Green Pages Where There Is No Doctor 2011 377
FOR RIVER BLINDNESS
(ONCHOCERCIASIS)
The best medicine for treating river blindness
is ivermectin. This new medicine kills the baby
worms slowly and does not cause the dangerous
reaction of other treatments. If ivermectin is not
available, an experienced health worker can give
diethylcarbamazine first and then also suramin.
Ivermectin is also very useful in treating scabies
and strongyloides (a very tiny worm).
Ivermectin (Mectizan, Stromectal)
Name:__________________ price:________ for_ ______
Often comes in: 3 or 6 mg. tablets
To determine the correct dose, weigh the person
or use the averages below.
CAUTION: Do not give to children who weigh less
than 15 kg. (or children who are under 5 years old),
to pregnant or breastfeeding women, or to persons
with meningitis or other serious illness. Do not drink
alcohol for a few days after taking ivermectin.
Dosage of ivermectin for river blindness
Give 1 time by mouth 150 mcg. per kg of weight,
or using 6 mg. tablets:
heavy adults (over 64 kg.): 2 tablets (12 mg.)
average adults (45 to 63 kg.): 1 ½ tablets
(9 mg.)
light adults and youth (26 to 44 kg.): 1 tablet
(6 mg.)
children (15 to 25 kg.): ½ tablet (3 mg.)
For river blindness, another dose is sometimes
needed after 6 months to 1 year.
Dosage of ivermectin for scabies or strongyloides
Give 1 time by mouth 200 mcg. per kg of weight,
or using 6 mg. tablets:
heavy adults (over 64 kg.): 2 ½ tablets
(15 mg.)
average adults (45 to 63 kg.): 2 tablets
(12 mg.)
light adults and youth (26 to 44 kg.):
1 ½ tablets (9 mg.)
children (15 to 25 kg.): 1 tablet (6 mg.)
For scabies, repeat this dosage after 10 to 14 days.
Diethylcarbamazine (Hetrazan, Banocide)
Name:__________________ price:________ for_ ______
Often comes in: tablets of 50 or 100 mg.
Diethylcarbamazine kills the young worms,
but not the adults. The medicine should be used
only under the direction of an experienced health
care worker. Pregnant women should avoid taking
diethylcarbamazine.
To avoid severe damage to the eyes, it is
important to start with a low dose. Take the
medicine like this:
First day: ½ mg./kg., 1 time only
Second day: ½ mg./kg., 2 times
Third day: 1 mg./kg., 3 times
Continue taking 1 mg./kg. 3 times a day for
13 more days. (Example: a person who weighs
60 kg. would take 1 single dose of 30 mg. the first
day; 60 mg. in 2 doses (of 30 mg. each) the second
day, and 3 doses of 60 mg. each, per day, for
14 days.) Take the medicine after meals.
Diethylcarbamazine may cause severe allergic
reactions, which can partly be controlled with
antihistamines—or cortico-steroids, given by a
health worker.
Side effects: Diethylcarbamazine sometimes
causes headache, tiredness, weakness, loss of
appetite, stomach upset, cough, chest pains,
muscle or joint pain, fever and rash.
Suramin (Naphuride, Bayer 205, Antrypol.
Germanin)
Name:__________________ price:________ for_ ______
Often comes in: powder for injection, 1 g. in a vial
This is more effective than diethylcarbamazine
in killing adult worms and should be used after
treatment with diethylcarbamazine, when reactions
have nearly stopped. Suramin sometimes poisons
the kidneys. If swelling of the feet or other signs of
urinary poisoning occur, stop using this medicine.
Persons with kidney problems should not use it.
Suramin must be given intravenously and should
only be used with the assistance of an experienced
health worker. For adults inject 1 g. of suramin in 10
ml. of distilled water once a week for 5 to 7 weeks.
Start with a small test dose of 200 mg. Treat allergic
reactions with antihistamines.