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Albendazole

Comprehensive Guide to Albendazole: Uses, Dosage, Side Effects, and More

What is Albendazole?

Albendazole is a broad-spectrum anthelmintic medication used to treat a variety of parasitic worm infections, such as neurocysticercosis, hydatid disease, and intestinal helminthiases. As a benzimidazole derivative, this drug works by inhibiting parasite microtubule polymerization, leading to their death. Marketed under brand names like Albenza, the treatment is administered orally and is highly effective against tapeworms, roundworms, and flukes, making it a critical tool in global health, particularly in regions with high parasitic disease prevalence. The medication’s benefits include its wide-ranging efficacy, oral administration, and established safety profile when used under medical supervision, though it requires monitoring for potential liver and bone marrow toxicity.

Overview of Albendazole

Generic Name: Albendazole

Brand Name: Albenza, Zentel, others

Drug Group: Anthelmintic; benzimidazole derivative

The drug is used to treat

  • Neurocysticercosis (caused by Taenia solium).
  • Hydatid disease (caused by Echinococcus species).
  • Intestinal infections, including ascariasis, hookworm, pinworm, and strongyloidiasis.
  • Off-label uses for other parasitic infections (e.g., giardiasis, microsporidiosis).

Key Characteristics

Form: Oral tablets (200 mg, 400 mg); chewable tablets; oral suspension.

A box of Albendazole Tablets IP 400 mg by Cadila Pharmaceuticals, showing packaging details and a single blister pack with two white tablets, indicating an anthelminthic medication.
Albendazole 400 mg tablets, manufactured by Cadila Pharmaceuticals, are an anthelmintic medication commonly used to treat a variety of parasitic worm infections in adults and children.

Mechanism: Disrupts parasite microtubule formation, impairing glucose uptake and leading to parasite death.

Approval: FDA-approved (1996 for Albenza) and EMA-approved for parasitic infections.

Indications and Uses of Albendazole

Neurocysticercosis: Treats cysticercosis caused by pork tapeworm (Taenia solium), reducing brain cysts and seizures.

Hydatid Disease: Manages cystic echinococcosis caused by Echinococcus granulosus or E. multilocularis, shrinking cysts in the liver, lungs, or other organs.

Intestinal Helminthiases:

  • Ascariasis (Ascaris lumbricoides).
  • Hookworm (Ancylostoma duodenale, Necator americanus).
  • Pinworm (Enterobius vermicularis).
  • Strongyloidiasis (Strongyloides stercoralis).
  • Trichuriasis (Trichuris trichiura).

Off-Label Uses: Treats giardiasis, cutaneous larva migrans, or microsporidiosis under specialist guidance.

Note: The medication is not effective against all parasites; correct diagnosis is essential before use.

Dosage of Albendazole

Important Note: Albendazole dosage must be prescribed by a healthcare provider. Follow instructions precisely, as dosing varies by infection, patient weight, and duration.

Dosage for Adults

Neurocysticercosis:

  • Weight ≥60 kg: 400 mg twice daily with meals for 8–30 days.
  • Weight <60 kg: 15 mg/kg/day (maximum 800 mg/day) in two divided doses.

Hydatid Disease:

  • Weight ≥60 kg: 400 mg twice daily with meals for 28 days, followed by 14-day drug-free intervals (up to three cycles).
  • Weight <60 kg: 15 mg/kg/day (maximum 800 mg/day) in two divided doses.

Intestinal Helminthiases:

  • Ascariasis, Hookworm, Pinworm: 400 mg single dose.
  • Strongyloidiasis, Trichuriasis: 400 mg once daily for 3 days.
  • Repeat doses may be needed after 2–3 weeks for certain infections.

Dosage for Children

  • ≥2 Years:
    • Neurocysticercosis, Hydatid Disease: 15 mg/kg/day (maximum 800 mg/day) in two divided doses.
    • Intestinal Infections: Same as adult dosing, adjusted for weight.
  • <2 Years: Limited data; use only under specialist supervision.

Dosage for Pregnant Women

Pregnancy Category C: Avoid during pregnancy, especially in the first trimester, due to potential teratogenicity. Use only if benefits outweigh risks; consult a healthcare provider.

Dosage Adjustments

Hepatic Impairment: Monitor closely; dose reduction may be needed due to liver metabolism.

Renal Impairment: No specific adjustments; monitor for toxicity.

Coadministration: Often used with corticosteroids (e.g., prednisone) in neurocysticercosis to reduce inflammation.

Additional Considerations

  • Take with a high-fat meal to enhance absorption.
  • Chewable tablets or suspension may be used for children or those unable to swallow tablets.

How to Use Albendazole

Administration: Take the medication orally with a high-fat meal to improve bioavailability. Swallow tablets whole or chew if using chewable form; shake suspension well.

Timing: Administer twice daily for neurocysticercosis/hydatid disease or as a single dose for intestinal infections, as prescribed.

Missed Dose: Take as soon as remembered unless it’s nearly time for the next dose; do not double doses. Consult your doctor if multiple doses are missed.

Additional Tips:

  • Complete the full course to ensure parasite eradication.
  • For neurocysticercosis, follow corticosteroid or anticonvulsant regimens as prescribed.

Contraindications for Albendazole

  • Patients with hypersensitivity to Albendazole, benzimidazoles, or formulation components.
  • Pregnant women (first trimester) unless no alternative exists.
  • Patients with severe hepatic impairment without medical supervision.

Warnings & Precautions for Albendazole

General Warnings

Liver Toxicity: The medication may cause elevated liver enzymes or hepatitis; monitor liver function tests (LFTs) before and during treatment.

Bone Marrow Suppression: Risk of leukopenia, agranulocytosis, or pancytopenia; monitor complete blood count (CBC) regularly.

Neurocysticercosis Inflammation: Cyst death may cause seizures or increased intracranial pressure; use corticosteroids and anticonvulsants as prescribed.

Teratogenicity: Animal studies suggest fetal harm; avoid in pregnancy unless essential.

Use in Specific Populations

Pregnancy: Category C; avoid, especially in first trimester. Use effective contraception during and for 1 month after treatment.

Breastfeeding: Minimal excretion in breast milk; use cautiously, weighing benefits against risks.

Elderly: No specific concerns, but monitor liver and kidney function.

Children: Safe for ≥2 years; limited data for younger children.

Immunocompromised Patients: Increased risk of disseminated infection (e.g., strongyloidiasis); monitor closely.

Additional Precautions

  • Inform your doctor about liver disease, blood disorders, or pregnancy plans.
  • Avoid raw or undercooked meat to prevent reinfection.

Overdose and Management of Albendazole

Overdose Symptoms

Overdose is rare but may cause:

  • Severe nausea, vomiting, or diarrhea.
  • Liver toxicity (e.g., jaundice, elevated LFTs).
  • Bone marrow suppression (e.g., fatigue, bruising).

Immediate Actions

Contact Healthcare Provider: Seek medical advice immediately.

Monitor: Check liver function and CBC for toxicity.

Supportive Care: Manage symptoms (e.g., fluids for gastrointestinal upset); no specific antidote exists.

Additional Notes

  • Overdose risk is low with proper dosing; store securely to prevent misuse.
  • Report persistent symptoms promptly.

Side Effects of Albendazole

Common Side Effects

  • Nausea or vomiting (3–6%)
  • Abdominal pain (1–6%)
  • Headache (1–11%)
  • Elevated liver enzymes (up to 16% in neurocysticercosis)
  • Dizziness
    These effects are usually mild and transient.

Serious Side Effects

Seek immediate medical attention for:

Liver Toxicity: Jaundice, dark urine, or right-sided abdominal pain.

Bone Marrow Suppression: Unusual bruising, bleeding, or severe fatigue.

Allergic Reactions: Rare; rash, hives, or difficulty breathing.

Neurologic: Seizures or increased intracranial pressure in neurocysticercosis.

Additional Notes

  • Regular monitoring of LFTs and CBC is essential, especially for prolonged use.
  • Side effects may be more pronounced with high-fat meals due to increased absorption.

Drug Interactions with Albendazole

The medication may interact with:

CYP450 Inducers (e.g., Carbamazepine, Phenytoin): Decrease Albendazole levels, reducing efficacy; monitor or adjust doses.

CYP450 Inhibitors (e.g., Cimetidine, Ritonavir): Increase drug levels, raising toxicity risk; monitor LFTs.

Corticosteroids (e.g., Dexamethasone): Increase Albendazole’s active metabolite levels; used intentionally in neurocysticercosis.

Praziquantel: Increases Albendazole levels; monitor for toxicity in combination therapy.

Action: Provide your healthcare provider with a complete list of medications and supplements.

Patient Education or Lifestyle

Medication Adherence: Take Albendazole with a high-fat meal to enhance absorption; complete the full course to prevent resistance or recurrence.

Hygiene: Wash hands thoroughly, avoid raw/undercooked meat, and ensure clean water to prevent reinfection.

Monitoring: Attend regular appointments for LFTs and CBC, especially for neurocysticercosis or hydatid disease.

Infection Prevention: Educate household members about hygiene to prevent transmission of intestinal parasites.

Diet: Maintain a balanced diet to support recovery; high-fat meals enhance drug absorption.

Travel: Avoid endemic areas for parasitic infections; consult a doctor for prophylaxis if traveling.

Pharmacokinetics of Albendazole

Absorption: Poorly absorbed orally (~1–5%); enhanced by high-fat meals. Peak plasma concentration of active metabolite (Albendazole sulfoxide) is 131–1,320 ng/mL at 2–5 hours.

Distribution: Widely distributed; high concentrations in bile, cerebrospinal fluid, and cysts.

Metabolism: Rapidly metabolized in the liver to Albendazole sulfoxide (active) via CYP3A4 and flavin-containing monooxygenases.

Excretion: Primarily biliary; <1% excreted unchanged in urine.

Half-Life: Albendazole sulfoxide: 8–12 hours.

Pharmacodynamics of Albendazole

The drug exerts its effects by:

  • Binding to β-tubulin in parasites, inhibiting microtubule polymerization.
  • Impairing glucose uptake, leading to parasite immobilization and death.
  • Acting broadly against cestodes, nematodes, and trematodes.
  • Showing minimal host toxicity due to selective binding to parasite tubulin.

Storage of Albendazole

  • Temperature: Store at room temperature (20–25°C or 68–77°F); avoid moisture and heat.
  • Protection: Keep in original container to protect from light.
  • Safety: Store out of reach of children to prevent accidental ingestion.
  • Disposal: Follow local regulations or consult a pharmacist for safe disposal of unused or expired medication.

Frequently Asked Questions (FAQs)

Q: What infections does Albendazole treat?
A: The drug treats parasitic infections like neurocysticercosis, hydatid disease, and intestinal worms (e.g., pinworm, hookworm).

Q: Can Albendazole cause liver damage?
A: Yes, the medication may elevate liver enzymes; regular monitoring is required.

Q: Is Albendazole safe during pregnancy?
A: Category C; avoid, especially in the first trimester, unless essential. Use contraception during treatment.

Q: How should I take Albendazole?
A: Take with a high-fat meal to improve absorption; follow the prescribed dosing schedule.

Q: Can Albendazole prevent reinfection?
A: No, the treatment eliminates existing parasites; practice hygiene to prevent reinfection.

Regulatory Information for Albendazole

The medication is approved by:

U.S. Food and Drug Administration (FDA): Approved in 1996 (Albenza) for neurocysticercosis and hydatid disease.

European Medicines Agency (EMA): Approved for similar indications in the European Union.

Other Agencies: Approved globally (e.g., Drug Administration of Vietnam) for parasitic infections; consult local guidelines.

Disclaimer: This article provides general information about Albendazole for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting or stopping this drug or making any medical decisions. Improper use of this medication can lead to serious health risks, including liver toxicity or treatment failure.

References

  1. U.S. Food and Drug Administration (FDA). (2023). Albenza (Albendazole) Prescribing Information.
    • Official FDA documentation detailing the drug’s approved uses, dosage, and safety for the USA.
  2. European Medicines Agency (EMA). (2023). Zentel (Albendazole) Summary of Product Characteristics.
    • EMA’s comprehensive information on the medication’s indications and precautions in Europe.
  3. National Institutes of Health (NIH). (2023). Albendazole: MedlinePlus Drug Information.
    • NIH resource providing detailed information on the drug’s uses, side effects, and precautions.
  4. World Health Organization (WHO). (2023). WHO Model List of Essential Medicines: Albendazole.
    • WHO’s inclusion of Albendazole as an essential medicine for parasitic infections.
  5. The Lancet Infectious Diseases. (2018). Albendazole in the Treatment of Helminthic Infections.
    • Peer-reviewed article on the medication’s efficacy in parasitic infections (note: access may require a subscription).

Dr. Andrew Parker is a board-certified internal medicine physician with over 10 years of clinical experience. He earned his medical degree from the University of California, San Francisco (UCSF), and has worked at leading hospitals including St. Mary’s Medical Center. Dr. Parker specializes in patient education and digital health communication. He now focuses on creating clear, accessible, and evidence-based medical content for the public.

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