Albendazole

Indications

Albendazole is used for: Helminthiasis, Echinococcosis, Neurocysticercosis, Enterobiasis, Ascariasis, Hookworm infections, Strongyloidiasis, Giardiasis, Filariasis

Adult Dose

Oral Ancylostoma, Ascariasis, Hookworm, Trichostrongylus, Enterobius (Pinworm) 400 mg PO once as a single dose Tapeworm infections Adult: 400 mg daily on an empty stomach for 3 consecutive days. Max: 400 mg daily; 1200 mg for 3 days. If patient is not cured after 3 weeks, a second course of treatment is needed. In cases of Hymenolepis nana infestations, retreatment in 10-21 days is recommended. Strogyloidiasis or taeniasis - 400 mg once daily for three consecutive days. Giardiasis - 400 mg once daily for five days. Hydatid disease (Echinococcosis) Adult: <60 kg: 15 mg/kg daily in 2 divided doses. Max: 800 mg/day. >60 kg: 400 mg bid. Admin dose for three 28-day cycles w/ a 14-day drug-free interval in between each cycle. Neurocysticercosis Adult: <60 kg: 15 mg/kg daily in 2 divided doses (max: 800 mg/day) for 8-30 days. >60 kg: 400 mg bid for 8-30 days. Larva Migrans, Cutaneous & Trichuriasis 400 mg PO qDay x 3 days Larva Migrans, Visceral 400 mg PO BID x 5 days Fluke (Clonorchis Sinensis) 10 mg/kg PO qDay x7 days Gnathostomiasis, Microsporidiosis 400 mg BID x 21 days

Child Dose

Child: Usually PO 15 mg/kg/day (max 800 mg/day) q12h Oral Ascariasis, Enterobiasis, Trichuriasis, Hookworm infections Child: 1-2 years 200 mg as a single dose. OR 5 ml suspension 2 years 400 mg PO once as a single dose OR 10 ml suspension Max: 200 mg. Tapeworm infections Child: >2 years: 400 mg daily on an empty stomach for 3 consecutive days. Max: 400 mg daily; 1200 mg for 3 days. If patient is not cured after 3 weeks, a second course of treatment is needed. In cases of Hymenolepis nana infestations, retreatment in 10-21 days is recommended.

Renal Dose

Administration

Should be taken with food.

Contra Indications

Pregnancy and lactation. Neonates. Hypersensitivity, liver impairment.

Precautions

Monitor blood counts and liver function. Administer within 7 days of start of normal menstruation in women of childbearing age. Adequate nonhormonal contraceptive measures must be taken during and for 1 mth after therapy. Perform liver function tests and blood counts before and every 2 wk during high dose therapy of hydatid disease. Lactation: unknown, use caution.

Pregnancy-Lactation

Pregnancy Category: C Lactation: unknown, use caution

Interactions

Increased serum concentrations w/ dexamethasone, praziquantel and cimetidine. Decreased serum concentrations w/ aminoquinoline (antimalarials), carbamazepine, phenobarbital, and phenytoin.

Adverse Effects

Side effects of Albendazole : >10% Headache, Neurocysticercosis (11%), Hydatid disease (1.3%), Abnormal LFT, Hydatid disease (15.6%), Neurocysticercosis (<1%) 1-10% Abdominal pain, Hydatid disease (6%), Nausea/vomiting, Hydatid disease (3.7%), Neurocysticercosis (6.2%), Dizziness/vertigo, Hydatid disease (1.2%), Neurocysticercosis (<1%), Increased intracranial pressure, Neurocysticercosis (1%), Meningeal signs, Neurocysticercosis (1%), Alopecia (reversible), Hydatid disease (1.6%), Neurocysticercosis (<1%), Fever, Hydatid disease (1%) <1% (selected) Rash, Urticaria, Agranulocytosis, Aplastic anemia, Bone marrow suppression, Granulocytopenia, Pancytopenia, Thrombocytopenia, Hepatitis, Acute liver failure, Acute renal failure Potentially Fatal: Bone marrow depression.

Mechanism of Action

Albendazole sulfoxide (active metabolite), causes selective degeneration of cytoplasmic microtubules in intestinal and tegmental cells of intestinal helminths and larvae; glycogen is depleted, glucose uptake and cholinesterase secretion are impaired and desecratory substances accumulate intracellulary. ATP production decreases, causing energy depletion, immobilisation and worm death.