Albendazole is a broad-spectrum benzimidazole anthelmintic agent. It is a prodrug whose active metabolite, albendazole sulfoxide, exerts its anthelmintic effect by selectively and irreversibly inhibiting tubulin polymerization in parasitic cells, leading to depletion of energy (ATP) and immobilization. It is a first-line agent for neurocysticercosis and hydatid disease in India and is widely used in mass drug administration (MDA) programs for soil-transmitted helminthiasis.
Adult: Intestinal Helminths: 400mg as a single oral dose (often repeated after 2-4 weeks for some worms). Hydatid Disease: 400mg twice daily with meals for 28 days, repeated for 1-3 cycles with 14-day drug-free intervals. Neurocysticercosis: 400mg twice daily with meals for 8-30 days (as per cyst resolution). Weight-based: 15 mg/kg/day (max 800mg) in two divided doses.
Note: Tablet must be taken orally, swallowed whole with water. For systemic infections (hydatid, neurocysticercosis), MUST be taken WITH A FATTY MEAL (e.g., milk, butter, nuts) to enhance absorption. For intestinal worms, can be taken with or without food. Dosage cycles must be completed as prescribed.
Albendazole is a prodrug. Its active metabolite, albendazole sulfoxide, binds selectively and with high affinity to parasite beta-tubulin, inhibiting its polymerization into microtubules. This disrupts cytoplasmic microtubules in intestinal and larval stages of susceptible helminths.
Pregnancy: CATEGORY D. Contraindicated. Albendazole is teratogenic and embryotoxic in animals. Pregnancy must be excluded before starting therapy. Women of childbearing potential should use effective contraception during and for 1 month after treatment.
Driving: May cause dizziness or vertigo. Patients should be cautioned about operating machinery or driving until they know how the drug affects them.
| Dexamethasone / Cimetidine / Praziquantel | Increases plasma levels of albendazole sulfoxide by inhibiting CYP3A4 metabolism, potentially increasing efficacy and toxicity. | Moderate |
| Carbamazepine / Phenytoin / Phenobarbital | Decreases plasma levels of albendazole sulfoxide by inducing CYP3A4 metabolism, potentially reducing efficacy. | Moderate |
| Theophylline | Albendazole may increase Theophylline levels; monitor for toxicity. | Moderate |
| Warfarin | Potential interaction; monitor INR closely as albendazole may affect coagulation. | Moderate |