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What are the acute symptoms of ivermectin poisoning from veterinary formulations in adults?
Executive summary
Acute poisoning in adults from veterinary (animal) ivermectin formulations is repeatedly reported to cause primarily gastrointestinal and neurologic effects — nausea, vomiting, diarrhea, dizziness, ataxia (loss of balance), tremors, seizures, decreased consciousness, coma and in some cases death — and is managed with supportive care because there is no antidote [1] [2] [3]. Public-health agencies warned of a sharp rise in poison‑center calls after people ingested animal formulations during the COVID‑19 period [4] [5].
1. What people mean by “veterinary ivermectin” and why it matters
“Veterinary formulations” often include highly concentrated pour‑ons, injectables or drench products intended for large animals; those concentrations and excipients differ from human tablets, so accidental or intentional ingestion of these products can deliver much higher doses and provoke more severe toxicity than standard human prescriptions (not found in current reporting about exact concentrations, but the CDC advisory highlights that veterinary products intended for cattle or horses can be highly concentrated and result in overdose when taken by humans) [2].
2. The typical early (acute) symptoms reported to poison centers
Reports and public advisories list gastrointestinal symptoms as common early signs: nausea, vomiting and diarrhea. Those are frequently the first complaints recorded in acute exposures and are cited in CDC/FDA communications and state health advisories [1] [2].
3. The neurologic picture: the most concerning acute effects
Neurologic manifestations dominate serious cases: dizziness, ataxia (problems with balance and coordination), tremors, confusion, hallucinations, decreased level of consciousness, seizures and coma. Multiple federal and clinical summaries explicitly name these effects and note that some patients who used animal products developed neurologic symptoms and required hospitalization [1] [5] [2] [3].
4. Cardiovascular and other systemic findings
Acute overdose reports and FDA materials also include hypotension (low blood pressure) and allergic-type reactions such as itching and hives among possible manifestations. Agencies emphasize that severe systemic compromise can occur in high exposures [1].
5. Frequency and context: why poison‑center calls spiked
Public-health notices document a surge in misuse during the COVID‑19 pandemic, when people took ivermectin intended for animals or at much higher-than-prescribed doses; the CDC issued a health advisory after increased poison‑center calls, and media reporting connected that trend to hospitalizations with neurologic symptoms [4] [5] [1].
6. Management: no antidote, supportive care only
Clinical and manufacturer summaries state there is no specific antidote for ivermectin toxicity; treatment is supportive and symptomatic (airway/ breathing/ circulation support, seizure control, hydration, monitoring) and may include measures like activated charcoal if ingestion is recent — but primary care is supportive in hospital settings [3] [2]. Veterinary-product manufacturer guidance and clinical resources reiterate supportive care as standard [3].
7. Outcomes reported in the literature and advisories
Authorities warn that severe cases have progressed to coma and death; Health Canada, the FDA and CDC repeatedly stated that ingestion of animal formulations has been associated with seizures, coma and fatal outcomes in some reported cases, prompting public warnings [1] [5] [4] [6].
8. Alternative viewpoints and limits of the available reporting
Available sources focus on surveillance, public warnings and case reports rather than systematic dose–response data for humans exposed to veterinary products; they do not provide consistent numeric thresholds (milligrams/kg) that reliably predict which adults will develop which symptoms, and clinical trial literature on approved human ivermectin dosing addresses therapeutic use and safety at clinical doses rather than overdoses with animal products (available sources do not mention precise human toxicity thresholds for every veterinary formulation) [7] [8].
9. Practical takeaways and immediate actions
If someone has ingested veterinary ivermectin or an unknown formulation, poison‑control and emergency services are the recommended immediate contacts; public‑facing pages direct people to poison centers and emergency departments because severe neurologic and cardiovascular effects can develop [1] [9]. Health authorities stress using human‑approved medicines only under clinician guidance and warn strongly against self‑treating with animal products [1] [4] [6].
Limitations: this summary synthesizes public advisories, manufacturer statements and media reporting in the provided set; detailed clinical case series with dose‑response metrics and long‑term outcome data are not included among the supplied sources (available sources do not mention comprehensive dose‑response thresholds for veterinary formulations) [2].