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Albendazole

Class
Antihelmintic agents
Subclass
Benzimidazoles
Generic name
Albendazole
Brand names
Albenza®
Common formulations
Film-coated tablet
Dosage and administration
Adults patients
Treatment
Hydatid disease • Of liver, of lung, of peritoneum, caused by larval form of Echinococcus granulosus
Weight ≥ 60 kg
•
400 mg PO BID
28 Days, followed by a 14-day albendazole-free interval, with subsequent 28-day treatment cycles with 14-day pause for a total of 3 cycles.
Parenchymal neurocysticercosis • Caused by larval forms of Taenia solium
Weight ≥ 60 kg
•
400 mg PO BID for 8-30 days
Weight < 60 kg
•
7.5 mg/kg PO BID for 8-30 days
Maximum 800 mg daily.
Capillariasis • Off-label
•
200 mg PO BID for 10 days
Clonorchiasis • Off-label
•
400 mg PO BID
Take with food. Perform test of cure 1 month after treatment.
Disseminated non-ocular infections in patients with HIV infection • Associated with microsporidiosis, excluding Enterocytozoon bieneusi or Vittaforma corneae infections • Off-label
•
400 mg PO BID a duration of therapy until the CD4 count is >200 cells/mm^3 for at least 6 months after starting antiretroviral therapy
Enterobiasis • Off-label
•
400 mg PO once, followed by a repeat dose after 2 weeks
Hymenolepis nana infection • Off-label
•
400 mg PO daily for 3 days, retreat in 10-21 days in confirmed cases or if not eradicated in suspected cases
Microsporidiosis in patients without HIV infection • Off-label
•
400 mg PO BID for 14-28 days
Opisthorchiasis • Off-label
•
400 mg PO BID for 3 days, confirm eradication in 1 month
Take with food.
Toxocariasis • Off-label
•
400 mg PO BID for 5 days
Trichinellosis • Off-label
•
400 mg PO BID for 8-14 days
Trichostrongylosis • Off-label
•
400 mg PO once
Secondary prevention
Cutaneous larva migrans • Off-label
•
400 mg PO daily for 3 days
Disseminated non-ocular infections in patients with HIV infection • Associated with microsporidiosis, excluding Enterocytozoon bieneusi or Vittaforma corneae infections • Off-label
•
400 mg PO BID a duration of therapy until the CD4 count is >200 cells/mm^3 for at least 6 months after starting antiretroviral therapy
Gastrointestinal infections associated with microsporidiosis in patients with HIV infection • Excluding enterocytozoon bieneusi or vittaforma corneae infections • Off-label
•
400 mg PO BID a duration of therapy until the CD4 count is >200 cells/mm^3 for at least 6 months after starting antiretroviral therapy
Microsporidiosis in patients without HIV infection • Off-label
•
400 mg PO BID
Alternative
•
1 g PO daily
Other off-label uses
•
Treatment of ascariasis
•
Treatment of strongyloidiasis
•
Treatment of trichuriasis
Indications for use
Labeled indications
Adults
•
Treatment of hydatid disease (of liver, of lung, of peritoneum, caused by larval form of Echinococcus granulosus)
•
Treatment of parenchymal neurocysticercosis (caused by larval forms of Taenia solium)
Off-label indications
Adults
•
Treatment of ascariasis
•
Treatment of capillariasis
•
Treatment of clonorchiasis
•
Treatment of disseminated non-ocular infections in patients with HIV infection (associated with microsporidiosis, excluding Enterocytozoon bieneusi or Vittaforma corneae infections)
•
Treatment of enterobiasis
•
Treatment of hymenolepis nana infection
•
Treatment of microsporidiosis in patients without HIV infection
•
Treatment of opisthorchiasis
•
Treatment of strongyloidiasis
•
Treatment of toxocariasis
•
Treatment of trichinellosis
•
Treatment of trichostrongylosis
•
Treatment of trichuriasis
•
Secondary prevention of cutaneous larva migrans
•
Secondary prevention of disseminated non-ocular infections in patients with HIV infection (associated with microsporidiosis, excluding Enterocytozoon bieneusi or Vittaforma corneae infections)
•
Secondary prevention of gastrointestinal infections associated with microsporidiosis in patients with HIV infection (excluding enterocytozoon bieneusi or vittaforma corneae infections)
•
Secondary prevention of microsporidiosis in patients without HIV infection
Safety risks
Contraindications
Hypersensitivity to albendazole or its components
Warnings and precautions
Agranulocytosis, aplastic anemia
•
Use caution in patients with liver disease and patients with hepatic echinococcosis.
ALF
•
Use caution in patients with hepatic disease or biliary tract disease.
Increased ICP, neurologic abnormalities
•
Use extreme caution in patients being treated for neurocysticercosis. Co-administer steroids and anticonvulsants to prevent neurological symptoms as a result of parasitic death.
Neutropenia
•
Use caution in patients history of leukopenia or neutropenia or other bone marrow suppression.
Retinal pathology
•
Use extreme caution in patients being treated for neurocysticercosis presenting with retinal lesions.
Specific populations
Renal impairment
eGFR 0-90 mL/min/1.73 m²
•
Use acceptable. No dose adjustment required.
Renal replacement therapy
Continuous renal replacement
•
Use acceptable. No dose adjustment required.
Intermittent hemodialysis
•
Use acceptable. No dose adjustment required.
Peritoneal dialysis
•
Use acceptable. No dose adjustment required.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: D
•
Avoid use. Evidence of fetal harm in humans. Consider effective contraception for patients of child-bearing age using chronic therapy.
Breastfeeding
Acceptable for use during breastfeeding.
Unknown drug levels in breastfed infants.
No overt adverse effects reported in breastfed infants.
No overt adverse effects on lactation reported.
Adverse reactions
Common 1-10%
•
↑ liver enzymes, abdominal pain, dizziness, fever, hair loss, headache, nausea, vomiting, vertigo
Uncommon < 1%
•
Acute liver failure, agranulocytosis, agranulocytosis, aplastic anemia, congenital neutropenia, erythema multiforme, hepatitis, hypersensitivity reactions, ↑ liver enzymes, neutropenia, pancytopenia, asthenia, blurred vision, convulsion, somnolence, rhabdomyolysis, Stevens-Johnson syndrome
Interactions
Drug(s)
Check Interactions
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