Dosing and uses of Emverm, Vermox (mebendazole)
Adult dosage forms and strengths
tablet, chewable
- 100mg (Emverm)
- 500mg (Vermox)
Pinworm (Enterobius vermicularis)
100 mg PO as a single dose
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Roundworm (Ascaris lumbricoides)
Emverm: 100 mg PO q12hr for 3 days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox: 500 mg PO as a single dose
Whipworm (Trichuris trichiura)
Emverm: 100 mg PO q12hr for 3 consecutive days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox: 500 mg PO as a single dose
Hookworm (Ancylostoma duodenale, Necator americanus)
Emverm: 100 mg PO q12hr for 3 consecutive days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Giardia Duodenalis (Giardiasis; Off-label)
200 mg PO q8hr for 5 days
Mansonella Perstans (Filariasis; Off-label))
100 mg PO q12hr
Visceral Larva Migrans (Toxocariasis; Off-label)
100-200 mg PO q12hr for 5 days
Dosing Considerations
Chewable tablet, see Administration for complete instructions
Pediatric dosage forms and strengths
tablet, chewable
- 100mg (Emverm)
- 500mg (Vermox)
Pinworm (Enterobius vermicularis)
<2 years: Safety and efficacy not established
Emverm, ≥2 years: 100 mg PO as a single dose
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Roundworm (Ascaris lumbricoides)
Emverm
- <2 years: Safety and efficacy not established
- ≥2 years: 100 mg PO q12hr for 3 days
- If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox
- <1 year: Safety and efficacy not established
- ≥1 year: 500 mg PO as a single dose
Whipworm (Trichuris trichiura)
Emverm
- <2 years: Safety and efficacy not established
- ≥2 years: 100 mg PO q12hr for 3 consecutive days
- If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox
- <1 year: Safety and efficacy not established
- ≥1 year: 500 mg PO as a single dose
Hookworm (Ancylostoma duodenale, Necator americanus)
<2 years: Safety and efficacy not established
Emverm, ≥2 years: 100 mg PO q12hr for 3 consecutive days
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Dosing Considerations
Chewable tablet, see Administration for complete instructions
Emverm, Vermox (mebendazole) adverse (side) effects
Frequency not defined
Angioedema
Fever
Dizziness
Headache
Hematuria
Leukopenia
Seizures
Drowsiness
Decreased hemoglobin
Rash
Itching
Agranulocytosis
Alopecia (with high doses)
Abdominal pain
Diarrhea
Nausea
Toxic epidermal necrolysis
May increase AST, ALT, and GGT (hepatitis)
Stevens-Johnson syndrome
Vomiting
Neutropenia (sore throat, unusual fatigue)
Toxic epidermal necrolysis
Unusual weakness
Glomerulonephritis
Warnings
Contraindications
Hypersensitivity
Cautions
Neutropenia and agranulocytosis reported with high doses
Not effective for hydatid disease
Systemic exposure may increase with hepatic impairment
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in breast milk 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 Emverm, Vermox (mebendazole)
Mechanism of action
Blocks glucose uptake; inhibits the formation of helminth microtubules in susceptible adult intestine-dwelling helminths
Absorption
Absorption: 2-10%
Peak serum time: 2-4 hr
Distribution
Distribution: To serum, cyst fluid, liver, omental fat, and pelvic, pulmonary, and hepatic cysts; highest concentrations found in liver; relatively high concentrations found in muscle-encysted Trichinella spiralis larvae; crosses placenta
Protein bound: 90-95%
Vd: 1-2 L/kg
Metabolism
Metabolism: Extensively hepatic
Elimination
Half-life elimination: 3-6 hr
Excretion: Feces (primarily); urine (~2%)
Administration
Oral Administration
Emverm
- May take with or without food
- May be swallowed whole, chewed, or crushed and mixed with food
Vermox
- May take with or without food
- Chew tablet completely before swallowing, do not swallow tablet whole
- Difficulty chewing tablet
- Tablet can be placed in a spoon with ~2-3 mL of drinking water added onto the tablet using a dosing syringe
- Within 2 minutes, the tablet absorbs the water and turns into a soft mass with semisolid consistency, which can then be swallowed
