Albendazole is a benzimidazole anthelmintic agent with broad-spectrum activity against intestinal and tissue-dwelling nematodes and cestodes. Its mechanism of action involves selective inhibition of parasite microtubule polymerization, leading to impaired glucose uptake and eventual parasite death. This medication represents a cornerstone in antiparasitic therapy, particularly for endemic regions and complex parasitic infections. Clinical evidence supports its efficacy against multiple helminth species, making it a first-line treatment in numerous parasitic disease management protocols.

Features

• Active pharmaceutical ingredient: Albendazole 200mg/400mg
• Pharmacological class: Benzimidazole anthelmintic
• Mechanism: Binds to β-tubulin, inhibiting microtubule assembly
• Bioavailability: Enhanced with fatty meal administration
• Metabolism: Extensive first-pass metabolism to active sulfoxide metabolite
• Half-life: 8-12 hours (sulfoxide metabolite)
• Excretion: Primarily biliary; minimal renal excretion

Benefits

• Demonstrates efficacy against multiple nematode and cestode species
• Provides ovicidal, larvicidal, and vermicidal activity
• Offers convenient once or twice-daily dosing regimen
• Shows excellent tissue penetration, including CNS penetration
• Presents favorable safety profile when used appropriately
• Enables treatment of both intestinal and systemic parasitic infections

Common use

Albendazole is indicated for the treatment of various parasitic infections including neurocysticercosis caused by larval forms of Taenia solium, hydatid disease caused by Echinococcus granulosus, and intestinal infections by Ascaris lumbricoides, hookworm (Ancylostoma duodenale and Necator americanus), Enterobius vermicularis, Trichuris trichiura, and Strongyloides stercoralis. It is also used off-label for cutaneous larva migrans, microsporidiosis, and giardiasis in certain patient populations. The World Health Organization includes albendazole in its Model List of Essential Medicines for its public health significance in controlling soil-transmitted helminthiases.

Dosage and direction

Dosage varies according to the specific parasitic infection being treated. For neurocysticercosis: 15 mg/kg/day in two divided doses (maximum 800 mg/day) for 8-30 days. For hydatid disease: 15 mg/kg/day in two divided doses (maximum 800 mg/day) for 28-day cycles separated by 14-day drug-free intervals. For intestinal helminths: single 400 mg dose for most adults and children over 2 years. Administration with a fatty meal increases bioavailability by up to fivefold. Tablets should be swallowed whole with water; crushing or chewing is not recommended. Duration of treatment depends on parasite burden and clinical response.

Precautions

Hepatic function should be monitored during prolonged therapy due to potential hepatotoxicity. Complete blood counts should be performed regularly during long-term treatment because of possible bone marrow suppression. Use with caution in patients with pre-existing liver disease or impaired hepatic function. Corticosteroid therapy should be considered concurrently for neurocysticercosis to prevent inflammatory reactions to dying parasites. Effective contraception should be maintained during and for one month after treatment due to teratogenic potential. Retinal examination is recommended before and during prolonged treatment.

Contraindications

Hypersensitivity to albendazole, other benzimidazoles, or any component of the formulation. Pregnancy (category C) due to demonstrated teratogenicity and embryotoxicity in animal studies. Breastfeeding is not recommended during therapy. History of bone marrow suppression. Severe hepatic impairment without appropriate monitoring. Concomitant use with drugs that significantly inhibit cytochrome P450 enzymes may require dosage adjustment.

Possible side effect

Common adverse effects include abdominal pain, nausea, vomiting, headache, dizziness, and transient elevation of liver enzymes. Less frequently reported effects include leukopenia, thrombocytopenia, pancytopenia, alopecia, fever, and skin rash. Rare but serious adverse reactions include Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatitis, and acute liver failure. In neurocysticercosis, meningeal signs, headache, hypertension, intracranial hypertension, and seizures may occur due to inflammatory response to dying parasites.

Drug interaction

Cimetidine, dexamethasone, and praziquantel may increase plasma levels of albendazole sulfoxide. Carbamazepine, phenytoin, and phenobarbital may decrease albendazole levels. Theophylline levels may be increased when co-administered with albendazole. Concurrent use with other bone marrow suppressants may increase the risk of hematological toxicity. Monitor patients closely when used with CYP3A4 inhibitors or inducers.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Doubling of doses is not recommended. For single-dose regimens for intestinal parasites, take the missed dose when remembered and continue with normal hygiene measures to prevent reinfection.

Overdose

Symptoms of overdose may include nausea, vomiting, dizziness, headache, and abdominal pain. In severe cases, hepatic dysfunction, bone marrow suppression, or neurological symptoms may occur. There is no specific antidote. Treatment should be supportive and symptomatic. Gastric lavage may be considered if presented early after ingestion. Monitor hepatic function and complete blood counts closely. Hemodialysis is not likely to be effective due to high protein binding.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Protect from light and moisture. Keep container tightly closed. Do not store in bathroom or damp places. Keep out of reach of children and pets. Do not use if the packaging is damaged or shows signs of tampering. Discard any unused medication properly according to local regulations.

Disclaimer

This information is provided 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 be familiar with the complete prescribing information and current treatment guidelines. Dosage and administration may vary based on individual patient characteristics and local epidemiological patterns. Proper diagnosis of parasitic infection should be confirmed before initiating therapy.

Reviews

Clinical studies demonstrate cure rates of 72-98% for ascariasis, 81-92% for hookworm, and 90-100% for enterobiasis. In hydatid disease, long-term albendazole therapy shows success rates of 30-50% for cure and 50-70% for improvement. For neurocysticercosis, albendazole significantly reduces seizure frequency and promotes parasite clearance in 60-85% of cases. The medication is generally well-tolerated, with most adverse effects being mild and transient. Medical literature supports its position as a first-line antiparasitic agent in appropriate clinical scenarios.