Albendazole tablet uses
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Here is a complete overview of Albendazole tablet uses, drawn from Goldman-Cecil Medicine, Goodman & Gilman's Pharmacology, and Katzung's Pharmacology:
Albendazole (400 mg tablet) - Uses
Mechanism of Action
Albendazole belongs to the benzimidazole class. It binds to beta-tubulin in parasites, blocking microtubule polymerization. This also inhibits glucose uptake and mitochondrial fumarate reductase in helminths, ultimately causing worm paralysis and death. It does not affect human tubulin at therapeutic doses.
Approved / Established Indications
1. Intestinal Roundworm Infections (Soil-Transmitted Helminths)
- Ascaris lumbricoides (roundworm) - single 400 mg dose
- Hookworms (Ancylostoma duodenale, Necator americanus) - single 400 mg dose
- Trichuris trichiura (whipworm) - single 400 mg dose; 3-day course for heavy infections
- Enterobius vermicularis (pinworm) - single 400 mg, repeated after 2 weeks
2. Tissue-Dwelling Helminth Infections
- Neurocysticercosis (Taenia solium larvae in brain) - 15 mg/kg/day in 2 divided doses for 10-14 days, given with corticosteroids to reduce cerebral edema
- Echinococcal (Hydatid) disease (Echinococcus granulosus / multilocularis) - 400 mg twice daily for 1-6 months; used when surgery is not possible
3. Other Specific Conditions
- Strongyloides stercoralis - 400 mg twice daily for 7 days (alternative to ivermectin)
- Cutaneous larva migrans (Ancylostoma braziliense) - topical or oral use
- Trichinosis (Trichinella spiralis) - drug of choice
- Trichostrongylus species
- Capillaria philippinensis
- Giardia lamblia - used in some settings
Dosage Summary
| Condition | Dose | Duration |
|---|---|---|
| Intestinal roundworms (adults & children >2 yrs) | 400 mg single dose | Once |
| Children <2 years | 200 mg single dose | Once |
| Pinworm | 400 mg | Single dose, repeat in 2 weeks |
| Neurocysticercosis | 15 mg/kg/day (max 800 mg) in 2 divided doses | 10-14 days |
| Hydatid disease | 400 mg twice daily | 1-6 months (cycles of 28 days on, 14 days off) |
| Strongyloides | 400 mg twice daily | 7 days |
Always take with a fatty meal - fat increases absorption up to 5-fold, which is especially important for tissue infections.
Pharmacokinetics
- Poorly absorbed on an empty stomach; a fatty meal greatly boosts absorption
- Rapidly converted in the liver to albendazole sulfoxide (the active form)
- Half-life: 8-9 hours
- CSF concentration: ~40% of serum levels (relevant for neurocysticercosis)
- Eliminated mainly via kidneys
Important Contraindications & Precautions
- Pregnancy - embryotoxic in animals; contraindicated (start treatment in first week of menstrual cycle or after negative pregnancy test)
- Ocular or spinal cysticercosis - contraindicated (risk of damage)
- High-dose prolonged use can cause: alopecia, hepatitis, bone marrow suppression (monitor CBC and LFTs)
- Drug interactions: Dexamethasone increases albendazole levels by ~50%; praziquantel also increases levels; grapefruit juice alters half-life
WHO / Public Health Use
Albendazole is on the WHO Essential Medicines List and is used in mass deworming programs worldwide, particularly for school-age children in endemic areas for soil-transmitted helminths.
Sources: Goldman-Cecil Medicine (International Ed.), p. 3389; Goodman & Gilman's Pharmacological Basis of Therapeutics, p. 1345
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