ALBENDAZOLE

ALBENDAZOLe
(al-ben'da-zole)
Albenza
Classifications: anthelmintic agent;
Therapeutic: anthelmintic

Prototype: Mebendazole
Pregnancy Category: C

Availability

200 mg tablets

Action

A broad-spectrum oral anthelmintic agent. It is the only anthelmintic drug active against all stages of the helminth life cycle (ova, larvae, and adult worms). Its mechanism of action appears to cause selective degeneration of cytoplasmic microtubules in the intestinal cells of the helminths and larvae.

Therapeutic Effect

Albendazole ultimately causes decreased ATP production in the helminths, resulting in energy depletion, which kills the worms.

Uses

Treatment of neurocysticercosis caused by the larval form of pork tapeworm (Taenia solium), hydatid disease caused by the larval form of dog tapeworm (Echinococcus granulosus).

Contraindications

Hypersensitivity to the benzimidazole class of compounds or any components of albendazole; pregnancy (category C), children <6 y.

Cautious Use

Retinal lesions, lactation.

Route & Dosage

Neurocysticercosis
Adult/Child: PO >6 y, <60 kg, 15 mg/kg/d divided b.i.d. for 8–30 d cycle (max: 800 mg/d); ≥60 kg, 400 mg b.i.d. for 8–30 d cycle

Hydatid Disease
Adult/Child: PO >6 y, <60 kg, 15 mg/kg/d divided b.i.d. (max: 800 mg/d); ≥60 kg, 400 mg b.i.d. for 28 d cycle (then 14 d without drug & repeat regimen for 3 cycles)

Administration

Oral
  • Give with meals. Absorption is significantly increased with a fatty meal.
  • Do not exceed maximum total daily dose of 800 mg.
  • Store at 20°–25° C (68°–77° F).

Adverse Effects (≥1%)

Body as a Whole: Hypersensitivity reactions. CNS: Headache, dizziness, vertigo, increased intracranial pressure, meningeal signs, alopecia (reversible), fever. GI: Abnormal liver function tests, abdominal pain, nausea, vomiting. Hematologic: (Rare) Reversible leukopenia, granulocytopenia, pancytopenia, agranulocytosis. Skin: Rash, urticaria.

Interactions

Drug: Cimetidine, dexamethasone, praziquantel increase albendazole levels.

Pharmacokinetics

Absorption: Poorly absorbed from GI tract, absorption enhanced with a fatty meal. Peak: 2–5 h. Distribution: 70% protein bound; widely distributed, including cyst fluid and CSF; secreted into animal breast milk. Metabolism: In liver to active metabolite, albendazole sulfoxide. Elimination: In bile. Half-Life: 8–12 h.

Nursing Implications

Assessment & Drug Effects

  • Lab tests: Monitor WBC count, absolute neutrophil count, and liver function tests at start of each 28-d cycle and q2wk during cycle.
  • Withhold drug and notify physician if WBC count falls below normal or liver enzymes are elevated.
  • Note: Patients should be concurrently treated with appropriate steroid and anticonvulsant therapy.

Patient & Family Education

  • Take with meals (see ADMINISTRATION).
  • Do not become pregnant during or for at least 1 mo after therapy.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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