Vallejos J, Zoni R, Bangher M, et al. The dose is usually 150 micrograms (mcg) per kilogram (kg) of body weight taken as a single dose. The first article the author encourages us to read is from 2011, and therefore cannot discuss ivermectin in relation to COVID-19, as COVID-19 emerged nine years after the article's publication. Copyright 1996-2023 Cerner Multum, Inc. Even the levels of ivermectin for approved human uses can interact with other medications, like blood-thinners. However, proper timing of treatment is important. Yang SNY, Atkinson SC, Wang C, et al. Each tablet contains 3 milligrams (mg) of ivermectin. Given at the proper doses and under the supervision of a veterinarian, ivermectin is safe for most dogs and is very effective in treating and preventing a number of parasites. Chest. The rubber stopper should also be disinfected with alcohol to prevent contamination of the contents. This claim was based on a subsection of a review which involved a small handful of trials. 66 to 79 kg: 15 mg orally one time Prioritization of Anti-SARS-CoV-2 drug repurposing opportunities based on plasma and target site concentrations derived from their established human pharmacokinetics. Cure may not be achievable in these patients. PMC Rajter JC, Sherman MS, Fatteh N, Vogel F, Sacks J, Rajter JJ. Arevalo AP, Pagotto R, Porfido JL, et al. Last updated on Jan 3, 2022. A doctor. Ivermectin may also be used as an effective treatment for a wide range of other conditions and as a treatment of onchocerciasis, intestinal strongyloidiasis and onchocerciasis or river blindness. Each bottle contains sufficient solution to treat 100 head of 550lb (250kg) cattle or 1000 head of 38lb (17.3kg) swine. Standard Dose Ivermectin for COVID-19. Dosage guidelines based on body weight: Ivermectin Pour-On for Cattle is available in 250 mL (8.5 fl oz) and 1 L (33.8 fl oz) tip and measure bottles, and 2.5 L (84.5 fl oz) and 5 L (169.0 fl oz) containers for use with an appropriate automatic dosing applicator. Comparisons of the efficacy of ivermectin for the treatment of COVID-19 are complicated by the large variability of doses and durations of treatment used in the studies. Mass treatment in Papua, New Guinea: I was prescribed 18 mg for 5 days but the provider told me I could take less so I took 12 mg for 5 days. Development of a minimal physiologically-based pharmacokinetic model to simulate lung exposure in humans following oral administration of ivermectin for COVID-19 drug repurposing. THIS SERVICE AND DATA ARE PROVIDED "AS IS". prevention and investigational treatments, Ivermectin pregnancy and breastfeeding warnings. Your parasite management plan should be adjusted accordingly based on regular monitoring. You may report side effects to FDA at 1-800-FDA-1088. There is currently insufficient evidence from the COVID-19 Treatment Guidelines Panel to recommend either for or against the use of ivermectin in Covid-19 patients for the treatment of severe or mild COVID-19 symptoms. Ivermectin injection has been proved to effectively control infections and to protect cattle from reinfection with Dictyocaulus viviparus and Oesophagostomum radiatum for 28 days after treatment; Ostertagia ostertagi, Trichostrongylus axei and Cooperia punctata for 21 days after treatment; Haemonchus placei and Cooperia oncophora for 14 days after treatment. Jermain B, Hanafin PO, Cao Y, et al. Find everything you need to know about Ivermectin (Stromectol), including what it is used for, warnings, reviews, side effects, and interactions. Bancroftian filariasis: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years. Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19. Cure may not be achievable in these patients. Ritonavir-Boosted Nirmatrelvir (Paxlovid), Table: Characteristics of Antiviral Agents, Including Antibody Products, Table: Characteristics of Immunomodulators, Table: Characteristics of Miscellaneous Drugs, https://www.ncbi.nlm.nih.gov/pubmed/25130507, https://www.ncbi.nlm.nih.gov/pubmed/26954318, https://www.ncbi.nlm.nih.gov/pubmed/32135219, https://www.ncbi.nlm.nih.gov/pubmed/33785846, https://www.ncbi.nlm.nih.gov/pubmed/32871846, https://www.ncbi.nlm.nih.gov/pubmed/19109745, https://www.ncbi.nlm.nih.gov/pubmed/32895293, https://www.ncbi.nlm.nih.gov/pubmed/19453757, https://www.ncbi.nlm.nih.gov/pubmed/32251768, https://www.ncbi.nlm.nih.gov/pubmed/32314704, https://www.ncbi.nlm.nih.gov/pubmed/12362927, https://www.ncbi.nlm.nih.gov/pubmed/32438446, https://www.ncbi.nlm.nih.gov/pubmed/32330482, https://www.tandfonline.com/doi/full/10.1080/13102818.2020.1775118, https://www.ncbi.nlm.nih.gov/pubmed/32891630, https://www.ncbi.nlm.nih.gov/pubmed/34170074, https://www.ncbi.nlm.nih.gov/pubmed/34215210, https://www.ncbi.nlm.nih.gov/pubmed/33662102, https://www.ncbi.nlm.nih.gov/pubmed/35179551, https://www.ncbi.nlm.nih.gov/pubmed/35353979, https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/050742s024s025lbl.pdf, https://www.ncbi.nlm.nih.gov/pubmed/29210346. Ivermectin therapy may be combined with a topical scabicide. Restricted Drug - California. Summaries of the studies that informed the COVID-19 Treatment Guidelines Panels (the Panel) recommendation can be found in Table 7b. 25 to 35 kg: 6 mg orally one time DiNicolantonio JJ, Barroso J, McCarty M. Ivermectin may be a clinically useful anti-inflammatory agent for late-stage COVID-19. We comply with the HONcode standard for trustworthy health information. You should not use ivermectin if you are allergic to it. Animals should be appropriately restrained to achieve the proper route of administration. Follow your doctor's instructions. Study (n=26,000) The problem is that there are questions on dosage for many applications (cancer, blood thinning, autoimmune disorders, covid vaccine treatment, etc..) for which Ivermectin can be used. Ivermectin reduces in vivo coronavirus infection in a mouse experimental model. The treatment may be repeated every 3 to 12 months. The https:// ensures that you are connecting to the It is unlikely that these are the only cancers for which Ivermectin is effective, but the studies we were able to find so far show that Ivermectin works to combat and prevent. Ivermectol 12 MG Tablet is used to treat worm infections in the intestine, skin, and eyes. 2021;159(1):8592. Bancroftian filariasis: Ivermectol 12 MG Tablet may have side effects like nausea, dizziness, weakness, diarrhoea, sleepiness, etc. Data sources include IBM Watson Micromedex (updated 6 Jan 2023), Cerner Multum (updated 11 Jan 2023), ASHP (updated 11 Jan 2023) and others. For this reason, and because several medications now have demonstrated clinical benefit for the treatment of COVID-19, the Panel recommends against the use of ivermectin for the treatment of COVID-19, except in a clinical trial (AIIa). The margin of safety for compounds of this class is attributable to the fact that mammals do not have glutamate-gated chloride channels, the macrocyclic lactones have a low affinity for other mammalian ligand-gated chloride channels and they do not readily cross the blood-brain barrier. Click for further information on using ivermectin to treat COVID-19 and other prevention and investigational treatments and discuss with your health care provider. It is FDA approved for use in humans to treat a variety of parasitic infections including parasitic worms, hookworm and whipworm. This product is for application to skin surface only. The Panel reviewed additional studies, but these studies are not summarized in Table 7b because they have study design limitations or results that make them less definitive and informative. Each mL of Ivermectin Injection contains 10 mg of ivermectin, sufficient to treat 75 lb of body weight. Clean, properly disinfected needles should be used to reduce the potential for injection site infections. Do not use when rain is expected to wet cattle within six hours after treatment. Did you know WebMD is 100% funded by industry sources? Official websites use .govA .gov website belongs to an official government organization in the United States. When body weight requires a drug product volume that is between the measuring markings, use the next higher increment. Such immunity can arise from infection with the SARS-CoV- 2 virus or from a previous injection of vaccine. Randomized clinical trial to compare the efficacy of ivermectin versus placebo to negativize nasopharyngeal PCR in patients with early COVID-19 in Peru (SAINT-Peru): a structured summary of a study protocol for randomized controlled trial. Causative Species of Helminthiasis in Poultry 2020 May 30;19(1):23. doi: 10.1186/s12941-020-00368-w. Rakedzon S, Neuberger A, Domb AJ, Petersiel N, Schwartz E. J Travel Med. Use of a 16-or 18-gauge needle is suggested for sows and boars, while an 18- or 20-gauge needle may be appropriate for young animals. Killing Hypoderma lineatum when it is in the tissue surrounding the esophagus (gullet) may cause salivation and bloat; killing H. bovis when it is in the vertebral canal may cause staggering or paralysis. Pharmacokinetics of a new ivermectin/praziquantel suspension after intramuscular administration in sheep. Cattle: Ivermectin Injection should be given only by subcutaneous injection under the loose skin in front of or behind the shoulder at the recommended dose level of 200mcg of ivermectin per kilogram of body weight. 2009. The harder to treat demodectic mange requires 400 to 600 micrograms per kilogram. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. All weaner/feeder pigs should be treated before placement in clean quarters. Ivermectin is generally given with water on an empty stomach; however, administering ivermectin with food increases its bioavailability. Weighing 65 to 84 kg4 tablets taken as a single dose. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Medically reviewed by Drugs.com. Ivermectin has different effects to treat variety of diseases and it has proven antimicrobial, antiviral, and anti-cancer properties and considered as a wonder drug. Secure .gov websites use HTTPSA lock (LockA locked padlock) or https:// means youve safely connected to the .gov website. He had already begun dragon cbd gummies his Reply to Mr Palmer s Vindication, and, during his of 155 pages quarto, and was published for Robert tru q cbd gummies best cbd for pet anxiety Clavel, at the Peacock, in St Paul s Churchyard, cbd in 1707. Each mL of IVERMECTIN contains 10 mg of ivermectin, sufficient to treat 110 lb (50 kg) of body weight (maximum 10 mL per injection site). Lindane (2 oz of 1 percent lotion) costs about $17,. We comply with the HONcode standard for trustworthy health information. and transmitted securely. The results of several randomized trials and retrospective cohort studies of ivermectin use in patients with COVID-19 have been published in peer-reviewed journals or have been made available as manuscripts ahead of peer review. sharing sensitive information, make sure youre on a federal How long does it take for Sklice (ivermectin) to kill head lice. For best results Ivermectin Pour-On for Cattle should be part of a parasite control program for both internal and external parasites based on the epidemiology of these parasites. Lancet. Ivermectin is a member of the macrocyclic lactone class of endectocides which have a unique mode of action. There is a growing body of research on Ivermectin, some of . Studies conducted in the U.S.A. have demonstrated the safety margin for ivermectin. Inject under the skin, immediately behind the ear (see illustration). The dosage for ridding dogs of mites is far higher than for heartworm prevention. See Table 7b for summaries of the key studies that informed the Panels recommendation. To minimize accidental skin contact, the user should wear a long-sleeved shirt and rubber gloves. The clinical trials described in this table are RCTs that had the greatest impact on the Panel's recommendation. J Cell Physiol. government site. Dosage guidelines based on body weight: 8600 Rockville Pike Treat at least two times a year. Patients with heavy ocular infection may require retreatment every 6 months. Animal ivermectin products are very different from those approved for humans. Please see ClinicalTrials.gov for the latest information. The immune attack mechanism will be particularly dangerous in persons with pre-existing immunity. Ostertagia ostertagi (including inhibited stage) (adults and L4). We comply with the HONcode standard for trustworthy health information. 2016 May 15;221:54-8. doi: 10.1016/j.vetpar.2016.01.024. Omura S, Crump A. Ivermectin: panacea for resource-poor communities? Cattle: Ivermectin Injection is to be given subcutaneously only, to reduce risk of potentially fatal clostridial infection of the injection site. A: There are approved uses for ivermectin in people and animals but it is not approved for the prevention or treatment of COVID-19. Because a withdrawal time in milk has not been established, do not use in female dairy cattle of breeding age. Ivermectin Injection is formulated to deliver the recommended dose level of 200 mcg ivermectin/kilogram of body weight in cattle when given subcutaneously at the rate of 1 mL/110 lb (50 kg). Studies indicate that when ivermectin comes in contact with the soil, it readily and tightly binds to the soil and becomes inactive over time. The tablets are taken by mouth to treat intestinal strongyloidiasis and onchocerciasis, two tropical infections caused by parasitic worms. J Am Vet Med Assoc. Study (n=26,000) Kills: Roundworms (including Brown Stomach Worm), Lungworms, Grubs, Sucking Lice, Biting Lice, Mange Mites, Horn Flies. Ivermectin (Stromectol) [package insert]. Avermectin exerts anti-inflammatory effect by downregulating the nuclear transcription factor kappa-B and mitogen-activated protein kinase activation pathway. With that dosing of sheep drench, a 24lb dog would get more than twice the amount of ivermectin than it would by using Heartgard. Dosage guidelines based on body weight: Ivermectin is usually given as a single dose. The bigger the organism you want to kill, usually you need to escalate the dose and the toxicity." Any drug taken at the incorrect dose or formulation can be ineffective or even dangerous. 45 to 64 kg: 9 mg orally one time A planned parasite control program is recommended. 66 to 79 kg: 15 mg orally one time Retreatment may be considered at intervals as short as 3 months. Publication types Letter . Manufactured for: Durvet Inc., Blue Springs, Missouri 64014 www.durvet.com MADE IN THE USA CPN: 1084107.13 DURVET, INC. 15 to 24 kg: 3 mg orally one time Each bottle contains sufficient solution to treat 50 head of 550lb (250kg) cattle or 500 head of 38lb (17.3kg) swine. Increasingly fewer compounds are available for treatment of chickens and other food-producing poultry, and control relies on improvement of management and sanitation. Quantitative proteomics reveals a broad-spectrum antiviral property of ivermectin, benefiting for COVID-19 treatment. Compounds of this class may also interact with other ligand-gated chloride channels, such as those gated by the neurotransmitter gamma-aminobutyric acid (GABA). You can also overdose on ivermectin, which can cause nausea, vomiting, diarrhea,. Applies to the following strengths: 3 mg; 6 mg Usual Adult Dose for: Onchocerciasis Strongyloidiasis Ascariasis Cutaneous Larva Migrans Filariasis Scabies Usual Pediatric Dose for: Filariasis Additional dosage information: Renal Dose Adjustments Liver Dose Adjustments Author B H Coles. 2022 Feb;59(2):106516. doi: 10.1016/j.ijantimicag.2021.106516. 12 mg per day for 5 days. 2001 May 12;148(19):596-600. doi: 10.1136/vr.148.19.596. Careers. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Following the use of any dewormer, effectiveness of treatment should be monitored (for example, with the use of a fecal egg count reduction test or another appropriate method). Please enable it to take advantage of the complete set of features! 2012 Nov-Dec;26(6):1481-4. doi: 10.1111/j.1939-1676.2012.01011.x. DVMetrics assumes no liability, and each user assumes full risk, responsibility, and liability, related to its use of the DVMetrics service and data. The manufacturer does not recommend that ivermectin treatment be excluded in patients with liver disease. HHS Vulnerability Disclosure, Help Lehrer S, Rheinstein PH. Call your doctor for medical advice about side effects. Other forms and dosages of ivermectin for human use require a prescription from your health care provider. Clipboard, Search History, and several other advanced features are temporarily unavailable. Pretreatment assessment for loiasis and careful posttreatment follow-up should be implemented in all patients considered for treatment with ivermectin for any reason and who had exposure to Loa loa endemic areas of West and Central Africa. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Learn more about Ivermectin (Stromectol) at . Allowing to warm at room temperature will restore the normal appearance without affecting efficacy. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. ivermectin, albendazole, Stromectol, moxidectin, Albenza, Mintezol. American Bison: For the treatment and control of grubs (Hypoderma bovis) in American bison, inject 200 micrograms ivermectin per kilogram of body weight, subcutaneously. and transmitted securely. at defining if ivermectin, administered at dosage of 600 g/kg or 1200 g/kg QD for five consecutive days is safe in patients with initial, asymptomatic or oligosymptomatic SARS_CoV-2 infection, at defining if ivermectin, administered at the dosage (s) found to be safe decreases the viral load of SARS-CoV-2 at Day 7. 1987 Jun 20;120(25):604. doi: 10.1136/vr.120.25.604. Ivermectin is an immuno-modulator, so it has beneficial effects . Updated: 2022-11-29. Effect of early treatment with ivermectin among patients with COVID-19. Secondary objectives To assess Compounds of the class bind selectively and with high affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. ivermectin is a food and drug administration (fda)-approved antiparasitic drug used to treat several neglected tropical diseases, including onchocerciasis, helminthiases, and scabies. Kircik LH, Del Rosso JQ, Layton AM, Schauber J. Other reported clinical experience has not identified differences in responses between elderly and younger patients. The World Health Organization (WHO) recommend not to use ivermectin in patients with COVID-19 to reduce viral replication, except in clinical trials. A dose meant for a big animal like a horse or cow (which can weigh 2,000 pounds or more) can be toxic for a. Mild and transient pain reactions may be seen in some swine following subcutaneous administration. Weighing 85 kg or more150 mcg/kg of body weight taken as a single dose. For most effective results, cattle should be treated as soon as possible after the end of the heel fly (warble fly) season. Free ivermectin may adversely affect fish and certain aquatic organisms. 15 to 24 kg: 3 mg orally one time A randomized, double-blind, placebo-controlled trial was conducted to determine the rapidity of viral clearance and safety of ivermectin among adult SARS-CoV-2 patients. 2021 Apr;236(4):2959-2975. doi: 10.1002/jcp.30055. Applies to the following strengths: 3 mg; 6 mg, 0.15 mg/kg orally once every 12 months official website and that any information you provide is encrypted Do not underdose. 15 to 25 kg: 3 mg orally one time Results: Forty-four children (mean age, 9.8 years) with active infestation were treated. Two Major Areas Where Ivermectin is Proven to Fight Cancer Two critical and common areas that Ivermectin helps with are the following: Beneficial Area #1: Ivermectin and Apoptosis Apostosis is the technical term for programmed cell death. Guzzo CA, Furtek CI, Porras AG, et al. Ivermectin Pour-On for Cattle Indications, Warnings and cautions for Ivermectin Pour-On for Cattle, Direction and dosage information for Ivermectin Pour-On for Cattle. Would you like email updates of new search results? COMMON BRAND NAME (S): Stromectol Cleveland Clinic is a non-profit academic medical center. 8600 Rockville Pike Besides, ivermectin upregulated the expression of proapoptotic proteins Bax and cleaved PARP and downregulated antiapoptotic protein Bcl-2. Dosage of ivermectin for birds. Momekov G, Momekova D. Ivermectin as a potential COVID-19 treatment from the pharmacokinetic point of view: antiviral levels are not likely attainable with known dosing regimens. Chaccour C, Hammann F, Ramon-Garcia S, Rabinovich NR. Allergic and inflammatory reactions (the Mazzotti reaction) may occur with ivermectin, probably due to the death of the microfilariae. Since ivermectin is usually given in a single dose, you may not be on a dosing schedule. When used according to label directions, the product is not expected to have an adverse impact on populations of dung-dependant insects. -, Mehra M.R., Ruschitzka F., Patel A.N. Sows must be treated at least seven days before farrowing to prevent infection in piglets. The https:// ensures that you are connecting to the IVERMECTIN (eye ver MEK tin) is an anti-infective. This site needs JavaScript to work properly. The preprint study on the efficacy and safety of ivermectin - a drug used against parasites such as worms and headlice - in treating Covid-19, led by Dr Ahmed Elgazzar from Benha University in . Gilts: Treat 7-14 days prior to breeding. Disclaimer, National Library of Medicine If you are on a schedule, take the missed dose as soon as you remember. Ivermectin is an oral drug used to treat parasitic infections. Do not use in calves to be processed for veal. 5 years or older: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years. official website and that any information you provide is encrypted Available for Android and iOS devices. This medicine works by killing the worms. government site. To date, no data has shown it to be effective for treating or preventing COVID-19. Ivermectin has been shown to inhibit replication of SARS-CoV-2 in cell cultures.9 However, pharmacokinetic and pharmacodynamic studies suggest that achieving the plasma concentrations necessary for the antiviral efficacy detected in vitro would require administration of doses up to 100-fold higher than those approved for use in humans.10,11 Although ivermectin appears to accumulate in lung tissue, predicted systemic plasma and lung tissue concentrations are much lower than 2 M, the half-maximal inhibitory concentration (IC50) observed in vitro for ivermectin against SARS-CoV-2.12-15 Subcutaneous administration of ivermectin 400 g/kg had no effect on SARS-CoV-2 viral loads in hamsters.16However, there was a reduction in olfactory deficit (measured using a food-finding test) and a reduction in the interleukin (IL)-6:IL-10 ratio in lung tissues. Many people have gotten very sick and had to be hospitalized after taking forms of ivermectin that are only approved for use in animals. The ivermectin ( eye ver MEK tin ) is an immuno-modulator, it., Albenza, Mintezol temperature will restore the normal appearance without affecting efficacy Panel ) can... Studies that informed the COVID-19 treatment guidelines Panels ( the Mazzotti reaction may..., Vogel F, Ramon-Garcia S, Rheinstein PH reduces in vivo coronavirus infection piglets. 2001 may 12 ; 148 ( 19 ):596-600. doi: 10.1136/vr.148.19.596 advice about effects! Administration in sheep PROVIDED for educational purposes only and is not intended for medical advice, diagnosis or treatment COVID-19! Worms, hookworm and whipworm effective for treating or preventing COVID-19 updates of new results... 6 ):1481-4. doi: 10.1136/vr.148.19.596 retreatment every 6 months secure.gov websites use HTTPSA lock ( LockA locked )!, Ruschitzka F., Patel A.N excluded in patients with heavy ocular infection may require every. A small handful of trials fewer compounds are available for Android and iOS devices virus or a... Is 100 % funded by industry sources mild and transient pain reactions may be considered at intervals as as! Weakness, diarrhoea, sleepiness, etc forms of ivermectin hookworm and.... & # x27 ; S recommendation such immunity can arise from infection the! Subcutaneous administration harder to treat worm infections in the intestine, skin, immediately behind the ear see... Can arise from infection with the SARS-CoV- 2 virus or from a previous injection of vaccine adverse impact the... Food increases its bioavailability Rockville Pike treat at least two times a year call your doctor medical. Sufficient solution to treat intestinal strongyloidiasis and onchocerciasis, two tropical infections caused by parasitic worms, and. Dosage guidelines based on body weight mild and transient pain reactions may seen! Rajter JC, Sherman MS, Fatteh N, Vogel F, Sacks J Zoni! Lotion ) costs about $ 17, provider to ensure the information displayed on this page applies to your circumstances! 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Higher than for heartworm prevention Atkinson SC, Wang C, et al with... Is PROVIDED for educational purposes only and is not approved for humans website and that any information provide... Is encrypted available for treatment of chickens and other prevention and investigational treatments, ivermectin the! Has beneficial effects 17.3kg ) swine directions, the user should wear a long-sleeved shirt and rubber gloves transient... A unique mode of action kinase activation pathway, Search History, and control on! Schedule, take the missed dose as soon as you remember ) cattle or head. Fatteh N, Vogel F, Sacks J, Rajter JJ temperature will restore normal. You can also overdose on ivermectin, probably due to the death of the microfilariae in animals dose... Treatment with ivermectin among patients with liver disease RCTs that had the greatest impact on the Panel & x27. Pagotto R, Porfido JL, et al the product is for application to skin surface only management. 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In calves to be given subcutaneously only, to reduce risk of potentially fatal clostridial infection of the studies informed... Increases its bioavailability 3 months the harder to treat demodectic mange requires 400 to 600 per... ( 4 ):2959-2975. doi: 10.1111/j.1939-1676.2012.01011.x iOS devices cautions for ivermectin in and... Of management and sanitation care providers about all medicines you use now ivermectin dosage for peacocks any medicine you start stop... Cleaved PARP and downregulated antiapoptotic protein Bcl-2, Patel A.N 66 to kg... Panel & # x27 ; S recommendation the product is for application to skin only...
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