Sumex

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Sumex

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Sumex

Quick Facts: Sumex

Property Description
Active ingredient Ivermectin (INN)
Forms Tablets (Oral), Topical Cream, Topical Lotion
Pharmacological class Antiparasitic Agent (Macrocyclic Lactone Avermectin)
General purpose Elimination and control of parasitic infestations
Origin Semisynthetic (Derived from Streptomyces avermitilis)

What is the Core Identity and Classification of Sumex?

Sumex is a prescription-only medication whose active component is Ivermectin (INN), a substance belonging to the macrocyclic lactone avermectin pharmacological class. Ivermectin is a semisynthetic compound derived from natural fermentation products of the soil bacterium Streptomyces avermitilis, which places it in a specialized category of antiparasitic agents. This classification distinguishes it as a broad-spectrum agent primarily focused on disrupting the life cycle of various parasitic worms and arthropods. The drug's critical utility is clinically recognized, including its inclusion on the WHO Model List of Essential Medicines, confirming its global importance.


What are the Available Forms and Composition of Sumex?

The composition of Sumex includes the active ingredient Ivermectin formulated alongside various excipients for different uses. The product is available for both oral administration as tablets and for external use as topical cream or lotion preparations. This dual approach provides flexibility: oral forms are intended for systemic action against internal parasites, while topical preparations are engineered to act locally on the skin surface. The existence of these distinct forms allows healthcare providers to target both internal and external parasitic issues.


What is the General Purpose of This Antiparasitic Agent?

The general purpose of Sumex is the control and elimination of parasitic infestation by targeting the parasite’s nervous and muscular systems. Ivermectin achieves this by exhibiting selective binding to glutamate-gated chloride ion channels, which are vital components found in invertebrate cells but not significantly in mammals. This mechanism rapidly leads to the paralysis and death of the parasite, stopping the infection's progression. Pharmacological studies have highlighted the drug's rapid and unparalleled efficacy in quickly reducing the number of active parasites, which is the primary therapeutic goal.

Regulatory References

  1. Ivermectin Oral: MedlinePlus Drug Information

What side effects are possible with Sumex?

Possible Side Effects and Safety Information

The safety profile of Sumex, whose active ingredient is Ivermectin, is defined by regulatory documents that classify adverse reactions based on frequency and affected physiological systems. This information is derived exclusively from government health authority labels.

Adverse Reaction Classification

Adverse reactions commonly documented in official prescribing information affect the Nervous System (e.g., dizziness, somnolence, headache, tremor), the Gastrointestinal System (e.g., nausea, vomiting, diarrhea, abdominal pain), and the Skin and Subcutaneous Tissue (e.g., pruritus, rash, urticaria). Other common systemic effects include asthenia, fever, and musculoskeletal pain (arthralgia, myalgia).

Reactions associated with the death of microfilariae in filarial infections, known as the Mazzotti reaction, are expected and typically occur and resolve within the first week after administration. These systemic responses may involve orthostatic hypotension, tachycardia, and lymphadenopathy.

Serious Safety Considerations

Serious adverse reactions are documented, though their incidence is classified as not known or rare. These include signs of serious hepatic impairment (such as jaundice or elevated liver enzymes) and severe generalized skin reactions (such as blistering or peeling skin). A rare but potentially fatal encephalopathy is a high-alert safety concern, particularly documented in patients heavily co-infected with the Loa loa filarial worm.

Population-Specific Constraints

The medicine is contraindicated in patients with a known hypersensitivity to the active ingredient or any component. Safety and effectiveness for oral administration are not established in children weighing less than 15 kg, and use during pregnancy is generally advised against due to a lack of established safety data.

Overdose and Emergency Response

Overdose and when to seek help

Overdose with Sumex (Ivermectin) is officially documented to affect multiple body systems. Initial presentations often include common gastrointestinal effects such as nausea, vomiting, and diarrhea. More critical manifestations primarily involve the Central Nervous System (CNS) and Cardiovascular System. CNS symptoms may range from confusion, disorientation, lethargy, and loss of coordination (ataxia) to severe states like stupor, seizures, and coma. Cardiovascular signs documented are hypotension (low blood pressure) and tachycardia (fast heart rate).

Regulatory documents specify that overdose may lead to life-threatening outcomes, including respiratory failure and metabolic acidosis. Urgent help-seeking is required due to these risks.

Mandatory Emergency Actions:

  • Immediate medical treatment must be sought if any symptoms of overdose occur.
  • Contacting emergency services is explicitly required if the affected individual has collapsed, had a seizure, has trouble breathing, or cannot be awakened.
  • Management is strictly symptomatic and supportive therapy, as no specific antidote is known.

Overdose risk is heightened with co-administration of other CNS depressants (e.g., barbiturates) and the ingestion of highly concentrated non-human formulations.

Therapeutic Uses of Sumex

What Sumex Treats: Main Uses and Benefits

Sumex is generally used for the short-term symptomatic assistance needed when certain distressing symptoms arise. The medication is applied in clinical settings that involve acute, disruptive, and episodic symptom patterns.

It is considered relevant across conditions involving episodic or fluctuating manifestations and is often used to help manage symptoms that become more disruptive during flare-ups. This includes conditions presenting with systemic or localized discomfort and those associated with acute episodes, where short-term symptomatic assistance is appropriate.

The medication helps address symptom clusters that may become intense or disruptive, especially when they create noticeable physiological strain or interfere with daily functioning. By offering supportive relief, Sumex contributes to improved comfort during symptomatic periods. This supportive relief helps ease the overall symptom burden and assists with maintaining functional stability during difficult episodes.

This approach is helpful when a patient experiences heightened distress or discomfort and needs temporary support.

Quick Fact: Relief for Episodic Discomfort

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Who Can and Cannot Use Sumex?

The population eligibility for Sumex (Ivermectin) is defined by specific criteria set out in governmental regulatory documents. Use is strictly limited by absolute contraindications, age and weight restrictions, and pre-existing conditions.

Category Official Regulatory Statement
Populations for whom use is allowed (as stated in label) Adults and children with approved parasitic infections who meet the minimum weight requirements.
Populations for whom use is not recommended (if applicable) Individuals during pregnancy and lactation, due to insufficient human safety data and documented excretion into breast milk.
Populations for whom use is contraindicated Patients with known hypersensitivity to Ivermectin or any component of the formulation.

Age-Related and Condition-Specific Eligibility:

The oral formulation of Sumex is contraindicated in children weighing less than 15 kg because safety and efficacy have not been established in this low-weight group. Patients in West or Central Africa with suspected high Loa Loa microfilarial loads are subject to restrictions due to the risk of serious neurological events following treatment. Caution is advised for patients with severe hepatic impairment (liver disease), as the drug is extensively metabolized in the liver, which may affect the body's ability to process it.

What should I know about interactions with other medicines?

The official regulatory profile for Sumex (Ivermectin) is defined by pharmacokinetic and pharmacodynamic constraints documented by health authorities.

Pharmacokinetic Interactions

The active substance is primarily metabolized by the CYP3A4 enzyme. Co-administration with potent CYP3A4 inhibitors is officially documented to result in significantly increased plasma exposure of Ivermectin. This potential for altered drug levels is reinforced by its function as a substrate for the P-glycoprotein (P-gp) efflux transporter; substances that inhibit P-gp may also alter the level or effect of Ivermectin. Furthermore, the ingestion of food with the oral tablet formulation enhances the drug's absorption, leading to increased systemic exposure.

Restrictions and Cautions

To mitigate the exposure-altering effect of food, the oral tablet is subject to a formal timing rule, stating it must be taken on an empty stomach. Documented pharmacodynamic interactions include an association with an increased International Normalized Ratio (INR) when co-administered with Warfarin. The combination with Alcohol (Ethanol) is noted to produce an additive effect that increases the risk of sleepiness and dizziness. Co-administration with Diethylcarbamazine citrate (DEC) is not recommended in specific treatment contexts due to the risk of severe adverse reactions. A population-specific caution also exists for individuals with genetically reduced P-glycoprotein activity, who may face an increased risk of neurotoxic effects.

Mechanism of Action

Targeted Activation of Invertebrate Chloride Channels

The drug's primary action is executed via allosteric agonism at glutamate-gated chloride ion channels ( GluCls), which are uniquely prevalent and critical in invertebrate nerve and muscle cells. This targeted interaction initiates the sustained influx of negatively charged chloride ions ( Cl^-) into the parasite's excitable cells, which is the foundational molecular step leading to altered electrical signaling. This action leverages the biological difference in GluCl targets between parasites and mammals, which ensures functional selectivity of the mechanism.


Disruption of Parasite Neuromuscular Signaling

The massive influx of chloride ions causes profound cell membrane hyperpolarization, effectively disabling the nerve and muscle cells. This collapse of electrical potential results in the immediate and irreversible flaccid paralysis of the parasite's entire musculature, halting all motor functions, including essential feeding (pharyngeal pumping). This crucial physiological change drives the final physiological event.


Mechanism Limitations and Selective Toxicity

The mechanism is physiologically constrained to target parasites because GluCls are absent or protected in mammals. However, the mechanism is limited by the potential for parasites to develop target site resistance through genetic mutations in the GluCl receptor, which can reduce Ivermectin's binding affinity and, consequently, its mechanism-driven effect. The functional paralysis renders the parasite immobile and unable to ingest nutrients, leading to its death and physical elimination.

Dosage and Administration Information

Sumex is administered via two distinct official pathways: oral for systemic action using tablets, and topical for local skin application using cream or lotion preparations. The usage pattern is dictated by the chosen route, establishing different dosing and frequency protocols as outlined in regulatory documents.


The oral tablet is primarily prescribed as a single, weight-based dose for systemic conditions. Official guidelines indicate the dose is calculated based on the patient’s body weight, typically ranging from 150mu g to 200mu g per kilogram. This regimen is often non-recurring, though the need for re-treatment may be assessed at intervals, such as every mathbf3 to mathbf12 months, depending on the clinical context. In contrast, the topical forms are used on an extended, recurring schedule. The cream or lotion is applied once daily to the affected areas of the skin, with instructions specifying the use of a pea-sized amount for correct coverage.


A critical instruction for the oral administration of the tablet is the food relationship. The official label requires the tablet to be taken with water on an empty stomach; this means consuming no food mathbf2 hours before or after the dose. Usage constraints also apply to specific populations. The oral tablet formulation is officially not established for use in pediatric patients weighing less than mathbf15 kg. Furthermore, the topical cream or lotion must strictly be applied externally to the skin and must not be used orally, ophthalmically, or intravaginally.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Sumex

Evidence for Use in Intestinal Strongyloidiasis (Threadworm Infection)

Research examined oral Sumex in studies involving patients with intestinal strongyloidiasis, utilizing Randomized Controlled Trials (RCTs) and systematic reviews. Studies focused on parasite clearance (absence of S. stercoralis larvae in stool) and changes in patient-reported abdominal symptoms. Follow-up periods extended up to one year to confirm sustained absence of larvae. While research included immunocompromised individuals, data for long-term outcomes in severely immunosuppressed patients are not as extensively detailed as for the general population.


Evidence for Use in Onchocerciasis (River Blindness)

Evidence for Sumex was developed through large-scale, community-based RCTs and long-term public health observational studies, with follow-up over many years. Key outcomes monitored included microfilarial load in the skin and tracking the prevention of vision impairment. Research describes patterns observed in the reduction of microfilariae in affected communities. However, consistent long-term patient follow-up across remote settings poses challenges, and research documented severe reactions in areas with high rates of Loa loa co-infection.


Evidence for Use in Topical Applications

Research for topical Sumex uses double-blind, vehicle-controlled RCTs categorized by condition.

Research for Papulopustular Rosacea

Intermediate-term RCTs examined adults with inflammatory rosacea, monitoring the reduction in papules and pustules and changes in global skin assessment scores. Research provided limited information specifically characterizing the effect on the long-term, fixed redness (erythema) component of rosacea.

Research for Head Lice Infestation

Short-term trials focused on measuring the proportion of subjects confirmed to be free of live lice at specific follow-up points. Long-term research beyond the immediate resolution of the infestation is not the primary focus of these acute-treatment trials.


What Remains Uncertain About Sumex

Evidence highlights what is known and what is still uncertain. Long-term effects are not fully established for most indications beyond the initial treatment period, aside from the large-scale public health programs. Comparative evidence is lacking in some areas where a direct comparison against all standard treatment options has not been performed. Research does not determine whether an individual will respond similarly to the group patterns observed in trials.

Frequently Asked Questions (FAQ)

Common questions about Sumex (FAQ)


Q: How quickly should I expect to feel the effects of Sumex?

Studies and official information indicate that the time it takes to see full resolution of symptoms can vary depending on the condition being treated. While the medicine acts quickly on the targeted parasite, noticeable symptom relief may take several days or longer. This expected timeframe will be specific to your diagnosed condition.


Q: How does Sumex affect my ability to drive or operate machinery?

Official product information states that the specific effects of the medicine on driving have not been studied. Because adverse reactions like dizziness and drowsiness may occur, individuals should be aware of these potential effects and avoid driving or using heavy machinery if they experience them.


Q: What is the maximum amount of time Sumex has been studied for continuous use?

According to official regulatory documents, the length of treatment varies significantly based on the parasitic infection. Treatment may range from a single oral dose to a schedule of repeated doses every 3 to 12 months, which may continue for several years in the context of large-scale public health programs.


Q: What if I forget to store Sumex properly (e.g., in a hot car)?

Official product information specifies that the medicine must be stored at room temperature, protected from excessive heat and moisture. If the product has been exposed to extreme heat or otherwise improperly stored, its stability and effectiveness may be negatively affected. Disposal should be managed using local drug take-back programs or guidelines.


Q: Is there a generic version of Sumex available?

Yes, the active substance in Sumex is Ivermectin, which is the generic name for the medicine. Ivermectin is widely available as a generic medication.


Q: Is Sumex known to affect mood or mental clarity?

According to official safety documents, rare side effects involving the nervous system may include changes in consciousness, confusion, disorientation, agitation, and irritability. These are described as potential mood or mental changes, and individuals may choose to discuss any concerns with a healthcare professional.


Q: Does Sumex cause weight gain or weight loss?

Official regulatory documents indicate that changes in weight have been reported as less common or rare side effects. These include reports of both unusual weight gain, including rapid weight gain, and weight loss.


Q: Does Sumex interact with common over-the-counter pain relievers?

Official documents do not list specific common over-the-counter (OTC) pain relievers as known interactions. However, as with any medicine, official guidance emphasizes that patients inform their healthcare provider about all prescription and OTC medicines they are using.


Q: How long does Sumex typically stay in your system?

Based on human pharmacokinetic studies, the elimination half-life of the active ingredient is documented to be approximately 38.9 hours. The half-life refers to the time it takes for the concentration of the medicine in the body to be reduced by half.


Q: Is Sumex suitable for older adults?

Official prescribing information states that dosage adjustments are typically not required for age-related decline in kidney function. However, caution is advised for older patients who may also have severe liver disease, as the drug is primarily processed by the liver.


Q: What happens if I accidentally skip a dose of Sumex?

Official guidance on missed doses depends on the prescribed schedule. Since the oral form is often a single, non-recurring dose, missed dose instructions are not always applicable. For recurring therapeutic schedules, the product information indicates that if a dose is missed, it is generally considered to be taken when remembered, unless the next dose is due shortly.


Q: Can Sumex be taken with coffee or caffeine?

Caffeine is not specifically listed in regulatory documents as a known drug interaction. However, official guidance reminds patients to disclose all food, beverages, supplements, and other medicines to their healthcare provider.


Q: Can taking Sumex make you feel anxious or restless?

Official safety documents report that irritability and agitation have been noted as rare side effects. These reactions can be related to feelings of restlessness or unease.


Q: Does Sumex interact with birth control pills?

Birth control medications are not specifically documented as a known interaction in the official prescribing information. Since the medicine is metabolized by the CYP3A4 enzyme, patients are advised to discuss all medications, including hormonal contraceptives, with their prescriber.


Q: What should I do if my symptoms get worse after starting Sumex?

Regulatory sources state that patients should seek the advice of their healthcare provider if they experience any signs of serious side effects. Furthermore, if the condition being treated worsens or if existing symptoms become severe or do not resolve, seeking advice from the prescriber is consistent with official guidance.


Q: Is Sumex safe for people with kidney problems?

Official information indicates that dosage adjustments are typically not required for individuals with kidney (renal) impairment. This is because less than 1% of the drug is eliminated through the kidneys; the majority is eliminated through the feces.


Q: Will Sumex interfere with lab tests or medical procedures?

Official documents note a known association with an increased International Normalized Ratio (INR) when the medicine is used alongside Warfarin. Official guidance suggests informing healthcare providers that they are using this medicine before undergoing any laboratory tests or medical procedures.


Q: Is it safe to crush or split Sumex tablets?

Official instructions for the oral tablets differ based on the patient population. For adults, the tablets are intended to be swallowed whole. However, for use in qualifying children who meet the minimum weight requirement, the tablets are officially instructed to be crushed before swallowing.


Q: Are there any known interactions between Sumex and herbal remedies?

No specific interactions with herbal remedies are known or documented in the official prescribing information. As a general rule, official guidance suggests disclosing the use of all supplements, vitamins, and herbal products to a healthcare provider.

How should Sumex be stored and disposed of?

How to Store and Dispose of Sumex (Ivermectin)

Storage Conditions

Official regulatory information specifies that Sumex (Ivermectin) oral tablets must be stored at room temperature, typically between 20 C and 25 C, and away from excessive heat and moisture.

The medication must be kept in its original container and be protected from light. For all formulations, it is a required safety measure that the product be stored out of the sight and reach of children.

Handling and Disposal

Topical forms should not be frozen. If the product is a cream or lotion, it must be kept in a tightly closed container. Some topical formulations have a labeled in-use stability period and must be discarded after six months from opening.

Unused or expired Sumex must be disposed of in accordance with local regulatory requirements. Disposal guidelines, such as those from the FDA, recommend utilizing a drug take-back program or following specific instructions for home disposal, ensuring environmental protection, particularly regarding the aquatic environment.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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