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Distribution is how the drug travels around your body, and which organs it might stay inside or affect
How ivermectin travels around the body
How ivermectin travels around the body
Ivermectin can move around the body very easily. This is because it can attach very easily to small proteins (like albumin) in your blood stream [1, 2]. These proteins are like taxis for chemicals. Ivermectin easily attaches to these proteins because it is lipid soluble, so it can travel around the body until it reaches the organ it wants to get to [1, 2].
If a drug is lipid soluble, it can enter cells very easily [2, 3]. This is because the membrane of cells is also made of lipids, so it's very willing to let the drug to enter the cells [3]. This means that ivermectin has a very large volume of distribution (Vd) [3]. This is a measure used by pharmacologists to determine how widely a drug is distributed around the body [3].
The Vd of ivermectin is around 3.1-3.5L/Kg - this is very high [1]
A high Vd means that we expect a drug to move out of the blood stream and into other tissues [3]. For example, it might move into fat (also known as adipose) tissues and stay there [1].
However, if someone is malnourished and doesn't have a lot of adipose tissue, ivermectin can't move there, so remains in the blood stream [1]. This increases the risk of toxicity.
Which organs might ivermectin stay inside?
Which organs might ivermectin stay inside?
While we know that ivermectin might move into lots of different tissues, it is particularly attracted to the brain. We know that humans don't have the receptor ivermectin acts on to hurt parasites (read more about this here) [4, 5]. However, ivermectin can also act on other receptors in the human nervous system [6].
These receptors are called GABA-a receptors and they're found in the brain [1, 6].
GABA receptors usually respond to a neurotransmitter (a chemical that helps your brain send messages) to stop your brain and nervous system from working too quickly [1, 6]. It's like a speed limit for your neurons.
It's very hard for ivermectin to get into your brain, but if it did, it could stop GABA receptors from keeping your brain calm [1, 6, 7]. This can lead to serious side effects.
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