200 mcg/kg is arithmetic, not folklore
Human Stromectol dosing for intestinal strongyloidiasis is a single oral amount designed to give about 200 mcg of ivermectin per kilogram. The tablet is 3 mg. You count tablets from the label table, or you calculate once weight exceeds the printed bands.
Onchocerciasis uses about 150 mcg/kg and a different tablet-count table. Forum posts that say 'everyone takes five' skip both tables. Five 3 mg tablets is the strongyloides band for 66-79 kg, not a universal adult charm.
Indication first: label-lane reviews. Panel: ivermectin. This signal rates the math. It is not a COVID story and will not become one in the closing paragraph.
| Strongyloides kg | 3 mg tablets | Board note |
|---|---|---|
| 15-24 | 1 | Label Table 1 |
| 25-35 | 2 | Label Table 1 |
| 36-50 | 3 | Label Table 1 |
| 51-65 | 4 | Label Table 1 |
| 66-79 | 5 | Label Table 1 |
| 80+ | 200 mcg/kg | Prescriber confirms count |
Empty stomach still gates the weight dose
Perfect arithmetic with breakfast is still a failed administration. Take the full counted dose together with water unless the prescriber splits for nausea. Spreading tablets across days from a calendar is not the single-dose table.
If vomiting happens soon after the count, call the clinic. Do not automatically repeat the whole band at midnight. Exposure after a vomit is a clinical judgment, not a forum poll.
Edema and winter coats lie about kilograms. Weigh in the morning, shoes off, after the bathroom, not after a salty dinner. A 4 kg fluid swing can move a borderline patient across a tablet band. Write 'edema' on the scrap paper if the heart-failure clinic already knows that.
Caregivers should see the multiplication. A spouse who hears 'about five' and adds a sixth 'for luck' is how 18 mg becomes 21 mg. Circle the band on a printed table. Tape it to the bag.
Arithmetic tags that pass
- Species, then kg, then table or formula.
- Write mg = mcg/kg times kg / 1000.
- No weekly self-dose from leftover 3 mg.
Scrap paper that prevents a seventh tablet
Write species, mcg/kg target, kilograms, milligrams, then tablets. Circle the leftover decimal. That decimal is the prescriber's rounding problem, not a lucky extra 3 mg.
Household scales that disagree by three kilograms need one chosen morning reading. Rechecking after lunch is not a second opinion. Rechecking on a pharmacy scale the same morning is.
Amputee and wheelchair weights need a documented method. Do not borrow a cousin's 70 kg. Labelled bands start at 15 kg because small errors are large percentages in children.
Caregivers who hear 'about five' add a sixth. Tape the printed band to the bag. Show mg = mcg per kg times kg divided by 1000, then divide by 3, then stop.
Immunocompromised repeats are clinic repeats. Leftover tablets in a travel pouch are not a Saturday standing order. Forum five-counts without a species line fail before the multiplication starts.
Borderline kilograms need paper math
Weights at 80 kg (strongyloides) and 85 kg (oncho) leave the simple rows. 82 kg times 200 mcg/kg is 16.4 mg. That is not automatically six tablets. The prescriber confirms five versus six. Never round up for luck.
Weigh in kilograms the morning of the dose if the chart weight is old. A winter coat guess is how a 64 kg patient gets a 66-79 kg five-tablet row. Shoes off, number written, then the count.
Edema weight versus true kilograms
A 90 kg reading that is 6 kg of loop-diuretic-responsive fluid is not the same lean mass as a stable 90 kg. Ask the prescriber which weight to use when the patient is wet. Guessing high and rounding up is how extra 3 mg tablets appear.
Amputees and wheelchair scales need a documented method. Do not steal a cousin's 70 kg and call it close. The labelled bands start at 15 kg for a reason: small errors are large percentages in children.
If two household scales disagree by 3 kg, pick one, write it, and stay there for the count. Rechecking on a pharmacy scale the same morning is reasonable. Rechecking after lunch is not.
Show mg = mcg per kg times kg divided by 1000. Then divide by 3. Then stop. The leftover decimal is the prescriber's rounding problem, not a seventh tablet.
How a 3 mg tablet becomes a count
200 mcg/kg is 0.2 mg/kg. A 70 kg adult on the strongyloides target needs about 14 mg, which is the five-tablet band (15 mg) on the printed table. Do not 'round up for luck' to six. Extra milligrams are not a cleaner stool.
Show the multiplication on paper before the first swallow. Pharmacists can check it. Caregivers should see it. Verbal 'about five' fails at band borders.
| Oncho kg | 3 mg tablets | mcg/kg target |
|---|---|---|
| 15-25 | 1 | 150 |
| 26-44 | 2 | 150 |
| 45-64 | 3 | 150 |
| 65-84 | 4 | 150 |
| 85+ | calculate | 150 mcg/kg |
Strongyloides table versus oncho table
Oncho bands differ: 15-25 kg one tablet, 26-44 kg two, 45-64 kg three, 65-84 kg four, and 85 kg or more by 150 mcg/kg. Using the strongyloides five-tablet row for a 70 kg oncho patient overshoots the oncho table.
Write the infection name above the arithmetic. People who memorize one poster and apply it to the other parasite collect the wrong count. Yuki Tanaka wants the species on the bag, then the kg, then the tablets.
Pediatric rows stay with the prescriber
Children use the labelled weight rows with oversight. Do not scale an adult forum count by age. A 20 kg child on strongyloides is one 3 mg tablet on Table 1, not 'half of dad's five.' Poison control for veterinary exposures, not Stromectol improvisation.
School nurses calling about paste ingestion need toxicology, not this table. The label lane already closed that conversion.
Vomiting after a counted band
Call the clinic. Do not automatically repeat the whole band at midnight. Exposure after a vomit is a clinical judgment, not a forum poll.
Food before the count is an administration error, not a reason to double at night. Next time, empty stomach, water, tablets together unless a clinician split for nausea.
Pediatric handfuls already swallowed are poison control, not a 15-24 kg row after the fact. Age is not a row. Weigh, then use the labelled band with the prescriber.
Borderline 80 kg strongyloides and 85 kg oncho leave the simple rows. Paper math, then confirmation. Never round up for luck to a seventh tablet.
Write the stool or program date on the same card as the count. A perfect multiplication without follow-up is an unfinished rating. Indication still lives on label lane.
Why forum tablet counts fail
Forums flatten 200 mcg/kg into 'five for adults' and flatten 150 into the same five. They skip stool follow-up. They add COVID. Those posts fail every rating this site uses.
Sephira will not invent a Stromectol brand dollar to sell a count. Generic 3 mg x 10 cash on our fill card is $36.45 / $23.76 on GoodRx. The window prices what it stocks. The math does not change with the receipt.
Immunocompromised hosts and HTLV-1 stories are specialist repeats, not a forum 'take five every Saturday.' If the stool is still positive, the next count is a clinic count. Leftover tablets in a travel pouch are not a standing order.
Pediatric paste exposures still end this table. School nurses get poison control, not a 15-24 kg row. Adults who 'taste-tested' paste to match 200 mcg/kg get the same stop.
Shoes-off mornings before the band
Weigh after the bathroom, shoes off, before breakfast. A winter coat guess is how a 64 kg patient gets a 66-79 kg five-tablet row.
Oncho at 70 kg is often four 3 mg tablets at 150 mcg/kg. Strongyloides at 70 kg is the five-tablet 200 mcg/kg band. Write 150 or 200 at the top before you multiply.
Ninety kilograms times 200 mcg/kg is 18 mg on paper. The prescriber still confirms. Do not add a seventh for the extra kilos.
Show the arithmetic to every caregiver. Verbal about five fails at band borders. Tape the table to the bag. Indication still gates the math on label lane.
Weight rating before the first swallow
Show kg times mcg/kg. Pick the correct table. Empty stomach. Stool or program follow-up after. Reviewed 21 August 2026.
Indication check on label lane. Educational - disclaimer.