Make your own free website on Tripod.com

Healthcare Communications

Albendazole

 

The Ideal Anti-helminthic should...

...have a broad spectrum of action
... achieve high percentage of cure, preferably with a single dose
... not need administration of a purgative before and/or after the anti-helminthic itself
... not get systemically absorbed
... be free from toxic effects
... be palatable
... be affordable

 

 

Albendazole

- Broad spectrum benzimidazole derivative with actions similar to mebendazole
- Effective against many common intestinal
worms in a single dose

 

Mechanism of Action

Inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules

 

Pharmacokinetics

- Poorly absorbed from gastro-intestinal
tract due to poor aqueous solubility
- Absorbed drug rapidly undergoes extensive first-pass metabolism forming albendazole sulphoxide which has anthelmintic activity ; further metabolized in the liver to albendazole sulphone
- Widely distributed in the body including bile & cerebrospinal fluid
- Eliminated in the bile; only small amount excreted in urine
- The plasma half-life is approx. 8.5 hrs.

 

Indications

- Ascariasis
- Capillariasis
- Cutaneous larva migrans
- Cysticercosis
- Echinicoccosis
- Gnathostomiasis
- Hookworm infections
- Microsporidiosis, HIV associated diarrhoea
- Strongyloidiasis
- Toxocariasis
- Trichinosis
- Trichostrongyliasis
- Trichuriasis
- Mixed nematode infections

 

 

Dosage & Administration

Usual dose for adults & children aged 2 years or over with ascariasis, enterobiasis, hookworm infections or trichuriasis - 400 mg single dose. In enterobiasis, dose may be repeated in I-2 weeks
Capillariasis : 400 mg daily for 10 days Cutaneous larva migrans : Generally, 400 mg daily for 3 or 5 days alleviates discomfort; 400 mg single dose also appears effective
Cysticercosis : Patients > 60 kg :- 400 mg b.d; < 60 kg :- 15 mg/ kg/ day in two divided doses (max 800 mg/day) for 8- 30 days Echinicoccosis : Patients > 60 kg :- 400 mg twice daily for 28 days; < 60 kg :-15 mg/kg body-weight daily in two divided doses (max 800 mg/day)
Gnathostomiasis : 400 mg once or twice daily for 2 or 3 weeks

 

Adverse Reactions

- Generally well tolerated
- Abdominal pain, nausea
diarrhoea

 

Precautions & Contraindications

- No evidence of harm in pregnancy or lactation, use with caution in pregnant & lactating women
- Contraindicated in patients with known allergy to albendazole

 

 

Drug Interactions

- Plasma concentrations of albendazole may be raised when administered concomitantly with dexamethasone or praziquantel
- Concentrations of albendazole are raised in bile and hydatid cyst fluid when administered with cimetidine, which may increase its effectiveness in the treatment of echinococcosis.

 

 

Salient Features

- Broad spectrum benzimidazole , for single and mixed infections
- Effective in a single dose
- Poorly absorbed from G.I. Tract, hence effective in intestinal infections
- Absorbed drug converted into an active metabolite which is widely distributed in the body, and effective against various helminthic infections
- Effective in Ascariasis, capillariasis, cutaneous larva migrans, cysticercosis, echinicoccosis, gnathostomiasis, hookworm infections, microsporidiosis, strongyloidiasis, toxocariasis, trichinosis, trichostrongyliasis, trichuriasis, mixed nematode infections
- Well tolerated