Ivermectin Dosing Strategy to Achieve Equivalent Exposure Coverage in Children and Adults. Issue 3 (25th May 2019) - Brussee, Janneke M.
Abstract : Ivermectin is a commonly used broad‐spectrum antiparasitic drug, yet doses that produce consistent exposure coverage across age have not been characterized, and no data are available in children weighing < 15 kg. First, a population pharmacokinetic model is developed based on data from 200 children and 11 adults, treated with 100–600 μg/kg ivermectin. Second, model‐based simulations are performed to identify a dosing strategy that achieves equivalent exposure coverage in children and adults. Median (90% confidence interval) clearance of 0.346 (0.12–0.73) L/hour/kg in pre–school‐aged (2–5 years) children is similar to 0.352 (0.17–0.69) L/hour/kg in school‐aged (6–12 years) children but higher than in adults (0.199 (0.10–0.31) L/hour/kg), resulting in significantly lower exposure in children following a 200 μg/kg dose. Simulations indicate that a dose increase to 300 and 250 μg/kg in children aged 2–5 and 6–12 years, respectively, will achieve equivalent ivermectin exposure coverage in children and adults.