albendazole (Albenza)
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Introduction
Tradename: Albenza.
Indications
- treatment of parasitic diseases, including:
- Hydatid disease caused by Echinococcus granulosus
- neurocysticercosis
- preferably in combination with corticosteroids
- pinworms
Contraindications
Dosage
- 400 mg PO BID, max 800 mg QD
- 15 mg/kg/day if < 60 kg
- duration variable; 2 weeks suggested
- pinworms: 400 mg PO once[5]
- hookworms & whipworms: 400 mg PO QD for 3 days[5]
Tabs: 200 mg
Pharmacokinetics
- poorly absorbed from GI tract due to low water solubility
- absorption increased with concurrent oral fat
- rapidly converted to sulfoxide metabolite before reaching systemic circulation
- antihelminthic activity is due to primary metabolite albendazole sulfoxide
- plasma levels of albendazole sulfoxide maximal 2-5 hours after oral dose of albendazole
- therapeutic plasma levels of 0.46-1.59 ug/mL
- 70% binding to plasma proteins (albendazole sulfoxide)
- terminal elimination 1/2life of albendazole sulfoxide is 8-12 hours
- widely distributed
- pentrates into CSF
elimination via liver
1/2life = 8-12 hours albendazole sulfoxide
Adverse effects
(less toxic than older benzimidazoles)
- occasional diarrhea
- abdominal pain
- increase in serum transaminases & alkaline phosphatase
- leukopenia
- granulocytopenia
- thrombocytopenia
- seizures
- hydrocephalus
- alopecia
Drug interactions
- cimetidine decreases elimination & increases concentration of albendazole
Mechanism of action
- binds to free B-tubulin in parasite cells
- inhibits parasite microtubule polymerization
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996.
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1171
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Physician's Desk Reference (PDR) 52nd edition, Medical Economics, 1998
- ↑ 5.0 5.1 5.2 Prescriber's Letter 19(3): 2012 Alternatives to Vermox for Treatment of Intestinal Worms Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280308&pb=PRL (subscription needed) http://www.prescribersletter.com