Albendazole

Pronunciation

(al BEN da zole)


U.S. Brand Names

Albenza®



Generic Available

No



Use

Treatment of parenchymal neurocysticercosis caused by and cystic hydatid disease of the liver, lung, and peritoneum caused by

Taenia soliumEchinococcus granulosus

Use - Unlabeled/Investigational

Albendazole has activity against (roundworm); ; and (hookworms); cutaneous larva migrans; (pinworm); sp; sp (tapeworms); (filariasis); and (liver flukes); and (whipworm); visceral larva migrans (toxocariasis); activity has also been shown against the liver fluke , , , and . Albendazole has also been used for the treatment of intestinal microsporidiosis (), disseminated microsporidiosis ( sp, sp, ), and ocular microsporidiosis ().

Ascaris lumbricoidesAncylostoma caninumAncylostoma duodenaleNecator americanusEnterobius vermicularisGnathostoma spinigerum; GongylonemaHymenolepis nanaMansonella perstansOpisthorchis sinensisOpisthorchis viverriniStrongyloides stercoralisTrichuris trichiuraClonorchis sinensisGiardia lambliaCysticercus cellulosaeEchinococcus multilocularisEncephalitozoon intestinalisE. hellem, E. cuniculi, E. intestinalis, PleistophoraTrachipleistophoraBrachiola vesicularumE. hellem, E. cuniculi, Vittaforma corneae

Pregnancy Risk Factor

C



Pregnancy Implications

Albendazole has been shown to be teratogenic in laboratory animals and should not be used during pregnancy, if at all possible. Women should be advised to avoid pregnancy for at least 1 month following therapy. Discontinue if pregnancy occurs during treatment.



Lactation

Excretion in breast milk unknown/not recommended



Contraindications

Hypersensitivity to albendazole or any component of the formulation



Warnings/Precautions

Discontinue therapy if LFT elevations are significant; may restart treatment when decreased to pretreatment values. Becoming pregnant within 1 month following therapy is not advised.

Neurocysticercosis: Corticosteroids should be administered 1-2 days before albendazole therapy to minimize inflammatory reactions. Steroid and anticonvulsant therapy should be used concurrently during the first week of therapy to prevent cerebral hypertension. If retinal lesions exist, weigh risk of further retinal damage due to albendazole-induced changes to the retinal lesion vs benefit of disease treatment.

Adverse Reactions

N = Neurocysticercosis; H = Hydatid disease

>10%:

Central nervous system: Headache (11% - N; 1% - H)

Hepatic: LFTs Increased (~15% - H; <1% - N)

1% to 10%:

Central nervous system: Dizziness, vertigo, fever (

1%); intracranial pressure increased (1% - N), meningeal signs (1% - N)

Dermatologic: Alopecia (2% - H; <1% - N)

Gastrointestinal: Abdominal pain (6% - H; 0% - N); nausea/vomiting (3% to 6%)

Hematologic: Leukopenia (reversible) (<1%)

Miscellaneous: Allergic reactions (<1%)

<1%: Acute renal failure, agranulocytopenia, allergic reaction, granulocytopenia, pancytopenia, rash, thrombocytopenia, urticaria

Drug Interactions

(minor) of CYP1A2, 3A4; CYP1A2 (weak)

SubstrateInhibits

Ethanol/Nutrition/Herb Interactions

Food: Albendazole serum levels may be increased if taken with a fatty meal (increases the oral bioavailability by 4-5 times).



Mechanism of Action

Active metabolite, albendazole, 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, immobilization, and worm death.



Pharmacodynamics/Kinetics

Absorption: <5%; may increase up to 4-5 times when administered with a fatty meal

Distribution: Well inside hydatid cysts and CSF

Protein binding: 70%

Metabolism: Hepatic; extensive first-pass effect; pathways include rapid sulfoxidation (major), hydrolysis, and oxidation

Half-life elimination: 8-12 hours

Time to peak, serum: 2-2.4 hours

Excretion: Urine (<1% as active metabolite); feces

Dosage

Oral:

Children:

Cysticercus cellulosae (unlabeled use): 15 mg/kg/day (maximum: 800 mg/day) in 2 divided doses for 8-30 days; may be repeated as necessary

Echinococcus granulosus (tapeworm) (unlabeled use): 15 mg/kg/day (maximum: 800 mg) divided twice daily for 1-6 months

Children and Adults:

Neurocysticercosis:

<60 kg: 15 mg/kg/day in 2 divided doses (maximum: 800 mg/day) for 8-30 days

60 kg: 400 mg twice daily for 8-30 days

Note: Give concurrent anticonvulsant and steroid therapy during first week.

Hydatid:

<60 kg: 15 mg/kg/day in 2 divided doses (maximum: 800 mg/day)

60 kg: 400 mg twice daily

Note: Administer dose for three 28-day cycles with a 14-day drug-free interval in between.

Ancylostoma caninum, Ascaris lumbricoides (roundworm), Ancylostoma duodenale, and Necator americanus (hookworms) (unlabeled use): 400 mg as a single dose

Clonorchis sinensis (Chinese liver fluke) (unlabeled use): 10 mg/kg for 7 days

Cutaneous larva migrans (unlabeled use): 400 mg once daily for 3 days

Enterobius vermicularis (pinworm) (unlabeled use): 400 mg as a single dose; may repeat in 2 weeks

Gnathostoma spinigerum (unlabeled use): 400 mg twice daily for 21 days

Gongylonemiasis (unlabeled use): 10 mg/kg/day for 3 days

Mansonella perstans (unlabeled use): 400 mg twice daily for 10 days

Visceral larva migrans (toxocariasis) (unlabeled use): 400 mg twice daily for 5 days

Adults:

Cysticercus cellulosae (unlabeled use): 400 mg twice daily for 8-30 days; may be repeated as necessary

Disseminated microsporidiosis (unlabeled use): 400 mg twice daily

Echinococcus granulosus (tapeworm) (unlabeled use): 400 mg twice daily for 1-6 months

Intestinal microsporidiosis (unlabeled use): 400 mg twice daily for 21 days

Ocular microsporidiosis (unlabeled use): 400 mg twice daily, in combination with fumagillin

Administration

Administer with meals; administer anticonvulsant and steroid therapy during first week of neurocysticercosis therapy



Monitoring Parameters

Monitor fecal specimens for ova and parasites for 3 weeks after treatment; if positive, retreat; monitor LFTs, and clinical signs of hepatotoxicity; CBC at start of each 28-day cycle and every 2 weeks during therapy



Dietary Considerations

Should be taken with a high-fat meal.



Patient Education

Inform prescriber of all prescriptions, OTC medications, or herbal products you are taking, and any allergies you have. Do not take any new medication during therapy unless approved by prescriber. Take as directed, with meals. Follow prescriber's suggestions to prevent reinfection. May cause loss of hair (reversible); nausea or vomiting (small, frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help); or dizziness or headaches (use caution when driving or engaging in tasks that require alertness until response to drug is known). Report unusual fever, persistent or unresolved abdominal pain, vomiting, yellowing of skin or eyes, darkening of urine, or light colored stools. Inform prescriber if you are or intend to become pregnant. Breast-feeding is not recommended.

Pregnancy/breast-feeding precautions:

Dental Health: Effects on Dental Treatment

No significant effects or complications reported



Dental Health: Vasoconstrictor/Local Anesthetic Precautions

No information available to require special precautions



Mental Health: Effects on Mental Status

None reported



Mental Health: Effects on Psychiatric Treatment

May rarely cause bone marrow suppression; use caution with clozapine and carbamazepine. Carbamazepine may increase the metabolism of albendazole.



Dosage Forms

Tablet: 200 mg



References

de Silva N, Guyatt H, and Bundy D, "Anthelmintics. A Comparative Review of Their Clinical Pharmacology,"Drugs, 1997, 53(5):769-88.

Liu LX and Weller PF, "Antiparasitic Drugs,"N Engl J Med, 1996, 334(18):1178-84.

International Brand Names

Abentel® (BD, TH); Adazol® (EC); Alba® (BD); Albatel® (TH); Alben® (BD, BR, TH); Albenda® (TH); Albendazol® (BR, EC); Albendazol Genfar® (EC); Albendazol MK® (CO); Albenzol® (EC); Albezole® (IN); Albizol® (BD); Alda® (TH); Alentin® (BD); Alfuca® (TH); Alin® (BR); Almex® (BD); Alphin® (BD); Alzed® (BD); Alzental® (SG); Analon Galeno® (CO); Andazol® (TR); Anthel® (TH); Apardu-6® (DO); Asen® (BD); Avadyl® (DO); Avir® (EC); Azol® (BD); Ben-A® (BD); Bendapar® (MX); Bendex-400® (ZA); Bentel® (BD); Bentiamin® (BR); Bimenal® (YU); Ceprazol® (CL); Chuben® (BD); Ciclopar® (CO); Dalben® (HR, SI); Digezanol® (MX); Duador® (RO); Emanthal® (IN); Endoplus® (MX); Eskazole® (AT, AU, DE, ES, IL, MX, NL, RO); Estazol® (BD); Ethizol® (DO); Fagol® (EC); Gascop® (MX); Gendazel® (TH); Getzol® (CO); Helben® (ID); Imavermil® (BR); Italbenzol® (EC); Labenda® (TH); Leo (TH); Librabendazol® (EC); Lurdex® (MX); Mebel® (BD); Mebenix® (BR); Mesin® (TH); Monodox® (CO); Monozol® (BR); Mycotel® (TH); Nemozole® (IN); Obedozol® (CO); Parasin® (BR); Reben® (BD); Rotopar® (EC, HN, PA, SV); Sintel® (BD); Triben® (BD); Unizol® (DO); Vastus® (AR); Vermid® (BD); Vermigen® (EC); Vermital® (BR); Vermixide® (TH); Vermoil® (CL); Xadem® (CO); Zeben® (TH); Zentel® (AU, BR, CH, CL, CO, CR, CY, DO, EC, EG, FR, GT, HN, IN, IT, JO, KW, LB, MT, MX, PA, PL, PT, RO, SG, SV, SY, TH, ZA); Zenzera® (TH); Zestaval® (CY); Zoben® (BD); Zolben® (BR)



Review Date: 1969-12-31 Reviewed By: Keywords: ,
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