Paul A. Pham, Pharm.D. and John G. Bartlett, M.D.
Available formulation in Zambia: Tablet (chewable): 400 mg.
- Cyst caused by E. granulosus: 15 mg/kg/d up to 400 mg bid x 28 days. Repeat cycle x 2 with 14 days break between courses. Cure rates achieved in only 1/3 of pts; consider surgery if cyst accessible.
- Neurocysticercosis: >60 kg: 400 mg PO twice-daily x 8 days; <60 kg: 7.5 mg/kg (max 800 mg/d). Consider adding dexamethasone 2 mg q6h x 8 days.
- First line treatment of tapeworm (T. saginata and T. solium): 400mg once-daily x 3d. If pregnant, use praziquantel 10-20 mg/kg x 1.
- First line treatment of roundworm (A. lumbricoides), pinworm (E. vermicularis), hookworm (A. duodenale), whipworm (Trichuris trichiura or Trichocephalus trichiuris): 400 mg x1, may repeat after 3-4 wks if needed.
- Sandworm (A. braziliense): 400 mg once daily x 3d.
- Avoid in pregnancy
Zambia Information Author: Paul A. Pham Pharm.D.
- Neurocysticercosis caused by Taenia solium
- Hydatid disease caused by Echinococcus granulosus (Tape-worm)
| Albenza ||Albendazole||GlaxoSmithKline||oral|
|Eskazole; Zentel (non-US brands)||Albendazole||non-US manufacturer||Oral|
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
Microsporidiosis: 400 mg PO twice-daily with fatty meals (treat until CD4 count >200)
Hookworm: 400 mg PO x 1
Hydatid disease: 400 mg PO twice-daily with meals x 28 d followed by a 14-day drug-free interval for a total of 3 cycles. Note: when medically feasible, surgery is considered treatment of choice.
Neurocysticercosis: 400 mg PO twice-daily with meals for 8 to 30 days with corticosteroids during 1st wk of treatment to prevent cerebral hypertensive episodes
Toxocariasis: 400 mg PO twice-daily with meals x 5 d
Not removed in hemodialysis. Use usual dose.
- Reversible hepatoxicity (monitor LFTs q 2 wks)
- GI intolerance: Nausea, vomiting, diarrhea and abdominal pain
- Bone marrow suppression (i.e pancytopenia, aplastic anemia, agranulocytosis, and leukopenia), especially in pts with liver disease, including echinococcosis.
- Dizziness and headache
- Hypersensitivity reaction
- Increased transaminase levels
Active against Encephalitozoon intestinalis but poor activity against the more common Enterocytozoon bieneusi (parasites causing microsporidiosis). These species can be distinguished by EM or PCR. Also active against E. cuniculi.
- Dexamethasone: Monitor for albendazole toxicity; dose may need to be decreased. In some case reports trough concentration of albendazole was increased up to 56%.
Praziquantel: Monitor adverse events of albendazole. Dose of albendazole may need to be decreased. In some case reports mean plasma concentration of albendazole was increased up to 50%.
- Theophylline: No reported interaction.
- Cimetidine: Increased albendazole levels in bile and cystic fluid following co-administration with cimetidine (clinical significance unknown).
Well-tolerated, oral, broad-spectrum anti-helminthic. Effective agent against microsporidiosis involving Encephalitozoon intestinalis. Unfortunately, 80% of HIV-related microsporidiosis caused by Enterocytozoon bieneusi, which has poor response to albendazole. ART is preferred treatment for microsporidiosis. Albendazole (400 mg PO x1) resulted in higher cure rate compared to mebendazole in the treatment of Ascaris, hookworm, and Trichuris.