Albendazole dosing

Tapeworm infections (T. saginata and T. solium) are treated with praziquantel 5 to 10 mg/kg as a single dose (use the same dose for adults and pediatric patients).3 The treatment for cysticercosis and neurocysticercosis may include surgery, anticonvulsants (neurocysticercosis can cause seizures), and anthelmintic therapy. The anthelmintic therapy of choice is albendazole 400 mg twice daily for 8 to 30 days. The pediatric dose of albendazole is 15 mg/kg (maximum 800 mg) in two divided doses for 8 to 30 days. The doses for both adults and pediatric subjects can be repeated if necessary. Praziquantel is an alternative therapy.3... 

Albendazole selectively blocks glucose uptake and depletes glycogen stores. ATP formation is thus inhibited. It should be administered on an empty stomach for intraluminal parasites and with a fatty meal for tissue parasites. It is metabolized to an active sulfoxide metabolite resulting in very low Albendazole blood levels. Albendazole sulfoxide is excreted in the urine with an elimination half-life of about 8 h. Used for 1-3 days in doses recommended for intestinal worms the incidence of adverse effects is similar in treatment and control groups. Hepato-toxicity may occur, especially after the higher doses that are needed for hydatid disease. Also alopecia has been reported. 

Mebendazole is used primarily for the treatment of A. lumbricoides, T. trichiura, E. vermicularis, and hookworm infections, in which it produces high cure rates. It is an alternative agent for the treatment of trichinosis and visceral larva migrans. Owing to its broad-spectrum anthelmintic effect, mixed infections (ascariasis, hookworm infestation, or enterobiasis in association with trichuriasis) frequently respond to therapy. High doses have been used to treat hydatid disease, but albendazole is now thought to be superior. 

D. In the United States intestinal helminths produce mild disease with nonspecific findings. Piperazine or pyrantel pamoate may be used for the treatment of ascariasis. Mebendazole is an effective drug to be taken for 3 days. Thiabendazole is not used in this condition but is used commonly in strongyloidiasis. Albendazole at a single dose of 400 mg is the preferred mode of therapy. It is a... 

Albendazole is a benzimidazole carbamate. After oral administration, it is erratically absorbed (increased with a fatty meal) and then rapidly undergoes first-pass metabolism in the liver to the active metabolite albendazole sulfoxide. It reaches variable maximum plasma concentrations about 3 hours after a 400-mg oral dose, and its plasma half-life is 8-12 hours. The sulfoxide is mostly protein-bound, distributes well to tissues, and enters bile, cerebrospinal fluid, and hydatid cysts. Albendazole metabolites are excreted in the urine. 

Antihistamines may be given for the first few days of therapy to limit allergic reactions, and corticosteroids should be started and doses of diethylcarbamazine lowered or interrupted if severe reactions occur. Cures may require several courses of treatment. For patients with high L loa worm burdens (more than 2500 circulating parasites/mL), strategies to decrease risks of severe toxicity include apheresis, if available, to remove microfilariae before treatment with diethylcarbamazine or therapy with albendazole, which is slower acting and better tolerated, before therapy with diethylcarbamazine or ivermectin. 

Albendazole is now the preferred drug, but when it is not appropriate or available, praziquantel has similar efficacy. Indications for praziquantel are similar to those for albendazole. The praziquantel dosage is 100 mg/kg/d in three divided doses for 1 day, then 50 mg/kg/d to complete a 2- to 4-week course. Clinical responses to therapy vary from dramatic improvements of seizures and other neurologic findings to no response and even progression of the disease. Praziquantel —but not albendazole—has diminished bioavailability when taken concurrently with a corticosteroid. Recommendations on use of both antihelminthics and corticosteroids in neurocysticercosis vary. 

The standard dosage, 25 mg/kg (maximum 1.5 g) twice daily, should be given after meals. Tablets should be chewed. For strongyloides infection, treatment is for 2 days. Cure rates are reportedly 93%. A course can be repeated in 1 week if indicated. In patients with hyperinfection syndrome, the standard dose is continued twice daily for 5-7 days. For cutaneous larva migrans, thiabendazole cream can be applied topically, or the oral drug can be given for 2 days (although albendazole is less toxic and therefore preferred). 

Bockarie MJ etal Efficacy of single-dose diethylcarbamazine compared with diethylcarbamazine combined with albendazole against Wuchereria bancrofti infection in Papua New Guinea. Am J Trap Med Hyg 2007 76 62. [PMID 17255231]... 

In ruminants, oral doses of albendazole are readily absorbed from the gut. Following absorption, albendazole undergoes extensive metabolism by rapid first-pass oxidation of its sulfoxide group to form albendazole sulfoxide, then further oxidation to form albendazole sulfone, and by deacetylation of the carbamate group to form albendazole-2-aminosulfone. Albendazole sulfoxide, albendazole sulfone, and albendazole-2-aminosulfone are the main metabolites found in tissues, whereas other minor metabolites have been also detected at much lower concentrations. 

When sheep were similarly U eated with an oral dose of netobimin, total residues in all tissues except milk were generally lower than those in cattle. Albendazole, albendazole sulfoxide, albendazole sulfone, and albendazole-2-aminosulfone accounted for nearly all the residues in muscle and fat tissues at time points ranging from 18 h to 20 days. In liver and kidney, however, these metabolites accounted for a lower proportion of the total residues as time progressed, indicating the presence of bound residues. 

Benzimidazoles (mebendazole or albendazole) have been the most used treatment, but a combination of albendazole plus praziquantel may be more effective than a benzimidazole on its own (Mohamed et at., 1998 Ayles et a/., 2002 El-On, 2003). As cimetidine increases benzimidazole serum concentrations it may enhance their activity (Bekhti and Pirotte, 1987 Wen et ai, 1994). Whilst for some patients chemotherapy is the sole treatment, even where there will be surgical intervention, treatment with benzimidazoles is recommended before surgery (Keshmiri et ai, 2001). A range of doses have been used for treatments of patients but 12-15 mg/kg/day over weeks or months may be best, although an emulsion... 

Shenoy RK, Dalia S, John A et al. (1999) Treatment of the mi-crofilaraemia of asymptomatic brugian filariasis with single doses of ivermectin, diethylcarbamazine or albendazole, in various combinations. Ann Trop Med Parasitol 93 643-651... 

Visceral larva migrarts Toxocoto ccims. dicthylcarbamazinc. albendazole Progressive escalation of dose lessens allergic... 

Larva migrans Albendazole (single dose) or topical thiabendazole. ... 

Bhatla, V., Sarin, S.K. Hepatic visceral larva migrans evolution of the lesion, diagnosis, and role of high-dose albendazole therapy. Amer. J. Gastroenterol. 1994 89 624-627... 

Albendazole, a benzimidazole derivative closely related to mebendazole (qv), is used in the treatment of helminth infections, such as gastrointestinal roundworms, hydatid disease, neurocysticercosis, larva migrans cutanea, and strongyloidiasis (1). Provided that an adequate concentration is attained within the cyst, it is scolicidal. In high doses given for prolonged periods or cyclically, it is... 

The efficacy of 2 years of mass chemotherapy against ascariasis has been evaluated in Iran (5). A single dose of albendazole 400 mg was given at 3-month intervals for 2 years to every person, except children under 2 years of age and pregnant women. After 2 years of treatment the prevalences, based on 2667 post-treatment samples, had fallen (Table 1). There were no adverse effects of mass treatment with albendazole. 

In a report on the use of albendazole 15 mg/kg/day in two divided doses for 14 days in the treatment of persistent neurocysticercosis (10), adverse reactions were monitored in 43 patients with seizures and a sohtary cysticercal cyst, who had not been treated before. In aU patients CT scans confirmed the presence of a solitary cyst less than 2 cm in diameter. Antiepileptic treatment was continued. In seven patients dexamethasone 8 mg/day in four divided doses was given for the first 5-7 days after the start of treatment. Follow-up CT scans at 4-10 weeks after the start of treatment showed responses in 20 patients, with complete disappearance in seven patients and a reduction to 50% of the pretreatment size in the other 13. There were adverse effects in 15 patients, with a maximum on the fifth day after the start of treatment. Six patients had severe headaches, 11 had partial seizures, and 2 had epileptic seizures and severe postictal hemiparesis that persisted for a week or more. Because of these serious adverse effects treatment was discontinued in seven patients and dexamethasone was added in those patients who were not already taking it, although its use proved questionable. Adverse effects were seen in three of seven patients who took prophylactic steroid therapy and in 12 of 36 patients who did not. 

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