Albendazole: Uses, dosage, side effects, warnings & patient reviews

What is Albendazole?

Albendazole is a broad-spectrum antiparasitic medication. Its active compound is a member of the benzimidazole class of drugs, which are known for their anthelmintic (worm-killing) properties. It is a prescription-only medication, and generic versions are available.

The drug is specifically indicated for the treatment of systemic tissue infections caused by certain parasites. Its primary FDA-approved uses are for neurocysticercosis, caused by the pork tapeworm, and for cystic hydatid disease of the liver, lung, and peritoneum, caused by the dog tapeworm. It may also be used under medical direction for other parasitic infections.

How does albendazole work? The drug’s mechanism of action involves inhibiting the polymerization of beta-tubulin into microtubules in the parasitic cells. This disrupts critical processes like glucose uptake and cellular structure, leading to the parasite’s eventual depletion of energy stores and death.

How to Take Albendazole

Administration of albendazole must strictly follow a healthcare provider’s instructions due to its serious potential side effects and variable absorption.

Administration and Timing

Albendazole tablets, such as albendazole 400 mg, are taken orally. A critical factor for its effectiveness in treating systemic tissue infections is that it is absorbed poorly on an empty stomach. To achieve adequate therapeutic blood levels, the tablets must be taken with a meal, particularly a high-fat meal (containing approximately 40 grams of fat). This can increase drug absorption up to fivefold.

Course of Treatment

Treatment cycles typically consist of 28 days of dosing followed by a 14-day drug-free interval. The number of cycles required depends on the specific infection being treated, its severity, and radiographic evidence of cyst reduction. Treatment for intestinal parasites may involve a single dose. Never adjust the dose or duration of therapy without consulting your doctor.

Monitoring Requirements

Due to risks of liver injury and bone marrow suppression, medical supervision is mandatory. Patients will require regular blood tests, including complete blood counts (CBC) and liver function tests (LFTs), before starting each treatment cycle and every two weeks during therapy.

Side Effects of Albendazole

Albendazole can cause a range of adverse effects, from common and mild to serious and potentially life-threatening. Medical monitoring is essential to manage these risks.

What is Albendazole Used For?

Albendazole is prescribed for specific parasitic infections, primarily those affecting tissues rather than just the intestinal lumen.

Primary Medical Uses

• Neurocysticercosis: This is an infection of the central nervous system with the larval cysts of the pork tapeworm (Taenia solium). Albendazole is indicated for the treatment of active parenchymal lesions. Treatment often requires co-administration of steroid therapy and anti-seizure medications to manage the inflammatory response caused by dying parasites.
• Cystic Hydatid Disease: This condition, caused by the larval stage of the dog tapeworm (Echinococcus granulosus), involves cysts forming in the liver, lungs, and other organs. Albendazole is used as an adjunct to surgery or for inoperable cases.

Other Uses (May Be Off-Label)

Albendazole may also be used under physician direction for certain intestinal parasitic infections, such as pinworm (enterobiasis), hookworm, roundworm, and whipworm. For these common intestinal parasites, treatment often involves a single dose or short course, but diagnosis and treatment decisions must be made by a healthcare provider.

Important Safety Concerns and Considerations

Treatment with albendazole requires awareness of its significant and potentially serious risks, which necessitate strict medical supervision.

Teratogenic Risk and Pregnancy Prevention

Albendazole may cause fetal harm. It is assigned to Pregnancy Category D. Reliable contraception is mandatory for women of childbearing potential before, during, and after treatment. Pregnancy testing before initiating therapy is standard practice.

Hepatotoxicity (Liver Injury)

Elevations of liver enzymes are common. In rare cases, serious, potentially fatal liver injury, including acute liver failure, can occur. Patients with pre-existing liver conditions, such as hepatitis, require extreme caution. Regular monitoring of liver function tests (LFTs) is mandatory, and the drug should be discontinued if significant elevations occur.

Bone Marrow Suppression

Albendazole can cause a decrease in white blood cells (neutropenia) and, more rarely, pancytopenia (low levels of all blood cells). This increases the risk of infections and bleeding. Regular complete blood count (CBC) monitoring is required. Patients should report any signs of infection (fever, sore throat) or unusual bruising/bleeding immediately.

Neurological Events in Neurocysticercosis

When treating neurocysticercosis, the inflammatory response to dying cysts in the brain can lead to cerebral edema, increased intracranial pressure, seizures, and other neurological complications. Hospitalization for the first cycle of therapy is often recommended. Concomitant use of corticosteroids and anticonvulsant therapy is standard.

Critical Warnings for Albendazole Use

Monitoring for Hematologic and Hepatic Toxicity

Blood tests (CBC) and liver function tests must be performed at the start of each treatment cycle and every two weeks during therapy. Treatment should be withheld if clinically significant reductions in blood cell counts or liver enzyme elevations (exceeding twice the upper limit of normal) occur.

Risk of Retinal Damage

Rare cases of retinal damage have been reported with high-dose, long-term albendazole use. Patients should be monitored for visual changes.

Contraindications

Albendazole is contraindicated in individuals with known hypersensitivity to albendazole, other benzimidazole drugs (e.g., mebendazole), or any component of the formulation. Its use is also contraindicated during pregnancy.

Cysticercosis and Concomitant Steroid Use

To minimize the risk of neurological complications in patients being treated for neurocysticercosis, oral or intravenous corticosteroids are typically administered concurrently. Patients must be closely monitored.

Albendazole Dosage Information

Dosage is determined by a healthcare provider based on the type of infection, patient weight, and medical history. The following are general guidelines. Never self-prescribe or adjust dosage.

*Note: Dosage for intestinal parasites is often simpler but must still be prescribed by a doctor.

Drug Interactions with Albendazole

Albendazole has several important drug interactions that can affect its levels or increase the risk of side effects.

Additional Information

Storage and Handling

Store albendazole tablets at room temperature (between 15°C and 30°C or 59°F and 86°F), in a tightly closed container, away from light, excess heat, and moisture. Keep all medications out of the reach of children and pets.

Mechanism of Action in Detail

Albendazole belongs to the benzimidazole class. It works by selectively binding to free beta-tubulin in parasitic cells, inhibiting its polymerization into microtubules. Microtubules are essential for multiple cellular functions, including intracellular transport and maintenance of cell shape. Their disruption leads to impaired uptake of glucose and other nutrients, depletion of glycogen stores, and a decrease in ATP production, ultimately causing paralysis and death of the parasite.

Reporting Side Effects

You are encouraged to report negative side effects of prescription drugs to the relevant national health authority (e.g., the FDA in the United States). Reporting helps health authorities monitor drug safety and identify new risks.

References and Medical Sources

The information on this page is compiled from reputable medical sources and prescribing information.

1. U.S. Food and Drug Administration (FDA). Albenza (albendazole) Prescribing Information. [Revised 2009]. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020666s005s006lbl.pdf
2. MedlinePlus. Albendazole. U.S. National Library of Medicine; [Updated 2017]. https://medlineplus.gov/druginfo/meds/a610019.html
3. Centers for Disease Control and Prevention (CDC). Parasites – Resources – Health Professionals. https://www.cdc.gov/parasites/index.html
4. Drugs.com. Albendazole Professional Monograph. Drugs.com; [Updated 2024]. https://www.drugs.com/monograph/albendazole.html

Disclaimer: The information on this site is provided for informational purposes only and is not medical advice. It does not replace professional medical consultation, diagnosis, or treatment. Do not self-medicate based on the information presented on this site. Always consult with a doctor or other qualified healthcare professional before making any decisions about your health.