Ivermectin effect in treatment of patients with fascioliasis , Ivermectin is a semisynthetic, anthelmintic agent for oral administration. Ivermectin
is derived from the avermectins( a class of highly active broad-spectrum) . Ivermectin is a mixture containing at least 90% 5-O-demethyl-22,23-dihydroavermectin and less than 10% 5-O-demethyl-25-de(1-methylpropyl)-
22,23-dihydro-25-(1-methylethyl)avermectin , generally referred to as 22,23-dihydroavermectin . Its peak plasma concentration is 46 nanograms per mL after a single 12-mg dose . Ivermectin is metabolized by the liver and is excreted in the feces over an estimated period of 12 days, with less than 1% of the dose excreted in the urine. Ivermectin binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate muscle and nerve cells of the microfilaria. This binding causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell, leading to paralysis and death of the parasite. It's an experimental , open lable and pilot study . It's studied on patients with Fasciola in the first six months of 1390 until the number reaches to 40 patients. In this period all people over 18 years old with Fasciola symptoms include: fever, sweating, weakness, fatigue, cough, pain in RUQ, epigastric pain, nausea, vomiting, skin rashes, skin lesions, muscle pain, Jaundice, weight loss associated with positive laboratory tests include: ELISA (+)and hypereosinophilia in CBCdiff and the lack of exclusion criteria included: pregnancy, lactation, hypersensitivity to the drug come to Anzali Health Care and they are reffered for treatment to Gastrointestinal and Liver Diseases Research Center(GLDRC) in Guilan province Rasht city. In GLDRC after obtaining consent from a patient ,questionnaire included: personal data, previous history of Fasciola treatment, symptoms before treatment, tests (S / E, ELISA, ALK-P, ALT, AST, CBC diff) before treatment and prior to ultrasound fill then It's given appropriate dose Ivermectin 200 microgram per kg, ie 3 mg two tablets morning and night in one day to the patient. The patients follow by phone 24 and 48 and 72 hours after treatment . They visit 15 days,1 month and 3 months after treatment.