Medication Overview

Albendazole is an anthelmintic drug used in the management of a variety of parasitic worm infestations. It belongs to the benzimidazole class of drugs and operates by inhibiting tubulin polymerization, which prevents the parasites from absorbing glucose, ultimately leading to their death.

Indications and Usage

Albendazole is indicated for the treatment of infections caused by various intestinal parasites, including but not limited to Neurocysticercosis caused by Taenia solium, Hydatid disease caused by Echinococcus granulosus, and Enterobiasis (pinworm infection).

Dosage Forms

Albendazole is available in multiple dosage forms including tablets and oral suspensions. The tablets are typically supplied in 200 mg and 400 mg strengths. The oral suspension is generally provided in a 100 mg/5 mL concentration.

Recommended Dosages

For adults with Neurocysticercosis, the dosage generally starts at 400 mg twice daily for a duration of 8 to 30 days. For Hydatid disease, the dosage typically consists of an initial dose of 400 mg twice daily for 28 days, followed by a 14-day drug-free interval, then repeating the cycle.

Administration Instructions

Albendazole should be taken with meals to enhance its bioavailability. Patients are advised to swallow the tablets whole with water, and the oral suspension should be shaken well before use.

Mechanism of Action

Albendazole’s mechanism involves binding to the β-tubulin of the parasite, inhibiting the formation of microtubules, which disrupts the parasite’s cellular functions including transport and energy metabolism, leading to cell death.

Pharmacokinetics

Albendazole undergoes extensive first-pass metabolism in the liver; the main metabolite, albendazole sulfoxide, is responsible for the drug’s anthelmintic activity. Peak plasma concentrations are typically reached within 2-5 hours post-administration.

Contraindications

Albendazole is contraindicated in patients with known hypersensitivity to the drug or any of its components. It is also contraindicated in pregnancy, particularly in the first trimester, due to the potential for teratogenic effects.

Common Side Effects

Potential side effects of Albendazole include gastrointestinal disturbances such as abdominal pain, nausea, and vomiting. Other side effects may include headache, dizziness, and temporary hair loss.

Severe Adverse Reactions

Severe reactions can occur, including bone marrow suppression, hepatotoxicity, and hypersensitivity reactions. These require immediate medical attention and discontinuation of the drug.

Drug Interactions

Concomitant use with drugs such as cimetidine, praziquantel, and dexamethasone can increase the plasma concentration of albendazole sulfoxide. Using it with anticonvulsants like phenytoin may decrease its efficacy.

Special Populations

Extra caution is advised when administering to children under 2 years old or elderly patients due to differences in drug metabolism and increased susceptibility to side effects. Dose adjustments may be necessary.

Monitoring Requirements

Regular monitoring of liver function tests and blood counts is recommended, especially during long-term therapy. Baseline and periodic liver function assessments are crucial to detect hepatotoxicity early.

Storage Conditions

Store Albendazole tablets at room temperature, between 20°C to 25°C (68°F to 77°F). Keep the bottle tightly closed to protect from moisture. Oral suspension should be stored in its original container and kept away from heat and direct light.

Handling Precautions

Healthcare providers should follow standard protocols for handling cytotoxic drugs due to the potential risks of exposure. Use of personal protective equipment is recommended during the preparation and administration of the drug.

Patient Counseling

Patients should be educated about the necessity of completing the entire course of therapy even if symptoms improve before the end of treatment. Alert patients to the importance of adhering to recommended dietary intake to maximize drug absorption.

Pregnancy and Lactation

Albendazole is classified as pregnancy category C and should not be used during pregnancy unless the benefits outweigh the risks. Lactating mothers should either discontinue breastfeeding or refrain from taking the medication due to the unknown effects on the infant.

Overdose Management

In case of overdose, symptomatic and supportive measures should be implemented promptly. Gastric lavage may be considered if the ingestion is recent, along with activated charcoal to reduce absorption.

Brand Names

Albendazole is marketed under several brand names, including Albenza, Eskazole, and Zentel. Generic versions are also available.