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Pronunciation
(me BEN da zole)
Generic Available (U.S.)
Yes
Index Terms
Canadian Brand Names
Pharmacologic Category
Use: Labeled Indications
Treatment of Enterobius vermicularis (pinworms), Trichuris trichiura (whipworms), Ascaris lumbricoides (roundworms), and Ancylostoma duodenale or Necator amiericanus (hookworms)
Use: Unlabeled/Investigational
Treatment of Ancylostoma caninum (eosinophilic enterocolitis), Capillaria philippinensis (capillariasis), Giardia duodenalis (giardiasis), Mansonella perstans (filariasis), visceral larva migrans (toxocariasis)
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/use caution
Breast-Feeding Considerations
Since only 2% to 10% of mebendazole is absorbed, it is unlikely that it is excreted in breast milk in significant quantities.
Contraindications
Hypersensitivity to mebendazole or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Bone marrow suppression: Neutropenia and agranulocytosis have been reported with high doses and prolonged use.
Disease-related concerns:
• Hydatid disease: Not effective for hydatid disease.
Adverse Reactions
Frequency not defined.
Central nervous system: Dizziness, drowsiness, headache, seizure
Dermatologic: Angioedema, exanthema, itching, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Gastrointestinal: Abdominal pain, diarrhea, nausea, vomiting
Hematologic: Agranulocytosis, eosinophilia, hemoglobin decreased, leukopenia, neutropenia
Hepatic: ALT increased, AST increased, GGT increased, hepatitis
Renal: Cylindruria, glomerulonephritis, hematuria
Miscellaneous: Hypersensitivity reactions (anaphylactic, anaphylactoid)
Drug Interactions
Aminoquinolines (Antimalarial): May decrease the serum concentration of Anthelmintics. Risk C: Monitor therapy
CarBAMazepine: May decrease the serum concentration of Mebendazole. Risk C: Monitor therapy
Fosphenytoin: May decrease the serum concentration of Mebendazole. Risk C: Monitor therapy
MetroNIDAZOLE: Mebendazole may enhance the adverse/toxic effect of MetroNIDAZOLE. Particularly the risk for Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis may be increased. Risk D: Consider therapy modification
MetroNIDAZOLE (Systemic): Mebendazole may enhance the adverse/toxic effect of MetroNIDAZOLE (Systemic). Particularly the risk for Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis may be increased. Risk D: Consider therapy modification
MetroNIDAZOLE (Topical): Mebendazole may enhance the adverse/toxic effect of MetroNIDAZOLE (Topical). Particularly the risk for Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis may be increased. Risk D: Consider therapy modification
Phenytoin: May decrease the serum concentration of Mebendazole. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Food: Mebendazole serum levels may be increased if taken with food.
Storage
Store at 20°C to 25°C (68°F to 77°F).
Mechanism of Action
Inhibits the formation of helminth microtubules; selectively and irreversibly blocks glucose uptake and other nutrients in susceptible adult intestine-dwelling helminths
Pharmacodynamics/Kinetics
Absorption: 2% to 10%
Distribution: To serum, cyst fluid, liver, omental fat, and pelvic, pulmonary, and hepatic cysts; highest concentrations found in liver; relatively high concentrations found in muscle-encysted Trichinella spiralis larvae; crosses placenta
Protein binding: 95%
Metabolism: Extensively hepatic
Half-life elimination: 1-11.5 hours
Time to peak, serum: 2-4 hours
Excretion: Primarily feces; urine (5% to 10%)
Dosage
Children ≥2 years and Adults: Oral:
Ancylostoma duodenale (hookworm), Necator americanus (hookworm): 100 mg twice daily for 3 days or (unlabeled dosing) 500 mg as a single dose
Ascaris lumbricoides (roundworm): 100 mg twice daily for 3 days or (unlabeled dosing) 500 mg as a single dose
Enterobius vermicularis (pinworm): 100 mg as a single dose; may repeat in 2-3 weeks; treatment should include family members in close contact with patient
Trichuris trichiura (whipworm): 100 mg twice daily for 3 days or (unlabeled dosing) 500 mg as a single dose
Ancylostoma caninum (unlabeled use): 100 mg twice daily for 3 days
Capillaria philippinensis (capillariasis) (unlabeled use): 200 mg twice daily for 20 days
Giardia duodenalis (giardiasis) (unlabeled use): 200 mg three times a day for 5 days (Canete, 2006; Chandy, 2009)
Mansonella perstans (filariasis) (unlabeled use): 100 mg twice daily for 30 days
Visceral larva migrans (toxocariasis) (unlabeled use): 100-200 mg twice daily for 5 days
Administration: Oral
Tablets may be chewed, swallowed whole, or crushed and mixed with food.
Monitoring Parameters
Check for helminth ova in feces within 3-4 weeks following the initial therapy
Patient Education
Tablets may be chewed, swallowed whole, or crushed and mixed with food. Increase dietary intake of fruit juices. All family members and close friends should also be treated. To reduce possibility of reinfection, wash hands and scrub nails carefully with soap and hot water before handling food, before eating, and before and after toileting. Keep hands out of mouth. Disinfect toilet daily and launder bed linens, undergarments, and nightclothes daily with hot water and soap. Do not go barefoot and do not sit directly on grass or ground. May cause abdominal pain, nausea, vomiting, or hair loss (reversible). Report skin rash or itching, unusual fatigue or sore throat, unresolved diarrhea or vomiting, or CNS changes.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness
Mental Health: Effects on Psychiatric Treatment
Carbamazepine may decrease the effects of mebendazole; may rarely cause neutropenia; use caution with clozapine and carbamazepine
Nursing: Physical Assessment/Monitoring
Since worm infestations are easily transmitted, all persons sharing same household should be treated. Teach transmission prevention.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, chewable, oral: 100 mg
Pricing: U.S. (www.drugstore.com)
Chewable (Mebendazole)
100 mg (1): $16.41
References
Canete R, Escobedo AA, Gonzalez ME, et al, "Randomized Clinical Study of Five Days Apostrophe Therapy With Mebendazole Compared to Quinacrine in the Treatment of Symptomatic Giardiasis in Children," World J Gastroenterol, 2006, 12(39):6366-70.
Chandy E and McCarthy J, "Evidence Behind the WHO Guidelines: Hospital Care for Children: What Is the Most Appropriate Treatment for Giardiasis?" J Trop Pediatr, 2009, 55(1):5-7.
de Silva N, Guyatt H, and Bundy D, “Anthelmintics. A Comparative Review of Their Clinical Pharmacology,” Drugs, 1997, 53(5):769-88.
“Drugs for Parasitic Infections,” Med Lett Drugs Ther, 2007, 5(suppl):e1-14.
Hotez PJ, “Hookworm Disease in Children,” Pediatr Infect Dis J, 1989, 8(8):516-20.
International Brand Names
Lexi-Comp.com
Last full review/revision June 2011
Content last modified June 2011
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