Ivermectin‑Induced Chronic Liver Disease

Yes, I know, a liver is a different organ than your kidneys.

Ivermectin is a medicine that has been used for many years to treat parasitic infections in humans and some mammals. It is usually safe when taken in the correct dose and under medical supervision. However, in recent times, ivermectin has been used more widely, and sometimes without proper guidance. Because of this, some patients have developed liver problems after taking the drug.

Drug induced liver injury occurs when the liver becomes irritated or damaged by a medication. The liver is responsible for breaking down many substances, and when it cannot process a drug properly, inflammation may develop. In the case of ivermectin, this reaction is not common, but it has been reported in several patients[1][2]. These patients often developed symptoms a few days after taking the medicine.

The early signs of liver injury are usually mild. Patients may feel tired, lose their appetite, or experience nausea. Some may notice discomfort in the upper abdomen. As the liver becomes more affected, the symptoms become clearer. The skin or eyes may turn yellow, and the urine may become darker. These changes show that the liver is struggling to remove waste products from the blood.

Blood tests usually confirm the diagnosis. The liver enzymes become elevated, showing that the liver cells are irritated. In some patients, the pattern is mainly hepatocellular, while in others, cholestasis is more prominent. The exact pattern depends on how the liver reacts to the drug. In most cases, the injury improves once ivermectin is stopped. When the damage is prolonged, the liver may slowly progress to chronic disease.

Repeated or sustained injury from ivermectin, especially when taken in high doses or for long periods, can lead to chronic liver changes. The liver tissue may develop fibrosis, and its function may gradually decline.

The treatment for ivermectin induced liver injury is mainly supportive. Doctors monitor the patient closely and check the liver tests regularly. Most patients recover fully within a few weeks once the drug is stopped. Only in rare cases does the injury become severe or progress to chronic disease. The important point is that the medicine should be stopped as soon as the problem is recognized.

Ivermectin remains a useful drug, but it must be used correctly. When taken in high doses or without medical supervision, the risk of liver injury and chronic liver disease becomes higher. Patients should always consult a doctor before using ivermectin. This helps prevent complications and protects the liver from unnecessary harm.

We propose to call this Chronic Liver Disease of non‑Traditional causes (CLDnT): Ivermectin‑Induced Chronic Liver Disease.

[1] Sonderup et al: Ivermectin drug induced liver injury in South-African Medical Journal – 2023.
[2] Veit et al: First case of ivermectin-induced severe hepatitis in Transactions of the Royal Society of Tropical Medicine and Hygiene - 2006.