Eur Rev Med Pharmacol Sci, 2020). Experimental oncology studies are also examining interactions with PAK1 and WNT/β-catenin signaling, though these remain preclinical.

These findings broaden scientific understanding but have not yet led to approved therapeutic use. Compounded ivermectin simply allows prescribers to individualize dosing when clinically appropriate.

Benefits of Compounded Ivermectin Capsules

1. Precision Dosing: Enables exact mg/kg weight-based dosing (150–200 mcg/kg typical antiparasitic range).

2. Reduced Pill Burden: Allows higher strengths to minimize the number of capsules.

3. Allergen-Free Formulas: Exclude lactose, dyes, gluten, gmo and corn.

4. Custom Veterinary Strengths: For animal prescriptions requiring specific doses.

5. Enhanced Compliance: Flavored liquids or topical preparations can be made for improved adherence.

6. Supply Stability: Reliable option during commercial shortages.

Dosing Overview (For Reference)

• Strongyloidiasis: 200 mcg/kg as a single dose; repeat if needed.

• Onchocerciasis: 150 mcg/kg every 6–12 months.

• Scabies: 200 mcg/kg, repeated after 7–14 days if necessary.

• Rosacea (off-label): As directed by prescriber.

• Veterinary: Varies by species and clinical judgment.

Take on an empty stomach with water. Avoid grapefruit juice and excessive alcohol around dosing.

Safety, Interactions, and Monitoring

Common mild reactions: Itching, nausea, dizziness, or mild rash.
Rare but serious effects: Allergic reaction, confusion, low blood pressure, or elevated liver enzymes.
Drug interactions: May potentiate warfarin, sedatives, or other CNS depressants.
Pregnancy and lactation: Category C—use only if benefits outweigh risks.
Storage: Keep below 30 °C (86 °F) in a dry, dark environment. Typical beyond-use date: 6 months.

Patients should always consult a licensed prescriber and pharmacist before starting or adjusting therapy.

How to Obtain Compounded Ivermectin Capsules Safely

1. Consult Your Licensed Provider: Discuss indication, dosing, and goals.

2. Have the Prescription Sent to a Licensed 503A Pharmacy:
    Restorative Compounding Pharmacy + Wellness
    4450 Dixie Hwy, Ste A, Waterford, MI 48329
    (248) 266-5276
    www.restorativecompounding.com

3. Pharmacy Preparation: Pharmacists verify USP-grade ivermectin from FDA-registered suppliers, compound under USP <795> standards, and document full lot traceability.

4. Dispensing and Counseling: Capsules are labeled with strength, directions, and storage instructions. Patients receive personalized counseling and follow-up guidance.

References and Regulatory Framework

• U.S. FDA Label: Stromectol (ivermectin)

• World Health Organization Model List of Essential Medicines (2023 edition)

• Heidary F, Ghahramani M. “Ivermectin: A Systematic Review from Antiparasitic to Antiviral Activity.” Eur Rev Med Pharmacol Sci, 2020

• USP <795> Nonsterile Compounding Standards (2023 revision)

• Michigan Board of Pharmacy 503A licensure requirements

Key Takeaways

• Proven mechanism targeting glutamate-gated chloride channels for selective antiparasitic action.

• Precision formulation allows customized strengths and allergen-free excipients.

• Ongoing research explores broader biological pathways, though more trials are needed.

• Regulatory confidence ensured through USP-compliant compounding in a licensed 503A pharmacy.

Frequently Asked Questions

Is compounded ivermectin different from store-bought tablets?
Yes. Compounding allows for tailored doses, allergen-free bases, and pharmacist-verified purity that commercial tablets may not offer.

Can ivermectin be compounded for pets?
Yes, under veterinary prescription only. Dosing and formulation vary by species.

Is ivermectin safe for long-term use?
When prescribed and monitored appropriately, ivermectin has a strong safety record spanning decades of human and veterinary use.

Do compounded ivermectin capsules require refrigeration?
No. Store at room temperature below 30 °C in a dry environment away from moisture and light.

Final Thoughts

For patients and clinicians seeking precision-dosed, pharmaceutical-grade ivermectin, compounded capsules from a licensed 503A pharmacy like Restorative Compounding Pharmacy + Wellness deliver accuracy, transparency, and quality.

While research continues into ivermectin’s broader biological effects, its established antiparasitic benefits and long safety record remain clear. When prescribed appropriately and compounded under USP standards, ivermectin demonstrates how customized medicine can enhance both safety and effectiveness.