Ivermectin +Albendazole Tablet

This tablet combines two antiparasitic medicines.

Ivermectin 6 mg treats several worm and parasite infections.

Ivermectin 40 mg treats intestinal worms.

Together they cover a broader range of parasites.

They are used for intestinal worm infections.

They are also used for lymphatic filariasis.

Lymphatic filariasis is the infection that causes elephantiasis.

The combination is widely used in deworming programmes.

Parasite nerve and muscle cells have glutamate-gated chloride channels.

Ivermectin binds to those channels and opens them.

Chloride ions flood into the parasite cell.

The cell becomes electrically inactive.

The parasite is paralysed and then dies.

Human nerve cells lack these particular channels.

Ivermectin 24 mg also barely crosses the human blood-brain barrier.

That is why it is selective for the parasite.

Worm cells rely on a protein called beta-tubulin.

Beta-tubulin builds the internal scaffolding of the cell.

Albendazole binds to worm beta-tubulin and blocks it.

The worm can no longer absorb glucose.

It loses its energy supply and dies.

The two drugs attack parasites by different routes.

Each covers species the other covers less well.

Combining them clears more infections in one course.

It also reduces the chance of drug resistance developing.

Individual therapy treats a diagnosed infection.

That course is once daily for three days.

Mass drug administration is a public health programme.

That uses a single dose, repeated annually or six-monthly.

The two are not interchangeable.

In community programmes a height pole is often more practical than weighing scales. Both measures appear in the authorised product information, and either is acceptable.

This combination is not approved below 5 years of age or below 15 kg. Any child’s dose must come from the prescriber and the pack insert.

Take the tablet exactly as your doctor has directed.

Swallow the tablet with water.

Albendazole is better absorbed when taken with food.

A fatty meal improves its absorption further.

Ivermectin absorption is affected by food differently.

Follow the specific instruction on your pack.

Do not drink orange juice with this medicine.

Orange juice reduces how much ivermectin you absorb.

Do not drink grapefruit juice with this medicine.

Grapefruit juice raises albendazole levels.

Complete the full course even if you feel well.

All household members may need treating at the same time.

Wash hands thoroughly and keep fingernails short.

Wash bedding and underwear in hot water.

Known allergy to ivermectin or albendazole.

Known allergy to benzimidazole medicines.

Known allergy to any tablet ingredient.

High Loa loa microfilaraemia.

Mass treatment in Loa loa areas without risk measures.

Mass treatment during pregnancy.

Mass treatment in women intending to become pregnant.

Children under 5 years, or under 15 kg.

Mass treatment is contraindicated in pregnancy.

Individual treatment is not recommended in pregnancy.

That applies especially during the first trimester.

It may be used only if the clinical need outweighs the risk.

Use effective contraception for one month before treatment.

Continue it throughout the treatment course.

Continue it for one month after treatment ends.

This applies to individual and mass treatment.

Tell your doctor at once if you become pregnant.

Less than 2% of an ivermectin dose reaches breast milk.

In mass treatment, avoid it in the first week after birth.

Discuss breastfeeding with your doctor before treatment.

These include Stevens-Johnson syndrome.

They also include toxic epidermal necrolysis.

Both are life-threatening skin conditions.

Early signs are a spreading rash with blisters.

Peeling skin and mouth or eye sores are warning signs.

Fever often accompanies the rash.

Stop the medicine immediately if these appear.

Seek emergency medical care at once.

Do not take this medicine again afterwards.

Mild to moderate liver enzyme rises are very common.

Liver function monitoring is advised during individual therapy.

Low white cell counts have been reported uncommonly.

Severe blood disorders are very rare with short courses.

Those include pancytopenia and aplastic anaemia.

Intensive fortnightly blood counts and liver tests are required for the prolonged high-dose albendazole courses used in hydatid disease and neurocysticercosis. A three-day deworming course is not the same thing and does not require that schedule. Do not transfer those monitoring instructions onto this page.

Some people carry an unsuspected brain tapeworm cyst.

This is called neurocysticercosis.

It is more likely in areas with high pork tapeworm rates.

Treatment can trigger inflammation around a cyst.

That can cause seizures or raised pressure in the skull.

Tell your doctor about any history of seizures.

Report any new severe headache or fit after treatment.

Any liver disease or previous hepatitis.

Any blood disorder, or low blood counts.

Any history of seizures or epilepsy.

Asthma, which can worsen during treatment.

A weakened immune system, including HIV infection.

Any time lived in or travelled to Central or West Africa.

Any known eye worm or skin worm infection.

Pregnancy, suspected pregnancy, or breastfeeding.

Whether you are trying to conceive.

All other medicines, including warfarin and anticonvulsants.

I have a prescription and a confirmed or suspected diagnosis.

I weigh at least 15 kg and am at least 5 years old.

My doctor has told me how many tablets to take.

My doctor has told me how many days to take them.

I have told my doctor about any travel to Africa.

I am not pregnant and not trying to conceive.

I am using effective contraception if relevant.

I have no allergy to benzimidazole medicines.

I know to stop if a severe rash develops.

I will avoid orange and grapefruit juice.

I know my household may need treating too.

In filariasis and similar infections, itching, rash and fever soon after treatment can come from the body reacting to dying parasites rather than from the medicine itself. This is expected, usually mild and short-lived, but severe reactions still need medical review.

Clarithromycin and other macrolide antibiotics.

Ketoconazole and itraconazole.

Verapamil and diltiazem.

These are CYP3A4 inhibitors.

Grapefruit juice.

Dexamethasone raises the active metabolite by about 56%.

Praziquantel raises it by about 50%.

Cimetidine raises it in bile and cyst fluid.

Orange juice reduces ivermectin absorption.

Phenytoin and carbamazepine lower albendazole metabolite levels.

Phenobarbital has the same effect.

Warfarin: rare reports of a raised INR.

Have your INR checked if you take warfarin.

Theophylline levels may change; monitoring advised.

Alcohol and sedatives may theoretically add to neurotoxicity.

Tell your doctor about every medicine you take.

A spreading rash with blisters or peeling skin.

Sores in the mouth, eyes or genital area.

A rash with fever and feeling very unwell.

Swelling of the face, lips, tongue or throat.

Difficulty breathing or swallowing.

A seizure or fit.

Severe or sudden confusion or drowsiness.

A severe headache with vomiting.

Neck stiffness with fever.

Unusual bruising or bleeding.

A sore throat with high fever.

Your skin or eyes turn yellow.

Your urine becomes dark.

You have persistent severe abdominal pain.

You feel unusually tired or breathless.

Your vision changes.

Your symptoms have not improved after the course.

Two antiparasitic medicines in a single tablet.

They act by different mechanisms on the parasite.

Together they cover a broader range of worms.

Coverage includes hookworm, roundworm and whipworm.

It also covers Strongyloides stercoralis.

It treats lymphatic filariasis microfilariae.

A short course of one to three days is usually enough.

A short course improves the chance of completion.

One tablet is simpler than two separate medicines.

Combining drugs reduces the risk of resistance.

This combination holds a European regulatory opinion.

It is used in national deworming programmes worldwide.

Store at room temperature, below 30 degrees C.

The authorised product needs no special storage conditions.

Keep tablets in the original blister and carton.

Protect from light and moisture.

Do not store in a bathroom.

Do not refrigerate and do not freeze.

Keep away from direct sunlight and heat.

Keep out of the sight and reach of children.

Check the expiry date before use.

Do not use after the expiry date on the pack.

Return unused tablets to a pharmacy.