Dosing and uses of Albenza, (albendazole)
Adult dosage forms and 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
Pediatric dosage forms and 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
Albenza, (albendazole) adverse (side) 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 albendazole or benzimidazoles
Cautions
Monitor theophylline levels if used concomitantly
Potential for bone marrow suppression, aplastic anemia & agranulocytosis; monitor blood counts in all patients at the beginning of each 28-day cycle of therapy, and every 2 weeks while on therapy; discontinue therapy if clinically significant changes in blood counts occur
Pre-existing neurocysticercosis may be uncovered in patients treated w/ albendazole for other conditions, apparent by neurological symptoms (eg, seizures, increased intracranial pressure, focal signs); promptly treat w/ corticosteroid & anticonvulsant therapy
Obtain pregnancy test in women of reproductive potential prior to therapy and avoid usage in pregnant women except in clinical circumstances where no alternative management is appropriate; discontinue therapy if pregnancy occurs and apprise patient of potential hazard to fetus
Risk of retinal damage in retinal cysticercosis; cases of retinal involvement reported; examine patient for presence of retinal lesions before initiating therapy for neurocysticercosis
Reversible elevations of liver enzymes may occur; monitor liver enzymes before start of each treatment cycle and at least every 2 weeks while on therapy and discontinue if clinically significant elevations occur; patients with abnormal LFTs and hepatic echinococcosis are at increased risk of hepatotoxicity; discontinue therapy if LFT elevations >2 times upper limit of normal; may consider restarting treatment when LFT values return to pretreatment levels
Pregnancy and lactation
Pregnancy category: C
Lactation: unknown, use caution
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 of Albenza, (albendazole)
Mechanism of action
Causes degeneration of cytoplasmic microtubule in intestinal and tegmental cells of intestinal helminths
Pharmacokinetics
Absorption: <5%; may increase up to 4-5 times with a fatty meaL
Distribution: Well inside hydatid cysts & CSF
Protein Bound: 70%
Metabolism: Hepatic; extensive first-pass effect; pathways include rapid sulfoxidation (major), hydrolysis, & oxidation
Half-life: 8-12 hr
Peak Plasma Time: 2-5 hr
Excretion: urine (<1% as active metabolite); feces
