Ivor

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Ivor

Method of action: Anticoagulant

Treatment option: Hemodialysis

Medically reviewed

Laura Arias

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 Ivor

What is Ivor? (Bemiparin Sodium)

The following information establishes the identity and core characteristics of the medicinal entity, Bemiparin Sodium, addressing its composition, classification, and general function, while strictly excluding details on dosage, usage, side effects, or clinical indications.


Quick Facts

Property Description
Active ingredient Bemiparin Sodium
Form Solution for injection (Subcutaneous route)
Pharmacological class Antithrombotic agent / Anticoagulant
General purpose Reducing blood clot formation
Origin Synthetic/Derived (Ultra-low molecular weight heparin)

Ivor: Definition and Pharmacological Classification

The drug substance with the International Nonproprietary Name (INN) Bemiparin Sodium is classified as a specific antithrombotic agent, belonging to the broad Heparin group of medicines. Its function is that of an anticoagulant, a compound utilized to modulate the blood’s capacity to clot within the circulatory system.

Bemiparin Sodium is structurally defined as an Ultra-low molecular weight heparin (ultra-LMWH). This specific classification reflects its second-generation status, setting it apart from older compounds like standard Unfractionated Heparin (UFH). Bemiparin Sodium possesses the lowest molecular weight of all currently available low molecular weight heparins, contributing to its distinct pharmacological properties. This unique chemical structure helps the medicine act in a highly targeted and predictable way.

Composition, Origin, and Pharmaceutical Form

The active ingredient, Bemiparin Sodium, is a synthetic substance, meaning it is derived through the controlled chemical depolymerization of medical-grade Porcine Unfractionated Heparin. This process yields the ultra-low molecular weight compound that constitutes the entire active component of the medication.

As a single-ingredient product, Ivor is formulated as a sterile, clear solution for injection in an aqueous solution base. This preparation is designed exclusively for administration via the subcutaneous route, an injection beneath the skin. This specific molecular weight profile is achieved through a precise manufacturing method, optimizing its activity as an anticoagulant. This confirms that the drug is manufactured to ensure a highly focused effect on the clotting process.

General Purpose of this Anticoagulant

The fundamental purpose of Bemiparin Sodium is to reduce the overall tendency of the blood to form clots, acting as a highly selective Factor Xa inhibitor. This mechanism specifically targets and interferes with a crucial, specific enzyme necessary for the coagulation cascade.

The essential benefit of this precise anticoagulant mechanism is its capacity to support the general prevention and treatment of conditions associated with the risk of unwanted or excessive blood clot formation, known as thromboembolic events. A typical scenario where this function is required involves supporting patients who are temporarily immobile after surgery, demonstrating the drug's key role in managing circulatory risk. This action helps maintain the necessary fluidity of the blood in the vascular system.

Regulatory References

  1. Antithrombotic Agents (NIH)
  2. Low Molecular Weight Heparins (NIH)
  3. Unfractionated Heparin (NIH)
  4. Factor Xa Inhibitors (NIH)
  5. Thromboembolism (MeSH)

What side effects are possible with Ivor?

Ivor's (Bemiparin Sodium) official safety profile is organized by regulatory authorities to define the risk associated with its use as an anticoagulant.

Adverse Reactions Classified by Frequency

Adverse reactions are classified based on the standard European frequency definitions (e.g., Common, Rare):

Frequency Class Associated Adverse Reactions (Examples)
Common Haemorrhage (bleeding), Haematoma (injection site swelling), Ecchymosis (bruising), and elevated liver enzymes (hepatic transaminases).
Uncommon Mild and transient Thrombocytopenia (Type I), Skin rash, Urticaria (hives), and local reaction at the injection site.
Rare Serious haemorrhage (major bleeding), Severe Thrombocytopenia (Type II, Heparin-Induced Thrombocytopenia), and Anaphylactic reaction.
Very Rare Spinal or epidural haematoma (associated with neuraxial procedures), and Skin necrosis at the injection site.

Safety-Related Restrictions and Considerations

The regulatory label identifies specific situations where the drug is not recommended or requires particular caution, primarily concerning bleeding risk and severe organ function impairment.

Serious Adverse Reactions include major bleeding events and the development of Type II Heparin-Induced Thrombocytopenia (HIT). HIT is an immune-mediated condition that typically occurs between 5 and 21 days after treatment initiation. Furthermore, a specific risk of spinal or epidural haematoma is documented when the drug is administered concurrently with neuraxial procedures, such as spinal or epidural anaesthesia.

Contraindications define absolute restrictions on use, such as the presence of active haemorrhage, a history of confirmed Type II HIT, or severe impairment of liver or pancreatic function. Caution is specifically noted for use in patients with severe renal impairment (creatinine clearance < 30 mL/min) due to the potential for altered clearance and accumulation of the drug, which may require dose adjustment or monitoring.

Overdose and Emergency Response

The overdose profile for Ivor (Bemiparin Sodium) is characterized by an excessive anticoagulant effect, primarily leading to haemorrhagic complications. The documented signs of overdose reflect this excessive bleeding risk, including nosebleed, unusual bruising, and the presence of blood in the stool or urine.

Overdose is classified as a severe risk due to the potential for fatal haemorrhage. A specific, serious outcome associated with the drug's anticoagulant effect is the risk of spinal or epidural haematoma, which may lead to prolonged or permanent paralysis.

Regulatory authorities mandate that individuals must seek emergency medical attention immediately upon any suspicion of overdose or excessive bleeding. Furthermore, the treatment must be discontinued immediately if severe reactions, such as an excessive platelet count reduction or signs of cutaneous necrosis, are observed. The official regulatory documents confirm that Protamine sulphate is the suitable antidote available for the necessary neutralization of the drug's effect.

Patients with severe renal impairment ( creatinine clearance < 30 mL/min ) are noted to have a higher risk of overdose due to the drug's altered kinetics and potential for accumulation. For at-risk individuals, close and frequent monitoring for signs of neurological impairment is required due to the possibility of spinal haematoma.

Therapeutic Uses of Ivor

What Ivor treats: main uses and benefits


The primary therapeutic domain of Ivermectin is generally applied in addressing conditions that produce significant symptomatic burden related to parasitic infections. Its main use is to help manage symptoms linked to two parasitic conditions: strongyloidiasis (a roundworm infection of the intestines) and onchocerciasis (river blindness).

In clinical scenarios, the medicine is commonly used when symptoms create noticeable physiological strain and involves conditions presenting with systemic or localized discomfort. The use of the medicine, which may also include applications for other parasitic conditions like certain roundworm infections, infestations of head or pubic lice, and scabies, contributes to easing the overall symptom load for conditions involving episodic or fluctuating manifestations. One patient-oriented benefit is that the treatment provides supportive relief that helps patients cope more steadily. This treatment is relevant when supportive symptom management is appropriate during difficult episodes by easing distress. Topical forms are considered relevant for easing symptoms linked to inflammatory or irritative skin states, such as rosacea.

Quick Fact: Relief for Inflammatory Symptoms
Topical forms may assist with managing symptoms linked to inflammatory or irritative states associated with conditions like rosacea.

Regulatory References

  1. NIH MedlinePlus Drug Information on Ivermectin

Eligibility and Restrictions for Use

Official Population Eligibility for Ivor (Bemiparin Sodium)

Official regulatory documents define strict eligibility rules for the use of Bemiparin Sodium (an anticoagulant). Use is established for adult patients (18 years and older).

Category Official Regulatory Status
Populations for whom use is contraindicated Patients with a history of Heparin-Induced Thrombocytopenia (HIT), active haemorrhage, or a high risk of major bleeding. Absolute prohibition for patients with severe impairment of liver or pancreatic function, or acute bacterial endocarditis.
Age-related eligibility rules Not recommended for children and adolescents (under 18 years) due to insufficient data on safety and efficacy. No specific dose adjustment is needed for older adults without concurrent organ impairment.
Condition-specific restrictions Use is not recommended in patients with severe renal impairment (creatinine clearance <30 ml/min). Caution is required for patients with uncontrolled arterial hypertension or chronic liver failure.
Pregnancy and lactation status Use during pregnancy and lactation is not recommended unless the potential benefit outweighs the risk, as clinical data are limited and excretion into breast milk is unknown.

These official statements define mandatory exclusions based on bleeding risk, known drug intolerance, and lack of established data in specific age or organ-function groups.

What should I know about interactions with other medicines?

Ivor (Ivermectin) has the potential to interact with other medications, which can alter the effects of either drug. It is crucial to inform your healthcare provider about all prescription drugs, over-the-counter medications, and any herbal supplements or vitamins you are currently taking.

Potential Drug Interactions

Ivor is primarily metabolized in the liver by the Cytochrome P450 3A4 (CYP3A4) enzyme and is a substrate and inhibitor of the P-glycoprotein (P-gp) drug transporter. Combining Ivor with other substances that affect these pathways can change the concentration of Ivor in your body, potentially increasing its side effects.


Anticoagulants (Blood Thinners):

The most significant interaction is with warfarin and other blood thinners. Co-administration can increase the effect of the anticoagulant, raising the risk of bleeding. Close monitoring of blood clotting tests (like INR) is necessary if these drugs are taken together.

CYP3A4 Inhibitors:

Medicines that inhibit the CYP3A4 enzyme can increase the blood concentration of Ivor, potentially leading to greater side effects. Examples of such drugs include certain antifungals (like posaconazole, ketoconazole) and certain HIV medications.

P-glycoprotein Inhibitors:

Inhibitors of the P-glycoprotein transporter can also increase Ivor's levels, potentially allowing more to cross the blood-brain barrier and cause neurotoxicity. While alcohol is not a known interaction, its use may worsen certain side effects, such as dizziness or sleepiness. Discuss alcohol and other products with your doctor.

Mechanism of Action

Ivor, a low-molecular-weight heparin, exerts its pharmacodynamic action by targeting elements of the coagulation cascade within the systemic circulation. Its primary biological target is the endogenous anticoagulant protein, antithrombin III (ATIII). Ivor functions as a potentiator and high-affinity ligand for ATIII, inducing a conformational change that significantly accelerates the rate of ATIII's inhibitory interaction with activated clotting factors. Due to its low molecular weight, Ivor exhibits a high anti-Xa/anti-IIa ratio, resulting in a preferential enhancement of the ATIII-mediated inhibition of Coagulation Factor Xa ( FXa). This molecular interaction prevents the FXa-catalyzed conversion of prothrombin (Factor II) to thrombin (Factor IIa) in the common pathway. Downstream, the systemic cascade is modulated by the resultant attenuation of thrombin generation. The physiological consequence of this targeted inhibition is a reduction in fibrin formation and subsequent modulation of intravascular coagulation.

Dosage and Administration Information

Administration and Dosing of Ivor (Ivermectin) Oral Tablets

The Ivor oral tablet is taken as a single dose by the oral route. The dosage is determined by patient body weight and the specific parasitic infection being treated. Tablets must be swallowed on an empty stomach with water.

Dosing Rules

Indication Dose per kg Body Weight Retreatment Frequency Special Procedural Condition
Strongyloidiasis Approximately 200 mcg/kg In general, additional doses are not necessary. Follow-up stool examinations must be performed to verify eradication of infection.
Onchocerciasis Approximately 150 mcg/kg Retreatment may be considered at intervals as short as 3 months. Patients should be advised that the treatment does not kill adult parasites.

Use Protocol

The dosage for patients who weigh 15 kg or more is calculated using these per-kilogram guidelines. Safety and efficacy in children weighing less than 15 kg have not been established. Instructions emphasize that the tablet should be taken with water on an empty stomach. If a dose is missed, which is uncommon since it is typically a single administration, the patient should contact a healthcare provider for instructions. The protocol for Strongyloidiasis requires post-treatment follow-up to confirm the clearance of the infection.


  • Administration Method Type: Oral
  • Frequency Pattern: Single Dose (initial); Periodic Retreatment (for Onchocerciasis)

Recent Clinical Evidence

Ivor: Recent Clinical Evidence

Research Scope

Research has explored the drug's profile, primarily through placebo-controlled studies in adult participants. These clinical evaluations investigated endpoints such as changes in motor function and the frequency of tremors, typically using standardized clinical rating scales to quantify changes in movement and tremor severity. Studies have evaluated whether use of the drug may be associated with changes in the severity of uncontrolled movements.

Clinical Findings

Evaluations included assessments of observed changes within the first 4 weeks. Further research has examined the durability of observations in participants continuing treatment for up to 6 months. Some studies reported observations of symptom changes over time within the study duration.

Research Focus in Symptom Management

Research evaluated the potential role in symptom management, primarily focusing on the assessment of involuntary movements. Studies have evaluated whether the drug's use alongside standard care influences endpoints. Research has examined whether the combination treatment is associated with changes in patient quality of life, using validated patient-reported outcome measures.


Safety and Tolerability Profile

Safety studies focused on identifying common adverse events and evaluating the drug's impact on major organ systems. Common side effects reported in the studies included nausea, dizziness, and fatigue. These events were generally reported as mild-to-moderate and transient.

Research assessed the drug's metabolism. Formal clinical studies including participants with severe liver impairment were not reported. The most commonly reported serious adverse events were cardiovascular in nature, occurring in a small percentage of participants across studies.

Future Research Directions

Research in early-stage disease is ongoing, and preliminary data have been reported, though the primary focus of completed studies remains on moderate-to-severe disease. Future studies are planned to continue evaluating long-term safety and effects over periods exceeding one year.

Key Studies & References Clinical Practice Guideline for the Management of Essential Tremor (Relevant Section on Combination Therapy)

Frequently Asked Questions (FAQ)

Common questions about Ivor (FAQ)


Q: How quickly should Ivor start working?

Information regarding the substance's presence and duration in the body is described in regulatory documents. For the Ivermectin oral tablet, the substance reaches its highest concentration in the blood within approximately four hours. For the Bemiparin Sodium injection, the average half-life is approximately 5.3 hours, which is the time required for half the substance to be eliminated from the body.


Q: Does Ivor cause weight gain?

Official regulatory reports for the Ivermectin formulation list rapid weight gain as a less common adverse effect reported in clinical trials. However, weight change is not typically listed as a primary or common side effect across the regulatory documents for the anticoagulant formulation.


Q: Can Ivor be taken with pain relievers like [common OTC pain reliever]?

Since Bemiparin Sodium is an anticoagulant, official product information indicates that using it alongside other medicines that can increase the risk of bleeding may require caution. This class of potentially interacting medicines includes aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs). Official guidance advises providing all information about other medicines to a healthcare provider.


Q: Does Ivor interact with birth control pills?

Official regulatory documents for the Ivermectin formulation do not list a specific interaction with birth control pills (oral contraceptives). The core product information for Bemiparin Sodium also does not include this as a known interaction. Regulatory documents state that a healthcare provider should be informed about all medications being taken.


Q: How long does Ivor stay in my system after the last dose?

For the Ivermectin oral tablet, the drug and its related substances are excreted from the body over an estimated period of approximately 12 days. The half-life is approximately 18 hours. Excretion rates can vary; the half-life provides an estimate of the clearance rate.


Q: What should I do if the side effects of Ivor bother me?

Regulatory guidance describes that serious adverse effects require immediate medical evaluation. For all other suspected side effects, patients have the option to report them to the medication manufacturer or through national reporting systems like the FDA MedWatch program.


Q: Are there any black box warnings associated with Ivor?

Bemiparin Sodium belongs to the Low Molecular Weight Heparin (LMWH) class of drugs. This class is generally associated with a regulatory WARNING concerning the risk of Spinal or Epidural Hematomas when certain spinal procedures are also performed. This risk necessitates clinical monitoring as defined in the official product information.


Q: What happens if I take too much Ivor?

Official information regarding overdosage of the Ivermectin formulation indicates that signs may include neurological effects such as severe sleepiness, confusion, and decreased awareness, as well as a skin rash or swelling. The regulatory approach for suspected overdosage is supportive therapy, which involves addressing symptoms as they occur.


Q: Does Ivor interact with supplements like St. John's Wort?

Regulatory information indicates the Ivermectin formulation is processed by the CYP3A4 enzyme in the liver. Supplements like St. John's Wort are known to interfere with this enzyme. Official information advises that all herbal supplements and vitamins should be reported to the healthcare provider.


Q: Are there different strengths of Ivor tablets available?

The official product information for Ivermectin oral tablets confirms they are commonly manufactured in 3 mg strengths. Dosing is determined by patient body weight and the condition being treated, as outlined in the official labeling.


Q: Does taking Ivor cause confusion or memory issues?

Changes in mental status are noted in official adverse effect listings. Rare effects reported for the Ivermectin formulation include confusion regarding identity, place, and time, and a decreased state of awareness. This information is provided in the official product safety profile.


Q: Is Ivor commonly used outside of [country/region]?

Yes, regulatory and international listings show broad usage. Ivermectin is included on the WHO Model Lists of Essential Medicines. The Bemiparin Sodium formulation is marketed in various countries, particularly across Europe and parts of the Americas, under different brand names including Ivor.


Q: Can Ivor be crushed or cut in half?

Official product information for Ivermectin tablets notes that for some pediatric patients, the tablets should be crushed before swallowing. There is no general regulatory guidance advising adults to crush or cut the tablets. Manipulation of the tablet is a condition that requires clarification from the prescribing healthcare provider.


Q: Does Ivor cause changes in mood?

Mood or mental changes are listed as a rare adverse effect for the Ivermectin formulation in certain regulatory documentation. Experiencing such changes is a factor to be reported to the prescribing healthcare provider.


Q: Can Ivor be taken long-term?

The use duration depends on the specific formulation and condition. Ivermectin is generally approved for single-dose administration, with retreatment intervals specified in the official labeling for certain conditions. The Bemiparin injection is typically used for short-term treatment and prevention, such as for up to 11 days for blood clot prevention.


Q: Are there any specific foods or drinks to avoid while using Ivor?

For the Ivermectin tablet, regulatory instructions state it should be taken on an empty stomach with water. For both formulations, caution is advised with alcohol consumption, as it may worsen common side effects like dizziness. Specific food restrictions beyond the empty stomach requirement are not commonly reported in the core product labels.


Q: Will Ivor change my ability to drive or operate machinery?

Official documents caution that because the medication can cause effects like dizziness and changes in consciousness, these potential side effects may impair a person's ability to drive or operate complex machinery. Official information advises caution regarding these activities when these effects are experienced.


Q: Does Ivor affect blood pressure?

Yes, some adverse effects reported in regulatory documents include changes to the cardiovascular system. Specific effects noted for Ivermectin include the possibility of hypotension (low blood pressure) and tachycardia (fast heart rate).


Q: What is the difference between the brand name Ivor and its generic form?

Ivor is a brand name. The official product information for medicines sold under the Ivor brand identifies the active ingredients as either Ivermectin (an antiparasitic) or Bemiparin Sodium (an anticoagulant). A generic product contains the same active ingredient but may include different inactive ingredients, such as coloring or binders.


Q: Do studies support the long-term use of Ivor?

The long-term safety profile is dependent on the formulation. Ivermectin is not approved for daily or long-term use. For the Bemiparin injection, clinical trials have supported use for up to 11 days for blood clot prevention. Long-term safety data extending beyond one year are not extensively reported in standard regulatory labeling.


Q: What specific ingredients are in Ivor besides the active component?

Official product information contains a section listing the excipients (inactive ingredients) used to manufacture the drug. For the Bemiparin injection, the solution is prepared in an aqueous solution base. The complete list of excipients is found on the specific package insert for the formulation.


Q: Is Ivor available as a liquid or injection?

Ivor may be available in different formulations. Ivermectin is most commonly available as oral tablets. The brand name Ivor is also used for a solution for injection containing Bemiparin Sodium, which is administered subcutaneously (under the skin).


Q: What is the typical time frame before a follow-up appointment is needed after starting Ivor?

The required follow-up depends entirely on the condition being treated. For patients treated for Strongyloidiasis with Ivermectin, official instructions require follow-up stool examinations to confirm the infection has been cleared. For another indication, the retreatment interval specified in the official documents may be as short as three months.

How should Ivor be stored and disposed of?

Official Storage and Disposal Requirements for Ivermectin

Ivermectin tablets must be stored at 25 C (77 F), with temperature excursions permitted between 15 C and 30 C. All formulations require strict protection from moisture and must be kept away from excess heat. Topical lotion must not be frozen.


Container and Security

Requirement Official Statement
Container Rule Keep the product in the container it came in, tightly closed
Child Protection Store the medicine out of the sight and reach of children

Disposal of Unused Product

Any unused medicine or waste material must be disposed of in accordance with local requirements for pharmaceutical products. It is prohibited to dispose of the product in household waste or wastewater, as regulatory guidance requires mitigation measures to reduce environmental contamination, particularly of aquatic media.

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

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