Azithromycin + Ivermectin/albendazole = Precautionary

Effect on Concentration

Azithromycin
Increase
Applies within class?
No
Applies within class?
No

Pharmacologic Effects

Effect
N/A
Applies within class?
No
Effect
N/A
Applies within class?
No

Interaction History

N/A

Last Updated 22-May-2020

Summary

Slight increases in Cmax and AUC noted for azithro and the ivermectin component. All treatments were tolerated.

Sources

Study Design

This study was conducted to evaluate whether azithromycin has a pharmacokinetic interaction with the combination of ivermectin and albendazole. Eighteen healthy volunteers were administered single doses of azithromycin, ivermectin/albendazole, and the combination of the three agents in random, crossover fashion. To assess the presence of interactions, test (combination) and reference (single dose) data were compared using an estimation approach.

Study Results

Compared with reference phases, the geometric mean values for the combination arms azithromycin AUC(0-t) and C(max) were increased approximately 13 and 20, respectively, albendazole AUC(0-t) decreased by approximately 3 and C(max) increased approximately 3, and ivermectin AUC(0-t) and C(max) were increased 31 and 27, respectively. Albendazole sulfoxide AUC(0-t) and C(max) were decreased approximately 16 and 14, respectively. All treatments were well tolerated.

Study Conclusions

The interactions for azithromycin and albendazole were minimal although the increase in ivermectin exposure requires further study.

References

Amsden GW. Pharmacokinetics of azithromycin and the combination of ivermectin and albendazole when administered alone and concurrently in healthy volunteers. Am J Trop Med Hyg. 2007; 6: 1153-7.