Albendazole

drugbox
IUPAC_name = methyl [(5-propylsulfanyl-3H- benzoimidazol-2-yl) amino] formate

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CAS_number = 54965-21-8
ATC_prefix = P02
ATC_suffix = CA03
ATC_supplemental =
PubChem = 2082
ChemSpiderID = 1998
DrugBank = APRD00782
C=12 | H=15 | N=3 | O=2 | S=1
molecular_weight = 265.333 g/mol
bioavailability =
protein_bound =
metabolism = oxidation of sulfur atom to sulfoxide, the active metabolite
elimination_half-life =
pregnancy_category = D
legal_status = prescription
routes_of_administration = only oral route

Albendazole, marketed as Albenza, Eskazole, or Zentel, is a member of the benzimidazole compounds used as a drug indicated for the treatment of a variety of worm infestations. Although this use is widespread in the United States, the FDA has not approved albendazole for this indication.

Uses

It is effective against
* Threadworms or pinworms
* Roundworms,
* Whipworms
* Tapeworms
* Hookworms

In Africa, albendazole (donated by GlaxoSmithKline) is being used to treat lymphatic filariasis as part of efforts to stop transmission of the disease.Citation | author= The Carter Center| title="Lymphatic Filariasis Elimination Program"|url=http://www.cartercenter.org/health/lf/index.html|accessdate=2008-07-17] In sub-Saharan Africa, albendazole is used in conjunction with ivermectin, and elsewhere in the world, the medicine is used in combination with diethylcarbamazine.

Mode of action

Vermicidal: Albendazole (C₁₂H₁₅N₃O₂S) causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. The loss of the cytoplasmic microtubules leads to impaired uptake of glucose by the larval and adult stages of the susceptible parasites, and depletes their glycogen stores. Degenerative changes in the endoplasmic reticulum, the mitochondria of the germinal layer, and the subsequent release of lysosomes result in decreased production of adenosine triphosphate (ATP), which is the energy required for the survival of the helminth. Due to diminished energy production, the parasite is immobilized and eventually dies.

Albendazole also has been shown to inhibit the enzyme fumarate reductase, which is helminth-specific. This action may be considered secondary to the effect on the microtubules due to the decreased absorption of glucose. This action occurs in the presence of reduced amounts of nicotinamide-adenine dinucleotide in reduced form (NADH), which is a coenzyme involved in many cellular oxidation-reduction reactions.

Albendazole has larvicidal effects in necatoriasis and ovicidal effects in ascariasis, ancylostomiasis, and trichuriasis.

Dosage

Hydatid disease:

*Patients 60 kg or greater: 400 mg twice daily, with meals.
*Patients less than 60 kg: 15 mg/kg/day given in divided doses twice daily with meals (maximum total daily dose 800 mg).
*Treatment interval: 28-day cycle followed by a 14-day albendazole-free interval, for a total of 3 cycles.

NOTE: When administering albendazole in the pre- or post-surgical setting, optimal killing of cyst contents is achieved when 3 courses of therapy have been given.

Neurocysticerosis:

*Patients 60 kg or greater: 400 mg twice daily, with meals.
*Patients less than 60 kg: 15 mg/kg/day given in divided doses twice daily with meals (maximum total daily dose 800 mg).
*Treatment interval: 8-30 days.

Note: Patients being treated for neurocysticercosis should receive appropriate steroid and anticonvulsant therapy as required. Oral or intravenous corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of treatment.

ide effects

This medication may cause
*Dizziness, headache, fever, nausea, vomiting, or temporary hair loss.

In rare cases it may cause persistent sore throat, severe headache, seizures, vision problems, yellowing eyes or skin, dark urine, stomach pain, easy bruising, mental/mood changes, very stiff neck, change in amount of urine. Allergic reactions are also possible.

Contraindications

* Hypersensitivity to the benzimidazole class of compounds.

Pregnancy class

D (Australia) - Do not take when pregnant, and do not become pregnant for one month after taking this drug.

ee also

* Mebendazole
* Eradication of infectious disease
* Neglected diseases

References

External links

* [http://us.gsk.com/products/assets/us_albenza.pdf Prescribing information]
* [http://www.cartercenter.org/health/lf/index.html The Carter Center Lymphatic Filariasis Elimination Program]