albendazole (Rx)

Brand and Other Names:Albenza
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 200mg

Neurocysticercosis (Taenia Solium Tapeworm)

Indicated for treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium

<60 kg: 15 mg/kg/day divided BID PO x 8-30 days; not to exceed 800 mg/day 

≥60 kg: 400 mg PO BID x 8-30 days

Hydatid (Echinococcus Tapeworm)

Indicated for the treatment of cystic hydatid disease of the liver, lung, and peritoneum, caused by the larval form of the dog tapeworm, Echinococcus granulosus

<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 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

Dosage Modifications

Renal impairment: Not studied

Hepatic impairment

  • In patients with evidence of extrahepatic obstruction, systemic availability of albendazole sulfoxide was increased, as indicated by a 2-fold increase in maximum serum concentration and a 7-fold increase in area under the curve

Dosing Considerations

Concomitant medication to avoid adverse reactions

  • Neurocysticercosis
    • Patients should receive appropriate steroid and anticonvulsant therapy as required
    • Consider oral or IV corticosteroids to prevent cerebral hypertensive episodes during the first week of treatment

Monitoring parameters before and during treatment

  • Monitor blood cell counts at the beginning of each 28-day cycle of therapy, and every 2 weeks while on therapy in all patients
  • Monitor liver transaminases at the beginning of each 28-day cycle of therapy, and at least every 2 weeks during treatment in all patients
  • Obtain a pregnancy test in females of reproductive potential prior to therapy

Dosage Forms & Strengths

tablet

  • 200mg

Neurocysticercosis (Taenia Solium Tapeworm)

Indicated for treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium

<60 kg: 15 mg/kg/day divided BID PO x 8-30 days; not to exceed 800 mg/day 

≥60 kg: 400 mg PO BID x 8-30 days

Hydatid (Echinococcus Tapeworm)

Indicated for the treatment of cystic hydatid disease of the liver, lung, and peritoneum, caused by the larval form of the dog tapeworm, Echinococcus granulosus

<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

Dosage Modifications

Renal impairment: Not studied

Hepatic impairment

  • In patients with evidence of extrahepatic obstruction, systemic availability of albendazole sulfoxide was increased, as indicated by a 2-fold increase in maximum serum concentration and a 7-fold increase in area under the curve

Dosing Considerations

Concomitant medication to avoid adverse reactions

  • Neurocysticercosis
    • Patients should receive appropriate steroid and anticonvulsant therapy as required
    • Consider oral or IV corticosteroids to prevent cerebral hypertensive episodes during the first week of treatment

Monitoring parameters before and during treatment

  • Monitor blood cell counts at the beginning of each 28-day cycle of therapy, and every 2 weeks while on therapy in all patients
  • Monitor liver transaminases at the beginning of each 28-day cycle of therapy, and at least every 2 weeks during treatment in all patients
  • Obtain a pregnancy test in females of reproductive potential prior to therapy
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Interactions

Interaction Checker

and albendazole

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache

            • Neurocysticercosis (11%)
            • Hydatid disease (1.3%)

            Abnormal LFT

            • Hydatid disease (15.6%)
            • Neurocysticercosis (<1%)

            1-10%

            Abdominal pain

            • Hydatid disease (6%)

            Nausea/vomiting

            • Hydatid disease (3.7%)
            • Neurocysticercosis (6.2%)

            Dizziness/vertigo

            • Hydatid disease (1.2%)
            • Neurocysticercosis (<1%)

            Increased intracranial pressure

            • Neurocysticercosis (1%)

            Meningeal signs

            • Neurocysticercosis (1%)

            Alopecia (reversible)

            • Hydatid disease (1.6%)
            • Neurocysticercosis (<1%)

            Fever

            • Hydatid disease (1%)

            <1% (selected)

            Rash

            Urticaria

            Agranulocytosis

            Aplastic anemia

            Bone marrow suppression

            Granulocytopenia

            Pancytopenia

            Thrombocytopenia

            Hepatitis

            Acute liver failure

            Acute renal failure

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            Warnings

            Contraindications

            Hypersensitivity to the benzimidazole class of compounds or any components of albendazole

            Cautions

            Based on findings from animal reproduction studies, fetal harm when administered to a pregnant woman

            Patients being treated for neurocysticercosis should receive steroid and anticonvulsant therapy to prevent neurological symptoms (eg, seizures, increased intracranial pressure and focal signs)

            Cysticercosis may involve the retina; before initiating therapy for neurocysticercosis, examine for the presence of retinal lesions; if such lesions are visualized, weigh the need for anticysticeral therapy against the possibility of retinal damage resulting from inflammatory damage caused by albendazole

            Undiagnosed neurocysticercosis may be uncovered; evaluate patients with epidemiologic factors who are at risk for neurocysticercosis before initiation of therapy

            Hepatic effects

            • Mild to moderate elevations of hepatic enzymes have been reported; there are also case reports of acute liver failure of uncertain causality and hepatitis
            • If hepatic enzymes exceed twice the upper limit of normal, consider discontinuing therapy based on individual patient circumstances
            • Restarting treatment in patients whose hepatic enzymes have normalized off treatment; consider the risk/benefit of further treatment
            • Perform laboratory tests frequently if treatment is restarted

            Bone marrow suppression

            • Bone marrow suppression, aplastic anemia, and agranulocytosis may occur
            • Fatalities have been reported due to granulocytopenia or pancytopenia
            • Patients with liver disease and hepatic echinococcosis are at increased risk or bone marrow suppression
            • Discontinue if clinically significant decreased in blood cell counts occur
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            Pregnancy & Lactation

            Pregnancy

            Based on findings from animal reproduction studies, fetal harm may occur when administered to a pregnant woman

            Available human data from a small number of published case series and reports on the use of multiple-dose albendazole in the 1st trimester of pregnancy, and several published studies on single-dose albendazole use later in pregnancy, have not identified any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes

            Pregnancy testing is recommended for females of reproductive potential before treatment

            Animal data

            • In animal reproductive studies, oral administration of albendazole during organogenesis caused embryotoxicity and skeletal malformations in pregnant rats (at doses of 0.10 times and 0.32 times the maximum recommended human dose based on body surface area in mg/m2 ) and pregnant rabbits (at doses of 0.60 times the maximum recommended human dose based on body surface area in mg/m2 )
            • Associated with maternal toxicity in rabbits (at doses of 0.60 times the recommended human dose based on body surface area)

            Contraception

            • Fetal harm when administered to a pregnant woman
            • Advise females of reproductive potential to use effective contraception during treatment and for 3 days after the final dose

            Lactation

            Concentrations of albendazole and the active metabolite, albendazole sulfoxide, have been reported to be low in human breast milk

            There are no reports of adverse effects on the breastfed infant and no information on the effects on milk production

            Consider developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need and any potential adverse effects on the breastfed infant from albendazole or from the underlying maternal condition

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Causes degeneration of cytoplasmic microtubule in intestinal and tegmental cells of intestinal helminths

            Absorption

            Peak plasma time: 2-5 hr

            Peak plasma concentration: 1310 ng/mL

            Distribution

            Protein bound: 70% (detected in urine, bile, liver, cyst wall, cyst fluid, and cerebrospinal fluid)

            Metabolism

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

            Elimination

            Half-life: 8-12 hr

            Excretion: Urine (<1%)

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            Administration

            Oral Administration

            Take with food

            Tablets may be crushed or chewed and swallowed with a drink of water

            Storage

            Store at 20 -25°C

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.