Stromectol substitutes: what to use instead of ivermectin

Looking for a substitute for Stromectol (ivermectin)? The right choice depends on what you’re treating. Ivermectin is strong against several parasites, but other drugs can work better for specific infections like scabies, lice, or common intestinal worms. Below I list practical alternatives and what to know before you switch.

Best alternatives by condition

Scabies: The go-to alternative is topical permethrin 5% cream. You apply it from the neck down, leave it on overnight, and usually repeat after a week. For children or people who can’t use permethrin, doctors sometimes use sulfur preparations or oral alternatives — but always check with a clinician first.

Head lice: Over-the-counter permethrin 1% shampoos or pyrethrin-based products work well for many cases. If lice resist those, prescription options include malathion lotion or benzyl alcohol lotion. Follow the package directions exactly and comb wet hair with a fine-tooth comb to remove nits.

Intestinal worms (roundworms, hookworms, pinworms): Albendazole and mebendazole are common choices for many worm infections. Pyrantel pamoate is another simple, effective OTC option for pinworms and some roundworms. These drugs vary in dose and length of treatment, and effectiveness depends on the specific parasite.

Strongyloidiasis and onchocerciasis: Ivermectin is often preferred for these. If you can’t take ivermectin, albendazole is sometimes used but tends to be less effective. For onchocerciasis, doxycycline is used as an adjunct in some treatment plans because it targets Wolbachia bacteria that help the parasite survive.

How to pick a safe substitute

First, get a proper diagnosis. Symptoms can overlap, and using the wrong drug means wasted time and possible harm. Ask your healthcare provider to confirm the parasite type before switching meds.

Check safety issues: pregnancy, liver disease, and certain drugs can make some antiparasitics unsafe. Pregnant people should avoid some options and must talk to a clinician before taking any antiparasitic.

Follow dosing exactly. Under-dosing encourages resistance; over-dosing raises side-effect risks. If symptoms don’t improve after the recommended treatment, contact your provider — you may need a different drug or lab testing.

Buying tips: these meds are prescription-only in many places. Use licensed pharmacies and confirm they require a prescription when they should. Avoid online sellers that offer miracle cures or push unproven uses. If cost is a concern, ask your doctor about generic options — generic ivermectin, albendazole, and mebendazole are often much cheaper than brand-name products.

If you’re unsure which substitute fits your situation, talk to a clinician or pharmacist. That short conversation can save time and prevent unnecessary side effects.