Why horse paste is not a human tablet
Ivermectin sold for horses and cattle is a different product. The dose that works for animals is not the human row, and veterinary pastes are not tested as human drugs.1
A licensed U.S. pharmacy fills 3 mg tablets against a prescription. A feed-store tube is not a generic Stromectol and is not a bargain version of the same swallow.1 4
How many 3 mg tablets per kilogram
| Body weight | Strongyloidiasis (3 mg tablets) | Body weight | Onchocerciasis (3 mg tablets) |
|---|---|---|---|
| 15-24 kg | 1 | 15-25 kg | 1 |
| 25-35 kg | 2 | 26-44 kg | 2 |
| 36-50 kg | 3 | 45-64 kg | 3 |
| 51-65 kg | 4 | 65-84 kg | 4 |
| 66-79 kg | 5 | 85 kg or more | 150 mcg/kg |
| 80 kg or more | 200 mcg/kg |
Single oral dose, STROMECTOL label Tables 1 and 2 (Merck, DailyMed, April 2025).
For intestinal strongyloidiasis the labeled single dose is about 200 mcg per kg, on an empty stomach with water. For onchocerciasis it is about 150 mcg/kg.1
A 70 kg adult on the strongyloides row needs 14 mg, which rounds to five 3 mg tablets (15 mg). That rounding is the chart. Heavier adults at 80 kg and above stay on mcg/kg instead of a fixed tablet row.1
Empty stomach, stool checks, repeat doses
The tablets are swallowed with water on an empty stomach. A fatty meal raises how much is absorbed. The labeled worm studies still used the empty-stomach rule.1
Repeated stool examinations are needed to document clearance of Strongyloides. One course may not be enough.1
Ivermectin and COVID-19
FDA has not authorized or approved ivermectin to treat or prevent COVID-19 in people.2
Trials that tested the tablet against COVID-19 did not give it that indication. This page stays on the labeled parasites and the kilogram chart.2
Side effects and the warfarin note
The reactions people report most often are diarrhea, abdominal pain, nausea and vomiting, plus dizziness, headache, tiredness and fever.1
Ivermectin can raise INR when taken with warfarin. Loa loa geography is a stop question before a dose, because treatment in people who also carry that worm has been followed by serious neurologic events.1
Coupon prices for twenty 3 mg tablets
| Pharmacy | Ivermectin 3 mg x 20, GoodRx |
|---|---|
| Walgreens | $5.00 |
| CVS Pharmacy | $30.21 |
GoodRx coupon prices last updated 08/03/26. Average retail without a coupon: $69.68.
The tablet needs a U.S. prescription. On 08/03/26 GoodRx listed twenty 3 mg tablets at $5.00 at Walgreens and $30.21 at CVS, with average retail $69.68 without a coupon.3
Sources
- DailyMed: STROMECTOL (ivermectin) tablet, Merck
- FDA: Why you should not use ivermectin to treat or prevent COVID-19
- GoodRx: Ivermectin prices, updated 08/03/26
- FDA BeSafeRx: Considering an online pharmacy?
Consultation
Your questions, answered
Answered by Dr. Ivy Chukwu, MD · Infectious disease & clinical pharmacology
Answers follow the U.S. Stromectol (ivermectin) prescribing information.
My doctor prescribed ivermectin for strongyloides. How many 3 mg tablets do I take?
For strongyloidiasis the dose is about 200 micrograms per kilogram as a single oral dose. A 70 kg adult lands on five 3 mg tablets after rounding. The chart, not a leftover strip, sets the count.
Should I take the tablets with breakfast?
The label says empty stomach with water. A fatty meal raises absorption. Do not flip that yourself because a forum said more is better.
My neighbor uses horse paste. Same drug?
No. Animal products are made for large animals and may be highly concentrated. They are not the 3 mg human tablet and are not tested as a human dose.
I grew up in Cameroon. Does that matter?
It can. Loa loa is endemic in parts of Central Africa. Treating onchocerciasis with ivermectin in people who also carry Loa loa has been followed by encephalopathy and other neurologic events. Tell the prescriber that history before the first tablet.
General education from a clinician, not personal medical advice. Bring your own history to your own prescriber.