Two cases of the use of ivermectin during pregnancy have been reported. These reports found that the risk of fetal damage in pregnant women treated with ivermectin was no greater than control. The risk versus benefit should be considered in pregnant women heavily infected with parasites, especially during mass distribution of ivermectin in endemic areas. The advantage of treatment may outweigh any potential risk to the infant.

Ivermectin has been assigned to pregnancy category C by the FDA. Animal studies have revealed evidence of teratogenicity, but at doses that were also maternotoxic to the pregnant female. The manufacturer considers ivermectin contraindicated during pregnancy.

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Ivermectin is excreted into human milk in low concentrations. The manufacturer recommends that treatment during nursing only occur if the risk of delayed treatment to the mother outweighs the possible risk to the infant.

One review article recommends the use of ivermectin in lactating women after the infant is 7 days old.

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