Stromectol alternatives: what to know and when to consider them

If you’re looking for alternatives to Stromectol (brand name for ivermectin), you’re probably dealing with a parasitic infection or a skin problem like scabies. Ivermectin is a go-to drug for many parasitic infections, but it’s not always the only option. Different bugs, patient health, pregnancy, age, and drug interactions can make another medicine a better choice.

When to consider an alternative

Think about alternatives when you have medical reasons—pregnancy, breastfeeding, liver disease, or certain drug interactions—or when the parasite doesn’t respond to ivermectin. Also consider local availability: some places stock other antiparasitics more reliably. Never switch or stop treatment without talking to a clinician who knows your diagnosis and medical history.

Common alternatives and how they compare

Here are practical alternatives organized by condition so you can get a clear idea of options your clinician may discuss.

Intestinal worms: Albendazole and mebendazole are broad-spectrum options used for many roundworms and tapeworms. They’re often effective, widely available, and commonly used for mass-treatment programs. Depending on the parasite, treatment length varies—sometimes a single dose, sometimes several days.

Tapeworms and flukes: Praziquantel is the standard for many tapeworms and fluke infections. It works differently from ivermectin and is the usual choice when those parasites are suspected.

Scabies and lice: For skin infestations, topical drugs can be just as effective. Permethrin cream (5%) is a first-line topical treatment for scabies in many guidelines. Other topical options include benzyl benzoate, crotamiton, and sulfur ointments. For resistant cases or certain patient groups, oral ivermectin is sometimes used—but if ivermectin isn’t suitable, topical therapy is the alternative.

Onchocerciasis (river blindness): Ivermectin is the mainstay for killing microfilariae, but doxycycline targets the bacteria (Wolbachia) that some filarial worms depend on. Doxycycline requires a longer course and isn’t always suitable for pregnant women, but it’s useful as an adjunct in specific cases.

Strongyloidiasis: Ivermectin usually works best, but albendazole is sometimes used where ivermectin isn’t available. Albendazole tends to be less effective, so careful follow-up and testing are important if it’s used.

Whatever the diagnosis, correct identification of the parasite matters. Tests or stool exams can change the choice of drug. Also tell your provider about pregnancy, liver problems, and other meds to avoid interactions or side effects.

Want practical next steps? Get a proper diagnosis, ask your clinician why they recommend one drug over another, and check for follow-up testing to confirm cure. If you’re buying meds online, use licensed pharmacies and avoid unverified sources. Safe treatment starts with the right diagnosis and a conversation with a healthcare professional.