A fixed-dose combination (FDC) of a macrocyclic lactone anthelmintic (Ivermectin) and a benzimidazole carbamate anthelmintic (Albendazole). This combination provides a broad-spectrum, synergistic effect against a wide range of nematode (roundworm) infections, particularly effective in community-based Mass Drug Administration (MDA) programs for Lymphatic Filariasis (LF) elimination in India. Ivermectin acts on glutamate-gated chloride channels, while Albendazole inhibits microtubule polymerization.
Adult: For Lymphatic Filariasis MDA & STH: A SINGLE oral dose of Ivermectin (12mg) + Albendazole (400mg), repeated annually in endemic areas. For Strongyloidiasis (off-label): May require repeated doses (e.g., Ivermectin 200 mcg/kg single dose, repeated after 2 weeks).
Note: Administer orally with a full glass of water. SHOULD BE TAKEN WITH FOOD, preferably a fatty meal, to significantly enhance the absorption of both drugs. Tablets may be chewed, crushed, or swallowed whole.
The combination exerts a synergistic anthelmintic effect through two distinct mechanisms. Ivermectin binds with high affinity to glutamate-gated chloride channels (GluCl) found in nerve and muscle cells of invertebrates. This binding increases cell membrane permeability to chloride ions, leading to hyperpolarization, paralysis, and death of the parasite. Albendazole and its active metabolite Albendazole sulfoxide bind to parasite beta-tubulin, inhibiting microtubule polymerization. This disrupts glucose uptake, depletes energy stores (ATP), and inhibits cell division (mitosis), leading to larval degeneration and impaired motility of adult worms.
Pregnancy: CONTRANDICATED. Albendazole is Pregnancy Category C (animal studies show teratogenicity and embryotoxicity). Ivermectin is Category C. Risk of fetal harm. Pregnancy must be excluded before administration in MDA programs. Women of childbearing potential should use effective contraception during and for 1 month after treatment.
Driving: May cause dizziness, vertigo, or blurred vision. Patients should be cautioned about driving or operating machinery until their response is known.
| Rifampicin / Rifabutin | Potent CYP3A4 inducer; may significantly decrease Ivermectin plasma concentrations, reducing efficacy. | Major |
| Phenytoin / Carbamazepine | CYP3A4 inducers; may decrease Ivermectin levels. | Moderate |
| Cimetidine | May increase plasma levels of Albendazole sulfoxide by inhibiting its metabolism. | Moderate |
| Dexamethasone / Praziquantel | May increase plasma levels of Albendazole sulfoxide. | Moderate |
| Warfarin | Albendazole may potentially affect INR; monitoring recommended. | Moderate |
| Theophylline | Ivermectin may potentially inhibit its metabolism; monitor levels. | Minor |
Same composition (Ivermectin (12mg) + Albendazole (400mg)), different brands: