What are the recommended dosing regimens for albendazole and ivermectin when used together in adults and children, and what contraindications should be considered? | Rounds What are the recommended dosing regimens for albendazole and ivermectin when used together in adults and children, and what contraindications should be considered? | Rounds
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What are the recommended dosing regimens for albendazole and ivermectin when used together in adults and children, and what contraindications should be considered?

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Coadministration Dosing Regimens for Albendazole and Ivermectin in Adults and Children

Preventive chemotherapy regimens that coadminister ivermectin with albendazole use a single annual treatment dose. [1]

Dosing Regimen for Coadministration in Adults and Children

Mass drug administration dosing for lymphatic filariasis

  • Albendazole 400 mg orally as a single dose is given with ivermectin 200 mcg/kg orally as a single dose in countries with onchocerciasis co-endemicity. [1]

Dosing for Children When Coadministration Is Used in Refugee Presumptive-Treatment Protocols

  • Albendazole 200 mg orally as a single dose is given for children aged 12–23 months. [2]
  • Albendazole 400 mg orally as a single dose is given for children aged >2 years. [2]
  • Ivermectin 200 mcg/kg orally as a single dose is used for strongyloidiasis presumptive treatment. [2]
  • Presumptive ivermectin treatment should not be used if the child weighs ≤15 kg. [2]

Contraindications and Key Precautions

Contraindications for Albendazole

  • Known cysticercosis or neurocysticercosis is a contraindication to presumptive albendazole therapy. [2]
  • Seizures or neurologic disorders of unknown etiology are contraindications to presumptive albendazole therapy. [2]
  • Albendazole is contraindicated in children <1 year of age. [2]
  • Pregnancy is a contraindication to presumptive albendazole therapy. [2]
  • Known hypersensitivity or allergy is a contraindication to presumptive albendazole therapy. [2]

Contraindications for Ivermectin

  • Presence of Loa loa microfilaremia is a contraindication to presumptive ivermectin therapy. [2]
  • Ivermectin is contraindicated for children weighing <15 kg. [2]
  • Pregnancy is a contraindication to presumptive ivermectin therapy. [2]
  • Breastfeeding an infant <1 week old is a contraindication to presumptive ivermectin therapy. [2]
  • Known hypersensitivity or allergy is a contraindication to presumptive ivermectin therapy. [2]

Important Programmatic Considerations

  • A relative contraindication to presumptive ivermectin includes confirmed or suspected concomitant Loa loa infection, because treatment in persons with high Loa loa microfilarial load is associated with risk of fatal encephalopathy. [2]
  • Presumptive albendazole is contraindicated in known cysticercosis or neurocysticercosis, and seizures or unexplained neurologic disorders are treated as possible neurocysticercosis until evaluation. [2]

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