Albendazole is a benzimidazole carbamate anthelmintic agent with broad-spectrum activity against intestinal and tissue-dwelling nematodes and cestodes. This synthetic compound demonstrates potent vermicidal and ovicidal properties through selective inhibition of parasite-specific tubulin polymerization, disrupting microtubule formation and energy metabolism. The medication represents a cornerstone in antiparasitic therapy, particularly effective against neurocysticercosis, hydatid disease, and various soil-transmitted helminthiases. Its extensive clinical utilization stems from excellent tissue penetration and reliable efficacy across multiple parasitic species, making it an essential therapeutic option in both individual treatment and mass drug administration programs.

Features

• Synthetic benzimidazole derivative with broad antiparasitic spectrum
• Inhibits parasite tubulin polymerization and glucose uptake
• Active against larval and adult stages of susceptible helminths
• Demonstrates ovicidal activity against numerous parasite species
• Excellent tissue penetration, including central nervous system
• Metabolized to active sulfoxide metabolite (albendazole sulfoxide)
• Available in 200mg and 400mg tablet formulations
• Suitable for single-dose and prolonged treatment regimens

Benefits

• Comprehensive Parasite Elimination: Effectively targets both adult worms and developing larvae across multiple parasite species
• Reduced Transmission Risk: Ovicidal activity helps break the cycle of parasitic reinfection within communities
• Improved Nutritional Status: By eliminating intestinal parasites, enhances nutrient absorption and reduces anemia prevalence
• Prevention of Tissue Damage: Controls larval migration and cyst formation in vital organs including liver, lungs, and brain
• Cost-Effective Treatment: Provides high therapeutic value at relatively low cost, facilitating widespread use in endemic areas
• Flexible Dosing Regimens: Adaptable to both mass drug administration programs and individualized therapeutic approaches

Common use

Albendazole is primarily indicated for the treatment of various parasitic infections including neurocysticercosis caused by Taenia solium larvae, hydatid disease resulting from Echinococcus granulosus, and intestinal infections by Ascaris lumbricoides, hookworm (Ancylostoma duodenale and Necator americanus), Trichuris trichiura, and Enterobius vermicularis. It is also employed off-label for treatment of cutaneous larva migrans, gnathostomiasis, and microsporidiosis in immunocompromised patients. The World Health Organization recommends albendazole for preventive chemotherapy in public health programs targeting soil-transmitted helminthiases in endemic regions.

Dosage and direction

Neurocysticercosis: 15 mg/kg/day divided into two doses (maximum 800 mg/day) with meals for 8-30 days depending on cyst resolution. Concurrent corticosteroid therapy is recommended to minimize inflammatory reactions.

Hydatid disease: 15 mg/kg/day divided into two doses (maximum 800 mg/day) with meals for 28-day cycles followed by 14-day drug-free intervals. Typically requires 3 or more cycles with monitoring of cyst size.

Intestinal parasites: Single 400mg dose for most adults and children over 2 years. For strongyloidiasis, 400mg daily for 3 days.

Administration with fatty meals enhances bioavailability. Tablets should be swallowed whole and not crushed or chewed. Dosage adjustments may be necessary in patients with hepatic impairment.

Precautions

Hepatic function should be monitored before and during treatment, particularly with prolonged therapy. Complete blood counts are recommended during extended courses due to potential bone marrow suppression. Use with caution in patients with pre-existing liver disease or biliary obstruction. Corticosteroid coverage is advised when treating neurocysticercosis to prevent inflammatory responses to dying parasites. Women of childbearing potential should use effective contraception during and for one month after treatment. Retinal examination is recommended before treatment for ocular involvement.

Contraindications

Hypersensitivity to albendazole, other benzimidazoles, or any component of the formulation. Contraindicated in pregnancy due to potential teratogenic effects. Avoid use in patients with known bone marrow suppression. Not recommended for children under 1 year due to limited safety data. Avoid concomitant use with ritonavir due to significant interaction.

Possible side effect

Common: Headache (11%), nausea (6%), vomiting (4%), abdominal pain (4%), dizziness (3%), reversible alopecia (2%), elevated liver enzymes (16% with prolonged use)

Less common: Leukopenia, thrombocytopenia, hypersensitivity reactions, fever, meningeal signs in neurocysticercosis treatment

Rare: Stevens-Johnson syndrome, toxic epidermal necrolysis, agranulocytosis, pancytopenia, acute liver failure

Most adverse effects are mild and transient, with serious reactions occurring primarily with prolonged high-dose therapy.

Drug interaction

Cimetidine: Increases plasma levels of albendazole sulfoxide by approximately 50% Praziquantel: Increases plasma levels of albendazole sulfoxide by approximately 50% Dexamethasone: May increase albendazole sulfoxide levels Ritonavir: Significantly decreases albendazole sulfoxide levels - avoid concomitant use Carbamazepine, phenytoin, phenobarbital: May decrease albendazole levels Theophylline: Albendazole may decrease theophylline levels

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed dose. For once-daily dosing regimens, if remembered within 12 hours of missed dose, take immediately. If remembered later, skip the missed dose and resume regular schedule. For twice-daily dosing, if remembered within 6 hours of missed dose, take immediately.

Overdose

Symptoms may include nausea, vomiting, dizziness, headache, and abdominal pain. In massive overdose, bone marrow suppression, liver injury, or renal impairment may occur. There is no specific antidote. Gastric lavage may be considered if presented early. Supportive care including monitoring of blood counts and liver function is recommended. Hemodialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (15-30°C or 59-86°F). Protect from light and moisture. Keep container tightly closed. Do not store in bathroom or near kitchen sink. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any medication. The prescribing physician should make final determinations regarding appropriate therapy based on individual patient factors. Dosage recommendations may vary based on specific clinical circumstances and regional guidelines.

Reviews

“Albendazole has revolutionized our approach to neurocysticercosis management. The reduction in seizure frequency and cyst resolution rates are remarkable, though inflammatory responses require careful corticosteroid management.” - Neurology Specialist

“In mass drug administration programs, albendazole’s single-dose efficacy against soil-transmitted helminths has significantly reduced parasite burden in endemic communities. The safety profile makes it ideal for public health interventions.” - Tropical Medicine Expert

“While generally well-tolerated, we’ve observed that prolonged courses require vigilant monitoring of liver function and hematological parameters. The drug-food interaction is clinically significant and must be emphasized to patients.” - Clinical Pharmacologist