ABZEE (Albendazole suspension)
Anthelmintic indicated in single or mixed worms infestations including roundworms, hookworms, pinworms, whipworms, threadworms, tapeworms and strongyloides stercoralis. Also in the treatment of hydatid cysts, neurocysticercosis, giardia (duodenalis or intestinalis or lamblia) infections.
Contraindicated inpregnancy. Adequate non-hormonal contraceptive measures must be taken during and for one month after therapy. Also it is contraindicated in patients hypersensitive to the benzimidazole class of compounds.
Side effects and adverse reactions
Albendazole is usually well tolerated and adverse effects occur only in small percentage of patients. The adverse effects are usually mild and transient. They include abdominal pain, diarrhea, headache and dizziness.
Adverse effects have been reported more frequently when high doses are used for the treatment of hydatid disease and neurocysticercosis.
Hematologic: Leukopenia. There have been rare reports of granulocytopenia, pancytopenia, agranulocytosis, or thrombocytopenia.
Dermatologic: rash, urticaria
Hypersensitivity: allergic reactions
Renal: acute renal failure related to albendazole therapy has been observed.
Dexamethasone: Steady-state trough concentrations of albendazole sulfoxide were about 56% higher when 8 mg dexamethasone was coadministered with each dose of ablendazole (15mg/kg/day) in eight neurocysticercosis patients.
Praziquatel: in the fed state, praziquantel (40mg/kg) increased mean maximum plasma concentration and area under the curve of albendazole sulfoxide by about 50% in helathy subjects compared with a separate group of subjects hiven albendazole alone.
Cimetidine: Albendazole sulfoxide concentrations in bile and cystic fluid were increased about 2-fold) in hydatid cyst patients treated with cimetidine (10mg/kg/day) compared with albendazole (20mg/kg/day) alone.
Theophylline: the pharmacokinetics of theophylline (aminophylline 5.8 mg/kg infused over 20 minutes) were unchanged following a single oral dose of albendazole (400mg) in 6 healthy subjects
Precautions and warnings
Albendazole should not be used during pregnancy and if a patient becomes pregnant while taking this drug, the drug should be discontinued immediately and the patient should be apprised of the potential hazard to the fetus. Women of childbearing age should be cautioned against becoming pregnant while on albendazole or within 1 month of completing treatment.
Albendazole is excreted in animal milk. It is not known whether it is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when albendazole is administered to a nursing woman.
Liver function tests and blood counts before and every two weeks should be performed during high dose therapy for hydatid disease. Experience in children under the age of 6 years is limited. Albendazole should be taken with food.
Rare fatalities associated with the use of albendazole have been reported due to granulocytopenia or pancytopenia.
Patients being treated for neurocysticercosis should receive appropriate steroid and anticonvulsant therapy as required. Oral or intravenous corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of anticysticeral therapy. Cysticercosis may, in rare cases, involve the retina. Before initiating therapy for neurocysticercosis, the patient should be weighed against the possibilty of retinal damage caused by albendazole-induced changes to the retinal lesion.
Dosage and administration
10 ml (400mg) of Albendazole suspension as a single dose in both adults and children over two years of age. The usual dose in children between on and two years of age is 5 ml (200mg) of albendazole suspension as a single dose. In heavy mixed infestation involving Strongyloides or Taeniasis, a single daily dose may be inadequate and the dose may be given for three consecutive days.
If the patient is not cured after three weeks, a second course of treatment may be given. No special procedures, such as fasting or purging are required.
Albendazole has not been adequately studied in children under one year of age.
For Hydatid disease: 15mg/kg/day divided bid PO for 1-6 months (max: 800mg/day)
For Neurocysticercosis: 15mg/kg/day divided bid PO for 28 days (max: 800mg/day)
For Giardiasis (dose in children over 2 years of age): 400mg daily dose (10ml suspension) for five days