Albendazole
Mechanism :
Albendazole is a broad spectrum anti-helminthic.
The principal mode of action for albendazole is by its inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules in the intestines of nematodes worms, ultimately causing energy depletion and death of the organism.
Indication :
- Neurocysticercosis (Taenia Solium Tapeworm)
- Hydatid disease (Echinococcus Tapeworm)
- Strongyloidiasis
- Ascariasis
- Hookworm
- Pinworm
- Trichiasis
- Fluke (Clonorchis sinensis)
- Gnathostomiasis
- Microsporidiosis
- Cutaneous and Visceral larva migrans
Contraindications :
Albendazole is contraindicated in patients with known hypersensitivity to benzimidazole class of compounds, and in pregnancy.
Dosing :
Whipworm, threadworm, hookworm, ascariasis:
2-18 years: 400 mg single dose.
Strongyloidosis, tapeworm:
Children ≤10 kg: Oral: 200 mg once daily for 3 days; may repeat course in 3 weeks.
Children >10 kg and Adolescents: Oral: 400 mg twice daily for 7 days.
Neurocysticercosis and Hydatid disease:
<60 kg: 15 mg/kg/day orally divided into 2 doses in a day for 8-30 days for neurocysticercosis and for 28 days in hydatid disease followed by 14 drug-free days; given in 3 cycles. Maximum total daily dose, 800 mg.
>60 kg: 400 mg orally twice a day for 8-30 days in neurocysticercosis and for 28 days in hydatid disease followed by 14 drug-free days; given in 3 cycles.
Enterobius (pinworm):
400 mg once orally, repeated in 2 weeks.
Fluke (Clonorchis Sinensis):
10 mg/kg orally every day for 7 days.
Gnathostomiasis, Microsporiodiosis:
400 mg twice daily for 21 days.
Larva migrans:
Cutaneous: 400 mg oral every day for 3 days.
Visceral: 400 mg oral twice daily for 5 days.
Adverse Effect :
Abdominal pain, nausea, vomiting, abnormal liver function tests, headache, dizziness, vertigo, meningeal signs, raised intracranial pressure, reversible alopecia, fever, leukopenia, thrombocytopenia.
Interaction :
Theophylline, Anti-coagulants, Anti-convulsants, OCPs, Oral Hypoglycaemics: Induces cytochrome P450 system.
Dexamethasone, Cimetidine, Praziquantel: Plasma concentrations increased.
Aminoquinolines (Antimalarial): May decrease the serum concentration of Anthelmintics.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely dialysability. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unlikely dialysability. Dose as in normal renal function |
Hepatic Dose :
With extrahepatic biliary obstruction, the elimination of albendazole is prolonged. Use with caution.