Assess weight, potential Loa loa exposure, and hepatic function before ivermectin.
Absolute: hypersensitivity. Relative: weight below 15 kg, pregnancy, breastfeeding, hepatic disease, and suspected Loa loa infection.
Immediate reactions are rare but mandate class avoidance; consider alternate antiparasitic therapy.
Safety data are limited in low-weight patients; specialist oversight is advised when benefits outweigh risks.
Hepatic metabolism and reported hepatotoxicity warrant dose caution and liver test monitoring in chronic liver disease.
High microfilarial loads predispose to encephalopathy after ivermectin; obtain a travel history and parasitologic testing before empiric dosing.
Human reproductive data are limited; reserve for compelling indications after risk–benefit review.