search
Back to results

Bioavailability and Safety of Two Oral Fixed Dose Preparations Containing 18 mg Ivermectin (IVM 18 MG TABLETS, LICONSA S.A., Spain) Versus Reference Dosing (Weight Based) Containing 6 mg Ivermectin (REVECTINA®, Abbott Laboratórios do Brasil Ltda, Brazil)

Primary Purpose

Helminthiasis

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
T1, T2, T3
T1,T3,T2
T2,T1,T3
T2,T3,T1
T3,T1,T2
T3,T2,T1
Sponsored by
Insud Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Helminthiasis

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Caucasian subjects of either gender (male or female) with an age between 18 and 45 years (both inclusive).
  2. Medical history and physical examination with no relevant abnormal findings.
  3. No evidence of significant disease (organic or psychiatric) based on medical history, physical examination and complementary tests.
  4. Laboratory tests (complete hematology, clinical chemistry and urinalysis).
  5. Vital signs (systolic and diastolic blood pressure, heart rate and temperature) and electrocardiogram (ECG) record within normal range at screening.
  6. Participating female volunteers must use a reliable contraception method not containing hormones. List of accepted contraception method includes barrier methods (i.e. female/male condoms, diaphragms, spermicides), voluntary sterilization (female tubal occlusion) or non-medicated intrauterine devices (IUD) (i.e. inert or copper-releasing). Abstention is not considered a reliable contraception method.
  7. For female volunteers only: they must declare that they did not intend to become pregnant in the last month prior to screening and they do not intend to become pregnant during one month following the last study drug administration.
  8. Voluntary participation in the study, with written informed consent from the volunteer.
  9. The subject agrees to abstain from beverages or food containing methylxanthines (coffee, tea, cola, energy drinks, chocolate etc.), St John's Wort, vitamins, herbal remedies and chewing-gum for 48 hours prior to study drug administration and during each study period.
  10. The subject agrees to abstain from beverages or food containing grapefruit for 14 days prior to the first study drug administration and during the study (until last sample from the last period).

Exclusion Criteria:

  1. Background of allergy, idiosyncrasy or hypersensitivity to the study drugs or its excipients.
  2. Heavy consumer of stimulating drinks (>5 cups of coffee, tea, chocolate or cola drinks per day).
  3. Background of alcoholism or drug dependence in the last one year or daily consumption of alcohol > 40 gr/day for men or > 24 gr/day for women.
  4. Use of any medication within 15 days prior to taking the study treatment, including over-the-counter medications and medicinal plants (except for the use of paracetamol in short-term symptomatic treatments).
  5. Positive serology for hepatitis B, C or HIV.
  6. Background or clinical evidence of cardiovascular, respiratory, renal, hepatic, endocrine, gastrointestinal, hematological or neurological disease or other chronic diseases.
  7. Smokers or ex-smokers that gave up smoking less than 1 year prior to the study (day 1 of period I)
  8. Pregnancy or lactation status for female subjects.
  9. Participation in another clinical trial during the 3 months before starting the current trial.
  10. Donate blood in the 8 weeks prior to starting the study.
  11. Undergone major surgery during the previous 6 months.
  12. Clinically significant abnormal ECG with clinical significance in accordance with the CIM's clinical criterion
  13. Restrictive vegetarian diet
  14. Positive results to the breath alcohol test at screening or at Day -1
  15. Positive results to the drug abuse checks (urine test for: amphetamines, cannabinoids, opiates, benzodiazepines and cocaine) at screening or at admission on Day -1
  16. Epidemiological risk of being infected by Loa loa or other filariases, defined as those who have lived or have travelled to any of the following countries: Angola, Cameroon, Central Africa Republic, Chad, Congo, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Nigeria and Sudan.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    T1, T2, T3

    T1, T3, T2

    T2,T1,T3

    T2,T3,T1

    T3,T1,T2

    T3,T2,T1

    Arm Description

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)

    Outcomes

    Primary Outcome Measures

    Primary endpoint evaluated will be the PK parameters that define bioavailability in extent Ln [AUC0t]
    For group 3
    Primary endpoint evaluated will be the PK parameters that define bioavailability in extent in rate: Ln [Cmax] for each treatment in healthy volunteers with high weight (Group 3), calculated by means of a non-compartmental analysis.
    For group 3

    Secondary Outcome Measures

    Relative bioavailability for each treatment and for groups 1 and 2 will be evaluated with the PK parameters that define bioavailability in extent Ln [AUC0t]
    for group 1 and 2
    Relative bioavailability for each treatment and for groups 1 and 2 will be evaluated with the PK parameters that define bioavailability in extent in rate: Ln [Cmax]
    for group 1 and 2
    AUC0t (for non-compartmental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    AUC0∞ (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    %AUC extra (residual area) (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    tmax (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    tlag (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Cl/F (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    V/F (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    t1/2 (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Ke (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    MRT (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Cmax (for non-compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    tlag (for compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    ka (for compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Cl/F(for compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    V/F (for compartimental analysis)
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    vital signs
    To asses safety and tolerability of the treatments
    laboratory analysis
    To asses safety and tolerability of the treatments
    Incidence of adverse events.
    To asses safety and tolerability of the treatments
    ECG
    To asses safety and tolerability of the treatments

    Full Information

    First Posted
    May 17, 2017
    Last Updated
    May 30, 2017
    Sponsor
    Insud Pharma
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT03173742
    Brief Title
    Bioavailability and Safety of Two Oral Fixed Dose Preparations Containing 18 mg Ivermectin (IVM 18 MG TABLETS, LICONSA S.A., Spain) Versus Reference Dosing (Weight Based) Containing 6 mg Ivermectin (REVECTINA®, Abbott Laboratórios do Brasil Ltda, Brazil)
    Official Title
    Bioavailability and Safety of Two Oral Fixed Dose Preparations Containing 18 mg Ivermectin (IVM 18 MG TABLETS, LICONSA S.A., Spain) Versus Reference Dosing (Weight Based) Containing 6 mg Ivermectin (REVECTINA, Abbott Laboratórios do Brasil Ltda, Brazil)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    March 2016 (Actual)
    Primary Completion Date
    December 2016 (Actual)
    Study Completion Date
    January 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Insud Pharma

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Evaluation of the bioavailability and safety of one oral preparation containing fixed dose 18 mg ivermectin (IVM 18 MG TABLETS, LICONSA S.A., Spain) or two oral preparations containing fixed dose 18 mg ivermectin (IVM 36 MG TABLETS, LICONSA S.A., Spain) vs. reference dosing (weight based) of reference drug containing 6 mg ivermectin (REVECTINA®, Abbott Laboratórios do Brasil Ltda, Brazil) in fasting conditions. A monocentric, open, randomized, single dose, three-period crossover trial in healthy volunteers.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Helminthiasis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Crossover Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    54 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    T1, T2, T3
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Arm Title
    T1, T3, T2
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Arm Title
    T2,T1,T3
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Arm Title
    T2,T3,T1
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Arm Title
    T3,T1,T2
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Arm Title
    T3,T2,T1
    Arm Type
    Experimental
    Arm Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T1, T2, T3
    Other Intervention Name(s)
    Treatment 1-2-3
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T1,T3,T2
    Other Intervention Name(s)
    Treatment 1-3-2
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T2,T1,T3
    Other Intervention Name(s)
    Treatment 2-1-3
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T2,T3,T1
    Other Intervention Name(s)
    Treatment 2-3-1
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T3,T1,T2
    Other Intervention Name(s)
    Treatment 3-1-2
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Intervention Type
    Drug
    Intervention Name(s)
    T3,T2,T1
    Other Intervention Name(s)
    Treatment 3-2-1
    Intervention Description
    T1: Ivermectin 6 mg (Revectina®) administered according to the SmPC by body weight. T2: Ivermectin 18 mg (IVM 18 mg Tablet Liconsa x 1 tablet) T3: Ivermectin 36 mg (IVM 18 mg Tablet Liconsa x 2 tablets)
    Primary Outcome Measure Information:
    Title
    Primary endpoint evaluated will be the PK parameters that define bioavailability in extent Ln [AUC0t]
    Description
    For group 3
    Time Frame
    up to day 7
    Title
    Primary endpoint evaluated will be the PK parameters that define bioavailability in extent in rate: Ln [Cmax] for each treatment in healthy volunteers with high weight (Group 3), calculated by means of a non-compartmental analysis.
    Description
    For group 3
    Time Frame
    up to day 7
    Secondary Outcome Measure Information:
    Title
    Relative bioavailability for each treatment and for groups 1 and 2 will be evaluated with the PK parameters that define bioavailability in extent Ln [AUC0t]
    Description
    for group 1 and 2
    Time Frame
    up to day 7
    Title
    Relative bioavailability for each treatment and for groups 1 and 2 will be evaluated with the PK parameters that define bioavailability in extent in rate: Ln [Cmax]
    Description
    for group 1 and 2
    Time Frame
    up to day 7
    Title
    AUC0t (for non-compartmental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    AUC0∞ (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    %AUC extra (residual area) (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    tmax (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    tlag (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    Cl/F (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    V/F (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    t1/2 (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    Ke (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    MRT (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    Cmax (for non-compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    tlag (for compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    ka (for compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    D7
    Title
    Cl/F(for compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    V/F (for compartimental analysis)
    Description
    PK profile for each treatment and each study group will be evaluated by means of a compartmental and non-compartmental analysis
    Time Frame
    up to day 7
    Title
    vital signs
    Description
    To asses safety and tolerability of the treatments
    Time Frame
    up to week 6
    Title
    laboratory analysis
    Description
    To asses safety and tolerability of the treatments
    Time Frame
    up to week 6
    Title
    Incidence of adverse events.
    Description
    To asses safety and tolerability of the treatments
    Time Frame
    up to week 6
    Title
    ECG
    Description
    To asses safety and tolerability of the treatments
    Time Frame
    up to week 6

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    45 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Caucasian subjects of either gender (male or female) with an age between 18 and 45 years (both inclusive). Medical history and physical examination with no relevant abnormal findings. No evidence of significant disease (organic or psychiatric) based on medical history, physical examination and complementary tests. Laboratory tests (complete hematology, clinical chemistry and urinalysis). Vital signs (systolic and diastolic blood pressure, heart rate and temperature) and electrocardiogram (ECG) record within normal range at screening. Participating female volunteers must use a reliable contraception method not containing hormones. List of accepted contraception method includes barrier methods (i.e. female/male condoms, diaphragms, spermicides), voluntary sterilization (female tubal occlusion) or non-medicated intrauterine devices (IUD) (i.e. inert or copper-releasing). Abstention is not considered a reliable contraception method. For female volunteers only: they must declare that they did not intend to become pregnant in the last month prior to screening and they do not intend to become pregnant during one month following the last study drug administration. Voluntary participation in the study, with written informed consent from the volunteer. The subject agrees to abstain from beverages or food containing methylxanthines (coffee, tea, cola, energy drinks, chocolate etc.), St John's Wort, vitamins, herbal remedies and chewing-gum for 48 hours prior to study drug administration and during each study period. The subject agrees to abstain from beverages or food containing grapefruit for 14 days prior to the first study drug administration and during the study (until last sample from the last period). Exclusion Criteria: Background of allergy, idiosyncrasy or hypersensitivity to the study drugs or its excipients. Heavy consumer of stimulating drinks (>5 cups of coffee, tea, chocolate or cola drinks per day). Background of alcoholism or drug dependence in the last one year or daily consumption of alcohol > 40 gr/day for men or > 24 gr/day for women. Use of any medication within 15 days prior to taking the study treatment, including over-the-counter medications and medicinal plants (except for the use of paracetamol in short-term symptomatic treatments). Positive serology for hepatitis B, C or HIV. Background or clinical evidence of cardiovascular, respiratory, renal, hepatic, endocrine, gastrointestinal, hematological or neurological disease or other chronic diseases. Smokers or ex-smokers that gave up smoking less than 1 year prior to the study (day 1 of period I) Pregnancy or lactation status for female subjects. Participation in another clinical trial during the 3 months before starting the current trial. Donate blood in the 8 weeks prior to starting the study. Undergone major surgery during the previous 6 months. Clinically significant abnormal ECG with clinical significance in accordance with the CIM's clinical criterion Restrictive vegetarian diet Positive results to the breath alcohol test at screening or at Day -1 Positive results to the drug abuse checks (urine test for: amphetamines, cannabinoids, opiates, benzodiazepines and cocaine) at screening or at admission on Day -1 Epidemiological risk of being infected by Loa loa or other filariases, defined as those who have lived or have travelled to any of the following countries: Angola, Cameroon, Central Africa Republic, Chad, Congo, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, Nigeria and Sudan.

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    Citations:
    PubMed Identifier
    29346388
    Citation
    Munoz J, Ballester MR, Antonijoan RM, Gich I, Rodriguez M, Colli E, Gold S, Krolewiecki AJ. Safety and pharmacokinetic profile of fixed-dose ivermectin with an innovative 18mg tablet in healthy adult volunteers. PLoS Negl Trop Dis. 2018 Jan 18;12(1):e0006020. doi: 10.1371/journal.pntd.0006020. eCollection 2018 Jan.
    Results Reference
    derived

    Learn more about this trial

    Bioavailability and Safety of Two Oral Fixed Dose Preparations Containing 18 mg Ivermectin (IVM 18 MG TABLETS, LICONSA S.A., Spain) Versus Reference Dosing (Weight Based) Containing 6 mg Ivermectin (REVECTINA®, Abbott Laboratórios do Brasil Ltda, Brazil)

    We'll reach out to this number within 24 hrs