What dosing regimens and routes (oral, IV) were used for ivermectin in oncology studies?
Executive summary
Clinical oncology investigations and case reports have used a wide range of ivermectin doses and schedules: from standard antiparasitic doses (150–400 µg/kg) cited in reviews to high, repeat oral regimens such as 30–60 mg daily for short windows in an ASCO trial (ivermectin 30, 45 or 60 mg PO daily on Days 1–3, 8–10, 15–17 of each 21‑day cycle) [1] [2]. Anecdotal and integrative‑medicine sources report much higher, weight‑based oral regimens up to 1–2 mg/kg/day used off‑label in small case series or online protocols, but peer‑reviewed human clinical evidence remains limited and sometimes negative [3] [4] [5].
1. Clinical trial dosing: measured, intermittent oral pulses
The clearest published clinical‑trial regimen comes from a 2025 phase I/II abstract combining ivermectin with the anti‑PD‑1 antibody balstilimab for metastatic triple‑negative breast cancer: patients received balstilimab IV on Day 1 and ivermectin orally at dose levels of 30, 45 or 60 mg daily on Days 1–3, 8–10 and 15–17 of each 21‑day cycle until progression or intolerance [2]. The study’s aim was to establish a recommended phase‑2 dose and safety profile, and the authors described the combination as “safe and well tolerated” in the abstract [2].
2. Preclinical and animal dosing: higher mg/kg exposures than human antiparasitic norms
Laboratory and animal studies frequently use substantially higher per‑kilogram ivermectin exposures than standard human antiparasitic dosing. For example, mouse experiments cited in breast cancer immunotherapy research used 5 mg/kg ivermectin in vivo [6]. Reviews cataloguing preclinical literature emphasize that anticancer activity in cell lines and animals often requires doses that exceed routine human parasitic regimens [7] [8].
3. Standard human antiparasitic dosing vs oncology repurposing proposals
Mainstream pharmacology references note that routine human doses for onchocerciasis, strongyloidiasis and enterobiasis are in the range of 150–200 µg/kg, with 400 µg/kg used for lymphatic filariasis [1]. That contrasts with repurposing proposals and online protocols that advocate much larger, repeated weight‑based regimens — commonly cited in non‑peer‑reviewed guides as 1–2 mg/kg/day or “daily or every‑other‑day” dosing near 2 mg/kg for advanced cancers [4] [9] [3]. These higher figures are far above standard antiparasitic regimens described in clinical reviews [1].
4. Routes of administration reported: mostly oral in human work; some historic subcutaneous data in trials/reviews
Human oncology reports and the ASCO abstract use oral ivermectin (PO) [2]. Older pharmacology literature and reviews note other routes in research contexts (for example, a historical trial administered ivermectin subcutaneously at high doses in a non‑oncology setting), but contemporary oncology trials emphasize oral dosing [1]. Memorial Sloan Kettering’s patient information focuses on single‑dose systemic ivermectin for parasitic infections and does not document oncology regimens [10].
5. Evidence quality and safety signals: small trials, case reports, and cautionary editorials
Systematic reviews and editorial pieces stress that human clinical evidence is scarce and preliminary; preclinical promise has not translated into large randomized trials or approvals for cancer therapy [7] [11]. Patient‑facing outlets and oncology commentators report mixed or null signals: a 2025 summary said a recent abstract showed “no real effect” of adding ivermectin in a metastatic triple‑negative setting, and mainstream media caution that there is no evidence to support people taking ivermectin to treat cancer [5] [12]. Integrative‑medicine blogs and anecdotal case compilations nevertheless promote high‑dose combinations including ivermectin, fenbendazole and supplements — often without rigorous safety data [3] [9] [13].
6. Competing narratives and potential agendas in reporting
Peer‑reviewed trial abstracts (ASCO) and scientific reviews frame ivermectin as a repurposing candidate warranting careful study [2] [7]. By contrast, many online guides and integrative practitioners promote aggressive, high‑dose weight‑based regimens (1–2 mg/kg/day) and combination protocols that lack randomized evidence and may encourage self‑medication [4] [9]. Journalistic and fact‑checking outlets warn that social‑media amplification, celebrity anecdotes and commercial interests can drive disproportionate enthusiasm that outpaces clinical proof [12] [14].
7. What’s not found in current reporting
Available sources do not mention large, randomized controlled trials proving clinical benefit of ivermectin for cancer, nor do they supply an established, regulatory‑approved oncology dosing standard beyond small phase‑1/2 work and preclinical studies [7] [2] [11]. Detailed pharmacokinetic bridging from the high doses used in animals to safe, effective human oncology doses is not presented in the cited material [6] [1].
Bottom line: human oncology work so far uses oral ivermectin in discrete, pulsed schedules (example: 30–60 mg PO daily on selected days of a 21‑day cycle in a phase I/II ASCO study), while much of the online and integrative discourse advocates far higher, continuous weight‑based dosing up to 1–2 mg/kg/day without high‑quality clinical proof; clinicians and patients should weigh small‑trial data and safety concerns before considering off‑label use [2] [4] [12].