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Compare Ivermectin vs. Metronidazole

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Ivermectin (Stromectol) and metronidazole (Flagyl) are both used to treat parasitic infections, but they belong to different medication classes. Ivermectin is an antiparasitic agent, while metronidazole is a nitroimidazole antibiotic. Ivermectin is FDA-approved for treating strongyloidiasis and river blindness, and it is sometimes used off-label for scabies. Metronidazole is used for a variety of bacterial and parasitic infections, including trichomoniasis and amebiasis. Ivermectin is typically taken as a single dose based on body weight, whereas metronidazole is usually taken multiple times a day for several days. Both medications are available as lower-cost generics. Common side effects of ivermectin include stomach pain and nausea, while metronidazole can cause headaches and a metallic taste. Both medications can interact with warfarin, and metronidazole should not be taken with alcohol or disulfiram due to serious interactions.

  • Ivermectin (Stromectol)
    Metronidazole (Flagyl)
  • Ivermectin (Stromectol)
    Metronidazole (Flagyl)

  • Summary of Ivermectin vs. Metronidazole

    Summary for Antiparasitic agent
    Prescription only

    Ivermectin (Stromectol) is an antiparasitic medication. It's used to treat infections caused by certain parasites in the tropical areas. Ivermectin (Stromectol) is also sometimes prescribed off-label for treating scabies. Ivermectin (Stromectol) can be taken by adults and children weighing 15 kg and more. Depending on what infection you have, you might only need a single dose of ivermectin (Stromectol), or repeated treatments. Some common side effects of ivermectin (Stromectol) include stomach pain and nausea. Watch out for dizziness, itching, rash, and swelling, which can be symptoms of a severe allergic reaction.

    Summary for Nitroimidazole antibiotic
    Prescription only

    Metronidazole (Flagyl) is an oral antibiotic for adults and children. It's used to treat certain bacterial and parasitic infections, including bacterial vaginosis (a type of vaginal bacteria infection) and trichomoniasis (a sexually transmitted infection, or STI). Metronidazole (Flagyl) is taken by mouth, typically 3 times a day. Some common side effects of this medication include diarrhea, nausea, and vomiting. Avoid drinking alcohol while taking and for 3 days after stopping metronidazole (Flagyl) because this combination can cause a serious reaction. Metronidazole (Flagyl) is available as a lower-cost generic.

  • Indications of Ivermectin vs. Metronidazole

    Indications for
    •Treatment of a parasitic gut infection caused by Strongyloides stercoralis (Strongyloidiasis)
    •Treatment of parasitic skin and eye infections caused by Onchocerca volvulus (Onchocerciasis, or river blindness)
    Indications for

    Treatment of certain bacterial and parasitic infections, including:

    •Trichomoniasis
    •Amebiasis (parasitic gut infection)
    •Serious bacterial infections, such as:
    •Abdominal infection (including peritonitis)
    •Skin infections
    •Gynecological infections (including endometritis)
    •Bloodstream infection (septicemia)
    •Bone and joint infections
    •Central nervous system infections (meningitis)
    •Lung infections (lower respiratory tract infections)
    •Heart infection (endocarditis)

  • Pros and Cons of Ivermectin vs. Metronidazole

    Pros and Const for Antiparasitic agent
    Pros
    •Available as a lower-cost generic medication
    •Only requires one dose of treatment for strongyloidiasis
    •Treatment of choice for river blindness
    Cons
    •Requires repeated stool tests to make sure your stomach infection is completely cleared
    •Must be taken on an empty stomach
    •Not a safe choice during pregnancy
    Pros and Const for Nitroimidazole antibiotic
    Pros
    •Taken by mouth
    •Available as a lower-cost generic medication
    •Can be used to treat different types of bacterial infection
    •Immediate-release formulations can be taken with or without food
    Cons
    •Immediate-release formulations needs to be taken multiple times a day for most infections
    •Serious interaction with alcohol
    •Can cause metallic taste in mouth
    •Not recommended while breastfeeding

  • Common Side Effects of Ivermectin vs. Metronidazole

    Common Side Effects for

    Reported by people treated for strongyloidiasis

    •Dizziness (3%)
    •Itching (3%)
    •Nausea (2%)
    •Diarrhea (2%)

    Reported by people treated for river blindness

    •Itching (28%)
    •Fever (23%)
    •Skin swelling or rash (23%)
    •Swollen lymph nodes (5-13%)
    •Joint pain (9%)
    Common Side Effects for

    Please note: These are common side effects reported by people who took extended-release metronidazole (Flagyl)

    •Headache (18%)
    •Inflammation of the vagina (15%)
    •Nausea (10%)
    •Metallic taste (9%)
    •Flu-like symptoms (6%)

  • Warnings of Ivermectin vs. Metronidazole

    Common Side Effects for
    •Severe allergic reaction (Mazzotti reaction)
    •Brain and nervous system problems
    Common Side Effects for
    •Possible risk of cancer
    •Serious allergic reactions
    •Brain and nerve problems
    •Liver and kidney problems
    •Risk of fungal infection
    •Risk of drug resistance
    •Lower white blood cell counts
    •Interaction with other medications

  • Prices with our coupons for Ivermectin vs. Metronidazole

    Learn more about Ivermectin
    Learn more about Metronidazole

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