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.
Side 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.
Mode 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.