Stromectol alternatives: what to use when ivermectin isn’t the best fit

If your doctor says Stromectol (ivermectin) isn’t the right choice, you still have good options. The best alternative depends on the infection: intestinal worms, scabies, or other parasitic illnesses each have different go-to drugs. Below I’ll walk through common alternatives, when they’re used, and simple safety tips so you can talk with your provider like a pro.

Common medical alternatives

Albendazole and mebendazole are the main alternatives for many intestinal worm infections. They work well against roundworms, hookworms, and some tapeworm stages. Doctors prefer albendazole for broader coverage; mebendazole is another solid pick when recommended. Both require a prescription and a confirmed diagnosis before starting.

Praziquantel is the standard treatment for schistosomiasis and most tapeworms. If your infection comes from freshwater parasites or certain tapeworm species, praziquantel often replaces ivermectin. It’s fast-acting but can cause dizziness or stomach upset, so plan rest after a dose.

For scabies, topical permethrin cream is a top alternative. Permethrin 5% applied to the whole body overnight usually clears mites and is safe for most adults and children over two months (follow local guidance). For crusted or resistant scabies, oral ivermectin is often added—so if you can’t take ivermectin, your doctor may repeat topical treatments or use combination strategies.

Doxycycline isn’t an antiparasitic by itself but it’s used alongside other drugs in specific infections like onchocerciasis because it targets symbiotic bacteria that help the parasite survive. That makes it a strategic alternative in some treatment plans rather than a direct replacement.

How to choose and stay safe

Start with the right diagnosis. Stool tests, skin scrapings, and blood tests show which parasite you actually have. The wrong drug won’t help and could cause side effects. Tell your provider about allergies, pregnancy, breastfeeding, liver or kidney problems, and other medicines you take—these conditions change which drug is safest.

Avoid buying prescription drugs from unverified online sellers. Use a licensed pharmacy, ask for a copy of the prescription, and check for pharmacist contact info. If cost is an issue, ask your clinic about generic versions or patient assistance programs—many antiparasitic drugs have affordable generics.

Watch for common side effects like nausea, headache, dizziness, or skin reactions, and report severe symptoms to your doctor. Follow treatment length exactly; stopping early can let the infection return. If household members are at risk (scabies, some intestinal parasites), treating close contacts and cleaning bedding and clothing reduces reinfection.

Want a quick next step? Get tested, bring a list of symptoms and meds to your appointment, and ask your provider why they choose one drug over another. That makes the plan clearer and safer for you.