Drug Detail:Albendazole (Albendazole [ al-ben-da-zole ])
Drug Class: Anthelmintics
Usual Adult Dose for Hydatid Disease
Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day
60 kg or more: 400 mg orally twice a day with meals
Duration of therapy: 28-day cycle followed by a 14-day drug-free interval, for a total of 3 cycles
Use: For the treatment of cystic hydatid disease of the liver, lung, and peritoneum due to the larval form of Echinococcus granulosus
Usual Adult Dose for Neurocysticercosis
Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day
60 kg or more: 400 mg orally twice a day with meals
Duration of therapy: 8 to 30 days
Comments:
- Patients should receive appropriate steroid and anticonvulsant therapy as needed.
- Oral or IV corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of therapy.
Use: For the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of Taenia solium
Usual Adult Dose for Cutaneous Larva Migrans
US CDC recommendations: 400 mg orally once a day for 3 to 7 days
Case Report (4)
400 mg orally twice a day for 3 to 5 days
Usual Adult Dose for Ascariasis
US CDC recommendations: 400 mg orally as a single dose
Usual Adult Dose for Pinworm Infection (Enterobius vermicularis)
Some experts recommend: 400 mg orally as a single dose; repeat in 2 weeks
Comments: Some clinicians recommend all household contacts of infected patients receive treatment, especially when multiple or repeated symptomatic infections occur, since such contacts commonly also are infected; retreatment after 14 to 21 days may be needed.
Usual Adult Dose for Filariasis
Some experts recommend: 400 mg orally twice a day for 10 days
Comments: Recommended for infection due to Mansonella perstans
Usual Adult Dose for Hookworm Infection (Necator or Ancylostoma)
US CDC recommendations: 400 mg orally as a single dose
Comments: Recommended for infection due to Ancylostoma duodenal or Necator americanus
Usual Adult Dose for Enterocolitis
Some experts recommend: 400 mg orally as a single dose
Comments: Recommended for eosinophilic enterocolitis due to A caninum
Usual Adult Dose for Visceral Larva Migrans (Toxicariasis)
US CDC recommendations: 400 mg orally twice a day for 5 days
Comments:
- Recommended for visceral toxocariasis
- Optimum duration of therapy is unknown; some clinicians recommend 20 days of therapy.
Usual Adult Dose for Strongyloidiasis
Some experts recommend: 400 mg orally twice a day for 7 days
Comments:
- Recommended as alternative therapy
- May be necessary to repeat or prolong therapy or use other agents in immunocompromised patients or patients with disseminated disease
Usual Adult Dose for Trichinosis
US CDC recommendations: 400 mg orally twice a day for 8 to 14 days
Usual Adult Dose for Trichostrongylosis
Some experts recommend: 400 mg orally as a single dose
Comments: Recommended as an alternative therapy
Usual Adult Dose for Whipworm Infection (Trichuris trichiura)
US CDC recommendations: 400 mg orally once a day for 3 days
Usual Adult Dose for Capillariasis
US CDC recommendations: 400 mg orally once a day for 10 days
Comments: Recommended as alternative therapy
Usual Adult Dose for Gnathostomiasis
US CDC recommendations: 400 mg orally twice a day for 21 days
Comments: Recommended for cutaneous symptoms
Usual Adult Dose for Clonorchis sinensis (Liver Fluke)
US CDC recommendations: 10 mg/kg/day orally for 7 days
Comments: Recommended as alternative therapy
Usual Adult Dose for Cysticercus cellulosae (Cysticercosis)
Some experts recommend: 400 mg orally twice a day for 8 to 30 days
Comments:
- May repeat as necessary
- Therapy for at least 30 days recommended in patients with subarachnoid cysts or giant cysts in the fissures.
- Surgical intervention (especially neuroendoscopic removal) or CSF diversion followed by treatment with this drug and steroids recommended for obstructive hydrocephalus.
- With prednisone or dexamethasone, recommended for arachnoiditis, vasculitis, or cerebral edema
Usual Adult Dose for Echinococcus Infection
US CDC recommendations: 400 mg orally twice a day for 1 to 6 months
Comments:
- Recommended for cystic echinococcosis in patients with small cysts or multiple cysts in several organs; treatment depends on the WHO classification of the cysts; this drug is not appropriate for all forms of the infection.
- This drug has been administered before surgery to facilitate safe surgical manipulation of cysts by inactivating protoscolices, altering cyst membrane integrity, and reducing cyst turgidity.
Usual Adult Dose for Loiasis
US CDC recommendations: 200 mg orally twice a day for 21 days
Comments:
- Recommended for symptomatic infection with microfilariae of Loa loa/mL less than 8000 and 2 rounds of diethylcarbamazine failed; or recommended for symptomatic loiasis with microfilariae of L loa/mL at least 8000 to reduce level to less than 8000 before diethylcarbamazine therapy
- Treatment of this infection is complex; experts with experience treating this disease and preventing complications of therapy should be consulted.
Usual Adult Dose for Microsporidiosis
Some experts recommend: 400 mg orally twice a day
Comments:
- Recommended for disseminated infection due to Encephalitozoon hellem, E cuniculi, E intestinalis, Pleistophora species, Trachipleistophora species, or Anncaliia vesicularum
- Recommended for intestinal infection due to E intestinalis; duration of therapy is 21 days
- With fumagillin, recommended for ocular infection due to E hellem, E cuniculi, or Vittaforma corneae
US CDC, National Institutes of Health (NIH), and HIV Medicine Association of the Infectious Diseases Society of America (HIVMA/IDSA) recommendations for HIV-infected patients: 400 mg orally twice a day
Comments:
- Recommended as preferred therapy (including treatment and secondary prophylaxis)
- Recommended for intestinal and disseminated (not ocular) infection due to Microsporidia other than Enterocytozoon bieneusi and V corneae
- With fumagillin, recommended for ocular infection for management of systemic infection
Usual Pediatric Dose for Hydatid Disease
Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day
60 kg or more: 400 mg orally twice a day with meals
Duration of therapy: 28-day cycle followed by a 14-day drug-free interval, for a total of 3 cycles
Comments: Hydatid disease is uncommon in infants and young children.
Use: For the treatment of cystic hydatid disease of the liver, lung, and peritoneum due to the larval form of E granulosus
Usual Pediatric Dose for Neurocysticercosis
Less than 60 kg: 15 mg/kg/day orally in divided doses twice a day with meals
Maximum dose: 800 mg/day
60 kg or more: 400 mg orally twice a day with meals
Duration of therapy: 8 to 30 days
Comments:
- Patients should receive appropriate steroid and anticonvulsant therapy as needed.
- Oral or IV corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of therapy.
Use: For the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of T solium
Usual Pediatric Dose for Capillariasis
US CDC and American Academy of Pediatrics (AAP) recommendations: 400 mg orally once a day for 10 days
Comments: Recommended as alternative therapy
Case Reports of Hepatic Capillariasis (n=2)
At least 18 months: 400 mg/day for 21 days, up to 100 days
Usual Pediatric Dose for Cutaneous Larva Migrans
US CDC and AAP recommendations:
Older than 2 years: 400 mg orally once a day for 3 days
Comments (US CDC): This drug is contraindicated in children younger than 2 years; may use topical agents in such patients
Case Report (n=1)
11 months: 2.5 mL (suspension: 200 mg/5 mL) orally twice a day for 3 days
Usual Pediatric Dose for Cysticercus cellulosae (Cysticercosis)
Some experts recommend: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
Duration of therapy: 8 to 30 days
Comments:
- May repeat as necessary
- Therapy for at least 30 days recommended in patients with subarachnoid cysts or giant cysts in the fissures.
- Surgical intervention (especially neuroendoscopic removal) or CSF diversion followed by treatment with this drug and steroids recommended for obstructive hydrocephalus.
- With prednisone or dexamethasone, recommended for arachnoiditis, vasculitis, or cerebral edema
Usual Pediatric Dose for Echinococcus Infection
US CDC and AAP recommendations: 10 to 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
Duration of therapy: 1 to 6 months
Comments:
- Recommended for cystic echinococcosis in patients with small cysts or multiple cysts in several organs; treatment depends on the WHO classification of the cysts; this drug is not appropriate for all forms of the infection.
- This drug has been administered before surgery to facilitate safe surgical manipulation of cysts by inactivating protoscolices, altering cyst membrane integrity, and reducing cyst turgidity.
Usual Pediatric Dose for Ascariasis
US CDC and AAP recommendations: 400 mg orally as a single dose
Usual Pediatric Dose for Pinworm Infection (Enterobius vermicularis)
AAP recommendations:
- Children less than 20 kg: 200 mg orally as a single dose; repeat in 2 weeks
- Children at least 20 kg: 400 mg orally as a single dose; repeat in 2 weeks
Some experts recommend: 400 mg orally as a single dose; repeat in 2 weeks
Comments: Some clinicians recommend all household contacts of infected patients receive treatment, especially when multiple or repeated symptomatic infections occur, since such contacts commonly also are infected; retreatment after 14 to 21 days may be needed.
Usual Pediatric Dose for Filariasis
Some experts recommend: 400 mg orally twice a day for 10 days
Comments: Recommended for infection due to M perstans
Usual Pediatric Dose for Hookworm Infection (Necator or Ancylostoma)
US CDC and AAP recommendations: 400 mg orally as a single dose
Comments: Recommended for infection due to A duodenal or N americanus
Usual Pediatric Dose for Enterocolitis
Some experts recommend: 400 mg orally once as a single dose
Comments: Recommended for eosinophilic enterocolitis due to A caninum
Usual Pediatric Dose for Loiasis
US CDC and AAP recommendations: 200 mg orally twice a day for 21 days
Comments:
- Recommended for symptomatic infection with microfilariae of L loa/mL less than 8000 and 2 rounds of diethylcarbamazine failed; or recommended for symptomatic loiasis with microfilariae of L loa/mL at least 8000 to reduce level to less than 8000 before diethylcarbamazine therapy
- Treatment of this infection is complex; experts with experience treating this disease and preventing complications of therapy should be consulted.
Usual Pediatric Dose for Visceral Larva Migrans (Toxicariasis)
US CDC and AAP recommendations: 400 mg orally twice a day for 5 days
Comments:
- Recommended for visceral toxocariasis
- Optimum duration of therapy is unknown; some clinicians recommend 20 days therapy.
Usual Pediatric Dose for Strongyloidiasis
Some experts recommend: 400 mg orally twice a day for 7 days
Comments:
- Recommended as alternative therapy
- May be necessary to repeat or prolong therapy or use other agents in immunocompromised patients or patients with disseminated disease
Usual Pediatric Dose for Trichinosis
US CDC and AAP recommendations: 400 mg orally twice a day for 8 to 14 days
Usual Pediatric Dose for Trichostrongylosis
Some experts recommend: 400 mg orally as a single dose with food
Comments: Recommended as an alternative therapy
Usual Pediatric Dose for Whipworm Infection (Trichuris trichiura)
US CDC and AAP recommendations: 400 mg orally once a day for 3 days
Usual Pediatric Dose for Gnathostomiasis
US CDC and AAP recommendations: 400 mg orally twice a day for 21 days
Comments: Recommended for cutaneous symptoms
Usual Pediatric Dose for Clonorchis sinensis (Liver Fluke)
US CDC and AAP recommendations: 10 mg/kg/day orally for 7 days
Comments: Recommended as alternative therapy
Usual Pediatric Dose for Microsporidiosis
Some experts recommend: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
Comments:
- Recommended for disseminated infection due to E hellem, E cuniculi, E intestinalis, Pleistophora species, Trachipleistophora species, or A vesicularum
- Recommended for intestinal infection due to E intestinalis
- With fumagillin, recommended for ocular infection due to E hellem, E cuniculi, or V corneae
US CDC, NIH, HIVMA/IDSA, Pediatric Infectious Diseases Society, and AAP recommendations for HIV-exposed and HIV-infected children: 15 mg/kg/day orally in divided doses twice a day
Maximum dose: 800 mg/day
US CDC, NIH, and HIVMA/IDSA recommendations for HIV-infected adolescents: 400 mg orally twice a day
Comments:
- Recommended as preferred therapy (including treatment and secondary prophylaxis)
- Recommended for intestinal and disseminated (not ocular) infection due to Microsporidia other than E bieneusi and V corneae
- With fumagillin, recommended for ocular infection for management of systemic infection
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Administer with food; oral bioavailability enhanced when administered with fatty meal (estimated fat content 40 g).
- May crush or chew tablets and swallow with a drink of water; chewable tablets also available for patients unable to swallow tablet whole.
Storage requirements:
- Store at 20C to 25C (86F to 77F).
General:
- Current guidelines should be consulted for additional information.
- Safety uncertain in patients younger than 6 years; studies using this drug in children as young as 1 year suggest that it is safe.
- According to WHO guidelines for mass prevention campaigns, this drug can be used in children as young as 1 year; many children younger than 6 years have used this drug (at reduced dose) in such campaigns.
Monitoring:
- General: Pregnancy test in women of reproductive potential (before starting therapy)
- Hematologic: Blood counts in all patients (at the start of each 28-day treatment cycle and every 2 weeks while on therapy)
- Hepatic: Liver enzymes/transaminases in all patients (at the start of each 28-day treatment cycle and at least every 2 weeks during therapy)
- Ocular: For retinal lesions (before starting therapy for neurocysticercosis)
Frequently asked questions
- What are Zentel 400mg used for?
- Albendazole: How long does it take to kill all the pinworms?
