Stromectol alternatives: what to use when ivermectin isn’t the right choice

Need a substitute for Stromectol (ivermectin)? Good question. Ivermectin is handy for several parasitic infections, but it’s not always available, suitable, or safe—especially in pregnancy, certain co-infections, or supply shortages. Below I’ll walk you through practical alternatives by condition and what to check before switching treatments.

Which alternatives work for common infections?

Scabies: Topical 5% permethrin cream is the go-to alternative for most people. Apply to the whole body as directed, wash off after the recommended time, and treat close contacts. Other topical options are benzyl benzoate and sulfur ointment. Oral ivermectin is often effective, but if you can’t take it, stick to topical therapy and talk to a clinician about repeat treatment.

Intestinal worms (roundworms, hookworm, pinworm): Albendazole and mebendazole are common, effective choices for many intestinal helminths. They cover a broad range of worms and are widely used around the world. For tapeworms and schistosomiasis, praziquantel is the right drug. If a specific parasite is suspected, stool testing helps pick the right medicine.

Strongyloides stercoralis: Ivermectin usually works best here, but if it’s unavailable, albendazole or thiabendazole may be used in some cases—though they’re generally less effective. Strongyloides can become severe in people on steroids or with weakened immune systems, so don’t delay getting medical care.

Onchocerciasis (river blindness): Ivermectin controls microfilariae, but doxycycline targets the bacteria (Wolbachia) that the parasite needs and can be used as part of alternative strategies. Note: diethylcarbamazine (DEC) can make symptoms worse in onchocerciasis and is not recommended for that infection.

How to choose an alternative safely

Start by identifying the exact parasite. Symptoms overlap, so testing—stool exam, skin scraping, blood tests—matters. Check pregnancy and breastfeeding status: many antiparasitics are not safe in pregnancy. Review other meds you take to avoid interactions. If you have immune problems or are on steroids, seek urgent care for suspected strongyloides or heavy infections.

Buy medicines from reputable pharmacies only. Don’t rely on unverified online sellers. If a drug is hard to find, a clinician can suggest a safe substitute or arrange the correct tests and follow-up. Finally, follow dosing and repeat-treatment advice closely; many treatments need a second round to clear eggs or newly hatched parasites.

If you’re unsure which option fits your situation, talk to a doctor, nurse, or pharmacist. You can also check our detailed guides on scabies, intestinal worms, and choosing safe online pharmacies for more practical tips and links to reliable resources.