Albendazole

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Albendazole

A benzimidazole broad-spectrum anthelmintic structurally related to mebendazole that is effective against many diseases. Albendazole is an anthelmintic (an-thel-MIN-tik) or anti- worm medication. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body. Albendazole is used to treat certain infections caused by worms such as pork tapeworm and dog tapeworm

Albendazole should not be used during pregnancy, unless there is no alternate treatment. You may need to have a negative pregnancy test before starting this treatment.

Indication

For the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium and for the treatment of cystic hydatid disease of the liver, lung, and peritoneum, caused by the larval form of the dog tapeworm, Echinococcus granulosus


Associated Conditions

Before taking this medicine

You should not use albendazole if you are allergic to albendazole, or to similar drugs such as mebendazole. To make sure albendazole is safe for you, tell your doctor if you have:

  • liver disease; or
  • bone marrow suppression.

Albendazole should not be used during pregnancy, unless there is no alternate treatment. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. Use effective birth control to prevent pregnancy while taking this medicine and for at least 1 month after your treatment ends. You may need to have a negative pregnancy test before starting this treatment.

Dosage

Neurocysticercosis (Taenia Solium Tapeworm): >60 kg: 400 mg PO BID x 8-30 days
<60 kg: 15 mg/kg/day divided BID PO x 8-30 days; not to exceed 800 mg/day

Hydatid (Echinococcus Tapeworm): >60 kg: 400 mg PO BID x 28 days, THEN 14 drug-free days x 3 cycles
<60 kg: 15 mg/kg/day divided BID PO, no more than 800 mg/day x 28 days, THEN 14 drug-free days x 3 cycles

Ancylostoma, Ascariasis, Hookworm, Trichostrongylus: 400 mg PO once

Capillariasis: 400 mg PO qDay x10 days

Larva Migrans, Cutaneous & Trichuriasis: 400 mg PO qDay x 3 days

Larva Migrans, Visceral: 400 mg PO BID x 5 days

Enterobius (Pinworm): 400 mg PO once, repeat in 2 weeks

Fluke (Clonorchis Sinensis): 10 mg/kg PO qDay x7 days

Gnathostomiasis, Microsporidiosis: 400 mg BID x 21 days

Administration: Take with food

How to use Albendazole

Take this medication by mouth with meals as directed by your doctor, usually 1 to 2 times daily. If you or your child have trouble swallowing tablets, you may crush or chew your dose and take it with water.

For some conditions (such as hydatid disease), your doctor may direct you to take this medication in a treatment cycle (for example, twice daily with meals for 28 days then stopping the medication for 2 weeks). Carefully follow your doctor’s instructions.

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Mechanism of action

Albendazole causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. 

The loss of the cytoplasmic microtubules leads to impaired uptake of glucose by the larval and adult stages of the susceptible parasites, and depletes their glycogen stores.

Degenerative changes in the endoplasmic reticulum, the mitochondria of the germinal layer, and the subsequent release of lysosomes result in decreased production of adenosine triphosphate (ATP), which is the energy required for the survival of the helminth. Due to diminished energy production, the parasite is immobilized and eventually dies.

Albendazole side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have:

  • signs of bone marrow suppression–sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing, easy bruising or bleeding; or
  • liver problems–nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • stomach pain, nausea, vomiting;
  • dizziness, spinning sensation;
  • headache; or
  • temporary hair loss.

This is not a complete list of side effects and others may occur

Interactions

Acalabrutinib

Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Co-administration may increase risk of myelosuppressive effects.

Altretamine: Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

Fosphenytoin: Fosphenytoin decreases levels of albendazole by increasing metabolism. Use Caution/Monitor. Fosphenytoin decreases levels of albendazole active metabolites; monitor for decreased efficacy.

Grape fruit will increase the level or effect of albendazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. 

Phenytoin: Phenytoin decreases levels of albendazole by increasing metabolism. Use Caution/Monitor. Phenytoin decreases levels of albendazole active metabolites; monitor for decreased efficacy.

Dexamethasone increases levels of albendazole by unspecified interaction mechanism.  

Praziquantel increases levels of albendazole by unspecified interaction mechanism. 

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed

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