Albendazole

Name: Albendazole

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. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Albendazole Interactions

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Other drugs may interact with albendazole, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

What side effects can this medication cause?

Albendazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • stomach pain
  • nausea
  • vomiting
  • headache
  • dizziness
  • reversible hair loss

Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section, call your doctor immediately:

  • sore throat, fever, chills, and other signs of infection
  • unusual bleeding or bruising
  • weakness
  • fatigue
  • pale skin
  • shortness of breath
  • rash
  • hives

Albendazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Dosing & Uses

Dosage Forms & Strengths

tablet

  • 200mg

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

Monitor: CBC, LFTs

Dosage Forms & Strengths

tablet

  • 200mg

Neurocysticercosis (Taenia Solium Tapeworm)

<60 kg: 15 mg/kg/day divided BID PO x 8-30 day; no more than 800 mg/day (maximum total daily dose, 800 mg) 

>60 kg: 400 mg BID x 8-30 day

Hydatid (Echinococcus Tapeworm)

<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 

>60 kg: 400 mg PO BID x 28 days, THEN 14 drug-free days x 3 cycles

Ancylostoma, Ascariasis, Hookworm, Trichostrongylus

400 mg PO x1 day

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 x 1, repeat in 2 weeks

Other Information

Administration

  • Take with food
  • If unable to swallow, may crush tablet & drink with water

Monitor

  • CBC, LFTs

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Side Effects of Albendazole

Serious side effects have been reported. See "Drug Precautions" section.

Common side effects including:

  • stomach pain
  • nausea
  • vomiting
  • headache
  • dizziness

This is not a complete list of albendazole side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Albendazole dosing information

Usual Adult Dose for Hydatid Disease:

Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day

60 kg or more: 400 mg orally twice a day with meals

Duration of therapy: 28-day cycle followed by a 14-day drug-free interval, for a total of 3 cycles

Use: For the treatment of cystic hydatid disease of the liver, lung, and peritoneum due to the larval form of Echinococcus granulosus

Usual Adult Dose for Neurocysticercosis:

Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day

60 kg or more: 400 mg orally twice a day with meals

Duration of therapy: 8 to 30 days

Comments:
-Patients should receive appropriate steroid and anticonvulsant therapy as needed.
-Oral or IV corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of therapy.

Use: For the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of Taenia solium

Usual Adult Dose for Cutaneous Larva Migrans:

US CDC recommendations: 400 mg orally once a day for 3 to 7 days

Case Report (4)
400 mg orally twice a day for 3 to 5 days

Usual Adult Dose for Ascariasis:

US CDC recommendations: 400 mg orally as a single dose

Usual Adult Dose for Pinworm Infection (Enterobius vermicularis):

Some experts recommend: 400 mg orally as a single dose; repeat in 2 weeks

Comments: Some clinicians recommend all household contacts of infected patients receive treatment, especially when multiple or repeated symptomatic infections occur, since such contacts commonly also are infected; retreatment after 14 to 21 days may be needed.

Usual Adult Dose for Filariasis:

Some experts recommend: 400 mg orally twice a day for 10 days

Comments: Recommended for infection due to Mansonella perstans

Usual Adult Dose for Hookworm Infection (Necator or Ancylostoma):

US CDC recommendations: 400 mg orally as a single dose

Comments: Recommended for infection due to Ancylostoma duodenal or Necator americanus

Usual Adult Dose for Enterocolitis:

Some experts recommend: 400 mg orally as a single dose

Comments: Recommended for eosinophilic enterocolitis due to A caninum

Usual Adult Dose for Visceral Larva Migrans (Toxicariasis):

US CDC recommendations: 400 mg orally twice a day for 5 days

Comments:
-Recommended for visceral toxocariasis
-Optimum duration of therapy is unknown; some clinicians recommend 20 days of therapy.

Usual Adult Dose for Strongyloidiasis:

Some experts recommend: 400 mg orally twice a day for 7 days

Comments:
-Recommended as alternative therapy
-May be necessary to repeat or prolong therapy or use other agents in immunocompromised patients or patients with disseminated disease

Usual Adult Dose for Trichinosis:

US CDC recommendations: 400 mg orally twice a day for 8 to 14 days

Usual Adult Dose for Trichostrongylosis:

Some experts recommend: 400 mg orally as a single dose

Comments: Recommended as an alternative therapy

Usual Adult Dose for Whipworm Infection (Trichuris trichiura):

US CDC recommendations: 400 mg orally once a day for 3 days

Usual Adult Dose for Capillariasis:

US CDC recommendations: 400 mg orally once a day for 10 days

Comments: Recommended as alternative therapy

Usual Adult Dose for Gnathostomiasis:

US CDC recommendations: 400 mg orally twice a day for 21 days

Comments: Recommended for cutaneous symptoms

Usual Adult Dose for Clornorchis sinensis (Liver Fluke):

US CDC recommendations: 10 mg/kg/day orally for 7 days

Comments: Recommended as alternative therapy

Usual Adult Dose for Cysticercus cellulosae (Cysticercosis):

Some experts recommend: 400 mg orally twice a day for 8 to 30 days

Comments:
-May repeat as necessary
-Therapy for at least 30 days recommended in patients with subarachnoid cysts or giant cysts in the fissures.
-Surgical intervention (especially neuroendoscopic removal) or CSF diversion followed by treatment with this drug and steroids recommended for obstructive hydrocephalus.
-With prednisone or dexamethasone, recommended for arachnoiditis, vasculitis, or cerebral edema

Usual Adult Dose for Echinococcus Infection:

US CDC recommendations: 400 mg orally twice a day for 1 to 6 months

Comments:
-Recommended for cystic echinococcosis in patients with small cysts or multiple cysts in several organs; treatment depends on the WHO classification of the cysts; this drug is not appropriate for all forms of the infection.
-This drug has been administered before surgery to facilitate safe surgical manipulation of cysts by inactivating protoscolices, altering cyst membrane integrity, and reducing cyst turgidity.

Usual Adult Dose for Loiasis:

US CDC recommendations: 200 mg orally twice a day for 21 days

Comments:
-Recommended for symptomatic infection with microfilariae of Loa loa/mL less than 8000 and 2 rounds of diethylcarbamazine failed; or recommended for symptomatic loiasis with microfilariae of L loa/mL at least 8000 to reduce level to less than 8000 before diethylcarbamazine therapy
-Treatment of this infection is complex; experts with experience treating this disease and preventing complications of therapy should be consulted.

Usual Adult Dose for Microsporidiosis:

Some experts recommend: 400 mg orally twice a day

Comments:
-Recommended for disseminated infection due to Encephalitozoon hellem, E cuniculi, E intestinalis, Pleistophora species, Trachipleistophora species, or Anncaliia vesicularum
-Recommended for intestinal infection due to E intestinalis; duration of therapy is 21 days
-With fumagillin, recommended for ocular infection due to E hellem, E cuniculi, or Vittaforma corneae

US CDC, National Institutes of Health (NIH), and HIV Medicine Association of the Infectious Diseases Society of America (HIVMA/IDSA) recommendations for HIV-infected patients: 400 mg orally twice a day

Comments:
-Recommended as preferred therapy (including treatment and secondary prophylaxis)
-Recommended for intestinal and disseminated (not ocular) infection due to Microsporidia other than Enterocytozoon bieneusi and V corneae
-With fumagillin, recommended for ocular infection for management of systemic infection

Usual Pediatric Dose for Hydatid Disease:

Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day

60 kg or more: 400 mg orally twice a day with meals

Duration of therapy: 28-day cycle followed by a 14-day drug-free interval, for a total of 3 cycles

Comments: Hydatid disease is uncommon in infants and young children.

Use: For the treatment of cystic hydatid disease of the liver, lung, and peritoneum due to the larval form of E granulosus

Usual Pediatric Dose for Neurocysticercosis:

Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day

60 kg or more: 400 mg orally twice a day with meals

Duration of therapy: 8 to 30 days

Comments:
-Patients should receive appropriate steroid and anticonvulsant therapy as needed.
-Oral or IV corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of therapy.

Use: For the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of T solium

Usual Pediatric Dose for Capillariasis:

US CDC and American Academy of Pediatrics (AAP) recommendations: 400 mg orally once a day for 10 days

Comments: Recommended as alternative therapy

Case Reports of Hepatic Capillariasis (n=2)
At least 18 months: 400 mg/day for 21 days, up to 100 days

Usual Pediatric Dose for Cutaneous Larva Migrans:

US CDC and AAP recommendations:
Older than 2 years: 400 mg orally once a day for 3 days

Comments (US CDC): This drug is contraindicated in children younger than 2 years; may use topical agents in such patients

Case Report (n=1)
11 months: 2.5 mL (suspension: 200 mg/5 mL) orally twice a day for 3 days

Usual Pediatric Dose for Cysticercus cellulosae (Cysticercosis):

Some experts recommend: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
Duration of therapy: 8 to 30 days

Comments:
-May repeat as necessary
-Therapy for at least 30 days recommended in patients with subarachnoid cysts or giant cysts in the fissures.
-Surgical intervention (especially neuroendoscopic removal) or CSF diversion followed by treatment with this drug and steroids recommended for obstructive hydrocephalus.
-With prednisone or dexamethasone, recommended for arachnoiditis, vasculitis, or cerebral edema

Usual Pediatric Dose for Echinococcus Infection:

US CDC and AAP recommendations: 10 to 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
Duration of therapy: 1 to 6 months

Comments:
-Recommended for cystic echinococcosis in patients with small cysts or multiple cysts in several organs; treatment depends on the WHO classification of the cysts; this drug is not appropriate for all forms of the infection.
-This drug has been administered before surgery to facilitate safe surgical manipulation of cysts by inactivating protoscolices, altering cyst membrane integrity, and reducing cyst turgidity.

Usual Pediatric Dose for Ascariasis:

US CDC and AAP recommendations: 400 mg orally as a single dose

Usual Pediatric Dose for Pinworm Infection (Enterobius vermicularis):

AAP recommendations:
-Children less than 20 kg: 200 mg orally as a single dose; repeat in 2 weeks
-Children at least 20 kg: 400 mg orally as a single dose; repeat in 2 weeks

Some experts recommend: 400 mg orally as a single dose; repeat in 2 weeks

Comments: Some clinicians recommend all household contacts of infected patients receive treatment, especially when multiple or repeated symptomatic infections occur, since such contacts commonly also are infected; retreatment after 14 to 21 days may be needed.

Usual Pediatric Dose for Filariasis:

Some experts recommend: 400 mg orally twice a day for 10 days

Comments: Recommended for infection due to M perstans

Usual Pediatric Dose for Hookworm Infection (Necator or Ancylostoma):

US CDC and AAP recommendations: 400 mg orally as a single dose

Comments: Recommended for infection due to A duodenal or N americanus

Usual Pediatric Dose for Enterocolitis:

Some experts recommend: 400 mg orally once as a single dose

Comments: Recommended for eosinophilic enterocolitis due to A caninum

Usual Pediatric Dose for Loiasis:

US CDC and AAP recommendations: 200 mg orally twice a day for 21 days

Comments:
-Recommended for symptomatic infection with microfilariae of L loa/mL less than 8000 and 2 rounds of diethylcarbamazine failed; or recommended for symptomatic loiasis with microfilariae of L loa/mL at least 8000 to reduce level to less than 8000 before diethylcarbamazine therapy
-Treatment of this infection is complex; experts with experience treating this disease and preventing complications of therapy should be consulted.

Usual Pediatric Dose for Visceral Larva Migrans (Toxicariasis):

US CDC and AAP recommendations: 400 mg orally twice a day for 5 days

Comments:
-Recommended for visceral toxocariasis
-Optimum duration of therapy is unknown; some clinicians recommend 20 days therapy.

Usual Pediatric Dose for Strongyloidiasis:

Some experts recommend: 400 mg orally twice a day for 7 days

Comments:
-Recommended as alternative therapy
-May be necessary to repeat or prolong therapy or use other agents in immunocompromised patients or patients with disseminated disease

Usual Pediatric Dose for Trichinosis:

US CDC and AAP recommendations: 400 mg orally twice a day for 8 to 14 days

Usual Pediatric Dose for Trichostrongylosis:

Some experts recommend: 400 mg orally as a single dose with food

Comments: Recommended as an alternative therapy

Usual Pediatric Dose for Whipworm Infection (Trichuris trichiura):

US CDC and AAP recommendations: 400 mg orally once a day for 3 days

Usual Pediatric Dose for Gnathostomiasis:

US CDC and AAP recommendations: 400 mg orally twice a day for 21 days

Comments: Recommended for cutaneous symptoms

Usual Pediatric Dose for Clornorchis sinensis (Liver Fluke):

US CDC and AAP recommendations: 10 mg/kg/day orally for 7 days

Comments: Recommended as alternative therapy

Usual Pediatric Dose for Microsporidiosis:

Some experts recommend: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day

Comments:
-Recommended for disseminated infection due to E hellem, E cuniculi, E intestinalis, Pleistophora species, Trachipleistophora species, or A vesicularum
-Recommended for intestinal infection due to E intestinalis
-With fumagillin, recommended for ocular infection due to E hellem, E cuniculi, or V corneae

US CDC, NIH, HIVMA/IDSA, Pediatric Infectious Diseases Society, and AAP recommendations for HIV-exposed and HIV-infected children: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day

US CDC, NIH, and HIVMA/IDSA recommendations for HIV-infected adolescents: 400 mg orally twice a day

Comments:
-Recommended as preferred therapy (including treatment and secondary prophylaxis)
-Recommended for intestinal and disseminated (not ocular) infection due to Microsporidia other than E bieneusi and V corneae
-With fumagillin, recommended for ocular infection for management of systemic infection

Introduction

Anthelmintic agent; benzimidazole derivative.1 4

Albendazole Dosage and Administration

Administration

Oral Administration

Administer orally with food.1 Food, especially fatty food, increases bioavailability.1 3 7

In patients (particularly young children) who have difficulty swallowing tablets whole, tablets may be crushed or chewed and swallowed with a drink of water.1

Dosage

Pediatric Patients

Neurocysticercosis Oral

Children weighing <60 kg: 15 mg/kg daily (up to 800 mg daily), administered as 2 equally divided doses with meals, for 8–30 days.1 8 Repeat as necessary.8

Children ≥6 years of age and weighing ≥60 kg: 400 mg twice daily with meals for 8–30 days.1 8 5 Repeat as necessary.8

Hydatid Disease Oral

Children <60 kg: 15 mg/kg daily (up to 800 mg daily), administered in 2 equally divided doses with meals for 28 days, followed by a 14-day albendazole-free interval.1 Repeat for a total of 3 dosage cycles.1

Children ≥6 years of age and weighing ≥60 kg: 400 mg twice daily with meals for 28 days, followed by a 14-day albendazole-free interval.1 Repeat for a total of 3 dosage cycles.1

Alternatively, 15 mg/kg daily (up to 800 mg daily) for 1–6 months has been recommended for treatment of hydatid cyst disease in pediatric patients.8

Ascariasis† Oral

Single 400-mg dose.8

Baylisascariasis† Oral

25–50 mg/kg daily for 10 days.18 Some clinicians recommend a 20-day regimen.8

Immediate treatment is recommended if infection is probable; treatment should not be delayed until patient is symptomatic.18

Enterobiasis† Oral

400-mg initial dose followed by a second 400-mg dose given 2 weeks later.8

Consider treating household contacts, especially in situations in which multiple or repeated symptomatic infections occur.8 13

Filariasis† Filariasis Caused by Mansonella perstans† Oral

400 mg twice daily for 10 days.8

Hookworm Infections† Cutaneous Larva Migrans (Creeping Eruption)† Oral

400 mg once daily for 3 days.8

Intestinal Hookworm Infections† Oral

Single 400-mg dose.8

Perform a repeat stool examination (using a concentration technique) for eggs of Ancylostoma duodenale or Necator americanus 2 weeks after treatment; repeat dose if results are positive.13

Eosinophilic Enterocolitis Caused by Ancylostoma caninum† Oral

Single 400-mg dose.8

Toxocariasis (Visceral Larva Migrans)† Oral

400 mg twice daily for 5 days.8 Optimum duration of therapy not known; some clinicians recommend up to 20 days of treatment.8

Strongyloidiasis† Oral

400 mg twice daily for 2 days.8

Repeated or prolonged therapy or use of other agents may be necessary in immunocompromised individuals or those with disseminated disease.8 13

Trichinellosis† Oral

400 mg twice daily for 8–14 days.8

Trichostrongyliasis† Oral

Single 400-mg dose.8

Trichuriasis† Oral

400 mg once daily for 3 days.8

Capillariasis† Oral

400 mg once daily for 10 days.8

Gnathostomiasis† Oral

400 mg twice daily for 21 days.a

Gongylonemiasis† Oral

10 mg/kg daily for 3 days.8

Trematode (Fluke) Infections† Oral

10 mg/kg daily for 7 days.8

Giardiasis† Oral

400 mg daily for 5 days (alone or in conjunction with metronidazole).8

Adults

Neurocysticercosis Oral

Adults <60 kg: 15 mg/kg daily (up to 800 mg daily), administered in 2 equally divided doses with meals, for 8–30 days.1 8 Repeat as necessary.8

Adults ≥60 kg: 400 mg twice daily with meals for 8–30 days.1 8 5 Repeat as necessary.8

Hydatid Disease Oral

Adults <60 kg: 15 mg/kg daily (up to 800 mg daily), administered in 2 equally divided doses with meals for 28 days, followed by a 14-day albendazole-free interval.1 Repeat for a total of 3 dosage cycles.1

Adults ≥60 kg: 400 mg twice daily with meals for 28 days, followed by a 14-day albendazole-free interval.1 Repeat for a total of 3 dosage cycles.1

Alternatively, 400 mg twice daily for 1–6 months has been recommended for treatment of hydatid cyst disease in adults.8

Ascariasis† Oral

Single 400-mg dose.8

Baylisascariasis† Oral

25–50 mg/kg daily for 10 days.18 Some clinicians recommend a 20-day regimen.8

Enterobiasis† Oral

400-mg initial dose followed by a second 400-mg dose given 2 weeks later.8

Consider treating household contacts, especially in situations in which multiple or repeated symptomatic infections occur.8 13

Filariasis† Filariasis Caused by Mansonella perstans† Oral

400 mg twice daily for 10 days.8

Hookworm Infections† Cutaneous Larva Migrans (Creeping Eruption)† Oral

400 mg once daily for 3 days.8

Intestinal Hookworm Infections† Oral

Single 400-mg dose.8

Perform a repeat stool examination (using a concentration technique) for eggs of Ancylostoma duodenale or Necator americanus 2 weeks after treatment; repeat dose if results are positive.13

Eosinophilic Enterocolitis Caused by Ancylostoma caninum† Oral

Single 400-mg dose.8

Toxocariasis (Visceral Larva Migrans)† Oral

400 mg twice daily for 5 days.8 Optimum duration of therapy not known; some clinicians recommend up to 20 days of treatment.8

Strongyloidiasis† Oral

400 mg twice daily for 2 days.8

Repeated or prolonged therapy or use of other agents may be necessary in immunocompromised individuals or those with disseminated disease.8 13

Trichinellosis† Oral

400 mg twice daily for 8–14 days.8

Trichostrongyliasis† Oral

Single 400-mg dose.8

Trichuriasis† Oral

400 mg once daily for 3 days.8

Capillariasis† Oral

400 mg once daily for 10 days.8

Gnathostomiasis† Oral

400 mg twice daily for 21 days.a

Gongylonemiasis† Oral

10 mg/kg daily for 3 days.8

Trematode (Fluke) Infections† Oral

10 mg/kg daily for 7 days.8

Giardiasis† Oral

400 mg daily for 5 days (alone or in conjunction with metronidazole).8

Microsporidiosis† Intestinal Microsporidiosis† Oral

400 mg twice daily for 21 days.8

Ocular Microsporidiosis† Oral

400 mg twice daily.8

Disseminated Microsporidiosis† Oral

400 mg twice daily.8

Prescribing Limits

Pediatric Patients

Neurocysticercosis Oral

Children weighing <60 kg: Maximum 800 mg daily.1 8

Hydatid Disease Oral

Children weighing <60 kg: Maximum 800 mg daily.1 8

Adults

Neurocysticercosis Oral

Adults weighing <60 kg: Maximum 800 mg daily.1 8

Hydatid Disease Oral

Adults weighing <60 kg: Maximum 800 mg daily.1 8

Special Populations

No special population dosage recommendations at this time.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Albendazole

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

200 mg

Albenza (with povidone)

GlaxoSmithKline

Commonly used brand name(s)

In the U.S.

  • Albenza

Available Dosage Forms:

  • Tablet, Chewable
  • Tablet

Therapeutic Class: Anthelmintic

Chemical Class: Benzimidazole

Precautions While Using albendazole

It is important that your doctor check your progress after treatment. This is to make sure that the infection is cleared up completely, and to allow your doctor to check for any unwanted effects. Blood tests may be needed to check for unwanted effects.

If your symptoms do not improve after you have taken albendazole for the full course of treatment, or if they become worse, check with your doctor.

For women of childbearing age, it is important that you use an effective form of birth control while using albendazole and for at least 1 month after your last dose. Also, your doctor should give you a pregnancy test before you start the medicine to make sure you are not pregnant.

Albendazole can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:

  • If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
  • Check with your doctor immediately if you notice any unusual bleeding or bruising; black, tarry stools; blood in the urine or stools; or pinpoint red spots on your skin.
  • Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
  • Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
  • Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
  • Avoid contact sports or other situations where bruising or injury could occur.

For patients treated for neurocysticercosis, albendazole may increase your risk for increased pressure in the head or seizures. Tell your doctor right away if you have these symptoms.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Pronunciation

(al BEN da zole)

Dosing Renal Impairment

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). However, the need for adjustment not likely since albendazole is primarily eliminated by hepatic metabolism.

Adverse Reactions

>10%:

Central nervous system: Headache (neurocysticercosis: 11%; hydatid: 1%)

Hepatic: Increased liver enzymes (hydatid: 16%; neurocysticercosis: <1%)

1% to 10%:

Central nervous system: Increased intracranial pressure (≤2%), dizziness (≤1%), vertigo (≤1%), meningism (1%)

Dermatologic: Alopecia (<1% to 2%)

Gastrointestinal: Abdominal pain (≤6%), nausea and vomiting (4% to 6%)

Miscellaneous: Fever (≤1%)

<1% (Limited to important or life-threatening): Acute hepatic failure, acute renal failure, agranulocytosis, aplastic anemia, erythema multiforme, granulocytopenia, hepatitis, hypersensitivity reaction, leukopenia, neutropenia, pancytopenia, skin rash, Stevens-Johnson syndrome, thrombocytopenia, urticaria

What is albendazole (albenza)?

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 may also be used for other purposes not listed in this medication guide.

  • Pinworms

Usual Adult Dose for Capillariasis

US CDC recommendations: 400 mg orally once a day for 10 days

Comments: Recommended as alternative therapy

Usual Adult Dose for Clornorchis sinensis (Liver Fluke)

US CDC recommendations: 10 mg/kg/day orally for 7 days

Comments: Recommended as alternative therapy

Usual Adult Dose for Loiasis

US CDC recommendations: 200 mg orally twice a day for 21 days

Comments:
-Recommended for symptomatic infection with microfilariae of Loa loa/mL less than 8000 and 2 rounds of diethylcarbamazine failed; or recommended for symptomatic loiasis with microfilariae of L loa/mL at least 8000 to reduce level to less than 8000 before diethylcarbamazine therapy
-Treatment of this infection is complex; experts with experience treating this disease and preventing complications of therapy should be consulted.

Usual Pediatric Dose for Pinworm Infection (Enterobius vermicularis)

AAP recommendations:
-Children less than 20 kg: 200 mg orally as a single dose; repeat in 2 weeks
-Children at least 20 kg: 400 mg orally as a single dose; repeat in 2 weeks

Some experts recommend: 400 mg orally as a single dose; repeat in 2 weeks

Comments: Some clinicians recommend all household contacts of infected patients receive treatment, especially when multiple or repeated symptomatic infections occur, since such contacts commonly also are infected; retreatment after 14 to 21 days may be needed.

Usual Pediatric Dose for Filariasis

Some experts recommend: 400 mg orally twice a day for 10 days

Comments: Recommended for infection due to M perstans

Usual Pediatric Dose for Enterocolitis

Some experts recommend: 400 mg orally once as a single dose

Comments: Recommended for eosinophilic enterocolitis due to A caninum

Liver Dose Adjustments

Data not available

Precautions

Consult WARNINGS section for additional precautions.

Albendazole Breastfeeding Warnings

This drug and its active metabolites are minimally excreted into breast milk. Because this drug acts primarily in the intestinal system of the mother and little is absorbed systemically, the WHO considers it compatible with breastfeeding. An informal consultation group concluded single-dose therapy can be used in lactating women. A single 400 mg oral dose was administered to 33 women who were breastfeeding infants (aged between 2 weeks and 6 months). Milk samples were collected prior to dosing and 6, 12, 24, and 36 hours after dosing. Maternal blood samples were collected 6 hours after dosing. Albendazole, albendazole sulfoxide, and albendazole sulfone were detectable in maternal blood and milk samples. Peak milk level for the sulfoxide metabolite was reached at about 6.9 hours and averaged 352 mcg/L and the half-life in breast milk was 12.4 hours; these properties were determined using data from 20 women who provided at least 3 milk samples. The sulfoxide metabolite level 36 hours after dosing averaged 57 mcg/L; the parent drug and the sulfone metabolite were undetectable (less than 661 mcg/L) in milk at this time. According to author estimation, a fully breastfed infant would be exposed to less than 0.1 mg/kg of the sulfoxide metabolite over the 36 hours after a 400 mg maternal dose and have even less exposure to the parent drug; this correlates to an infant dose less than 1.5% of the weight-adjusted maternal dose. A single 400 mg oral dose was administered to 2 mothers with intestinal parasites while exclusively breastfeeding their infants (aged between 1 and 6 months). No side effects were reported in the breastfed infants.

LactMed/WHO: Use is considered acceptable. -AU: Breastfeeding is not recommended during use of this drug and for at least 5 days or at least 1 month after therapy, depending on product. -US: Caution is recommended. Excreted into human milk: Yes Comments: The effects in the nursing infant are unknown.

Albendazole Identification

Substance Name

Albendazole

CAS Registry Number

54965-21-8

Drug Class

Antiinfective Agents

Anticestodal Agents

Antiparasitic Agents

Antiprotozoal Agents

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