Product Ivergalen


Therapeutic indications: treatment of sarcoptic mange in humans.

Composition: each tablet contains 3 mg of Ivermectin

Format: 4 tablets.


Advice to patients


- Scabies is a parasitic infestation of the skin caused by the Sarcoptes scabiei (var. hominis) mite. The infestation is specifically human. The proteins of the mites and the residues they produce cause a hypersensitivity reaction that causes an intense itch that increases in intensity at night.


- The transmission of scabies is by direct skin-to-skin contact between people where the mite moves through the skin. Contact needs to be prolonged, meaning that it is difficult for it to be transmitted through a quick handshake or hug. However, it can easily be transmitted between family members and sexual partners.

- In places where many people live together in enclosed spaces, such as nursing homes, nurseries, reception centres, prisons and hospitals, transmission is easy. Scabies can also be spread by indirect and prolonged contact through objects, such as recently contaminated clothing, towels and bedding.

- The mite requires human skin to complete its life cycle. When parasitising humans it can live from one to two months although outside the host, mites do not live more than three or four days at room temperature.

- The mite withstands cold and high humidity well. It cannot survive for more than ten minutes at 50ºC. An infested individual can transmit scabies, even if they have no symptoms.


- The period between infestation and the appearance of symptoms is around two weeks, although this can extend up to six weeks, especially if it is the first time the disease has been suffered since the sensitisation to the parasite is slower and itching appears later. In the case of reinfestation, itching appears much faster, one to four days after re-exposure.


- The infested person is immediately a potential source of infection for others, even in the absence of symptoms. The period of transmissibility begins from the first moment of infestation until the mite and eggs are destroyed by treatment. Clothing that has been in contact with the affected person is considered to have a potential risk of transmission until it is treated or until seven days have passed since its last use.

- The disease is no longer transmissible 24 hours after starting the first acaricidal treatment.

- Infested people should avoid intimate or sexual relations until treatment is completed and has been effective. The use of condoms does not prevent the transmission of scabies.


- Treatment should be given to all infested people with symptoms and their asymptomatic contacts, which may include people they live with, sexual contacts and especially anyone who has had direct and prolonged skin-to-skin contact with the infested person during the month prior to the onset of symptoms.

- All infested people and their contacts should be treated at the same time (within a 24-hour period) to avoid reinfections. It is important to remember that the first time a person is infested with scabies they will usually show no symptoms for the first two to six weeks and can still transmit scabies during this period.

- Cohabitants and contacts at risk without symptoms should be treated with a dose of oral ivermectin as they may be in the incubation period. 


These should be applied at the same time as the other treatment and control measures within 24 hours of a scabies diagnosis:

- Disinfection of undergarments, bedding, sheets, towels, stuffed animals etc. used by the infected person during the seven days before applying the treatment and any used during it.

- All clothes that can be washed should be put and carried in a plastic bag, making sure that they are placed directly into the washing machine to avoid contaminating other surfaces.

- Clothes should be washed with hot water (minimum ten minutes at 50ºC to 60ºC and tumble-dried for 20 minutes or dry-cleaned on a hot cycle) to kill mites.

- All bedding, towels and clothing should be changed daily.

- Clothes or material that cannot be washed in a washing machine or dry-cleaned (such as shoes, coats, blankets etc.) should be put directly in a tightly closed plastic bag for seven days so that the mites and eggs die.

- All staff collecting and/or washing the clothes of the affected person should wear a long-sleeved gown and disposable gloves.

- All creams, lotions and other skin products that have been used by people affected by scabies need to be disposed of before the start of treatment.


- The general cleaning of mattresses, pillows, upholstered furniture, carpets, and car seats is to be done with soap and water, ensuring all corners are reached. The area should then be thoroughly vacuumed. The use of the vacuum cleaner facilitates the elimination of the eggs and mites. On textile surfaces such as cushions or armchairs, vacuum with small nozzles for increased suction. The vacuum cleaner bag and filters should be changed after each job.

- Routine cleaning and disinfection with bleach of the furniture surfaces that the patient has touched. On such surfaces (for example, plastic chairs), it may be advisable to use steam-cleaning systems where temperatures of more than 120°C can be reached. Such systems could also be useful when cleaning the plastic covers of mattresses, pillows, etc. that have been in contact with the affected person, if the material allows it.

- Fumigation is not necessary.

- Since the symptoms of scabies are the result of a hypersensitivity reaction to the mites and their faeces, itching normally decreases after one or two days of treatment. It can continue with less intensity for several weeks, even though all the mites and eggs have died. The use of moisturising creams is recommended, as is keeping the skin clean and dry. 

Acknowledgements: Doctor. Constanza Riquelme, Dermatologgist MD Hospital Clínic de Barcelona, y Doctor. Sebastián Podlipnik, Dermatologist MD, PhD, Hospital Clínic de Barcelona.

The contents of this section are strictly directed to health professionals with practice in Spain and certified to prescribe pharmaceutical products, which require specialized training for their right interpretation. Please notice that pharmaceutical products might have a different summary of characteristics authorised in other countries.

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