From the Research
The CDC recommends ivermectin as part of a combination therapy for lymphatic filariasis treatment, with a standard dose of ivermectin 200 mcg/kg orally as a single dose, typically given together with albendazole 400 mg orally as a single dose. This combination is effective against Wuchereria bancrofti, the most common cause of lymphatic filariasis. The treatment regimen is based on the most recent and highest quality study available, which demonstrated the efficacy and safety of ivermectin in combination with albendazole for the treatment of lymphatic filariasis 1.
Key Considerations
- Ivermectin works by paralyzing the microfilariae (immature worms) in the bloodstream but does not kill adult worms, therefore treatment may need to be repeated annually until the adult worms die naturally, which can take several years.
- Patients should be monitored for side effects, which are usually mild and may include fever, headache, dizziness, and muscle pain, resulting from the body's reaction to dying microfilariae.
- Pregnant women, children under 15 kg, and individuals with severe illness should not receive ivermectin.
- Treatment should be administered under medical supervision, especially in areas where loiasis (another filarial infection) is endemic, as serious adverse reactions can occur in co-infected individuals.
Supporting Evidence
- A study published in 2022 demonstrated the superior efficacy of triple drug therapy with ivermectin plus DEC and albendazole (IDA) for clearing microfilaremia in individuals with lymphatic filariasis 1.
- Another study published in 2000 showed that ivermectin is a highly effective and generally well-tolerated microfilaricide, with a single dose of 400 microg/kg yielding maximal responses 2.
- A 2019 review of albendazole alone or in combination with microfilaricidal drugs for lymphatic filariasis found that albendazole makes little or no difference in clearing microfilaraemia or adult filarial worms in the 12 months post-treatment 3.
Treatment Regimens
- For infections with Brugia malayi or Brugia timori, the recommended regimen is diethylcarbamazine (DEC) 6 mg/kg orally daily for 12 days plus albendazole 400 mg orally as a single dose.
- The Global Programme to Eliminate Lymphatic Filariasis recommends mass treatment with albendazole co-administered with another antifilarial drug, with the target of elimination by 2020 4.