Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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
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
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.
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%)
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
Images
Patient Handout
Formulary
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