What is mebendazole used for. How does mebendazole work. What are the common side effects of mebendazole. How should mebendazole be taken. What precautions should be followed when taking mebendazole.

Understanding Mebendazole: A Powerful Anthelmintic Medication

Mebendazole is a widely prescribed medication that belongs to the anthelmintic class of drugs. It’s primarily used to treat various types of worm infections, including roundworms, whipworms, pinworms, and hookworms. The drug works by effectively killing these parasitic worms, providing relief to patients suffering from these infections.

How does mebendazole function in the body?

Mebendazole operates by interfering with the cellular structure of the parasitic worms. It specifically targets the worms’ microtubules, which are essential for their cellular functions. By disrupting these structures, mebendazole prevents the worms from absorbing nutrients, ultimately leading to their demise and elimination from the body.

Available Forms and Dosage Instructions for Mebendazole

Mebendazole is available in the form of chewable tablets. The dosage and duration of treatment can vary depending on the specific type of worm infection being treated and the brand of mebendazole prescribed.

What are the common dosage instructions for mebendazole?

• For Emverm (mebendazole):
  • Whipworm, roundworm, and hookworm infections: Usually taken twice a day, in the morning and evening, for 3 days.
  • Pinworm infections: Typically administered as a single dose.
• For Vermox (mebendazole):
  • Generally prescribed as a single dose for various worm infections.

It’s crucial to follow the specific instructions provided by your healthcare provider or the directions on the prescription label. If you’re unsure about any aspect of the dosage, consult your doctor or pharmacist for clarification.

Proper Administration of Mebendazole Tablets

The method of taking mebendazole can vary slightly depending on the brand and the patient’s ability to chew tablets.

How should mebendazole tablets be consumed?

• Emverm chewable tablets:
  • Can be chewed
  • Swallowed whole
  • Crushed and mixed with food
• Vermox chewable tablets:
  • Should be thoroughly chewed before swallowing
  • For those unable to chew, the tablet can be placed on a spoon with a small amount of water (2-3 mL) and allowed to soften for 2 minutes before swallowing

Potential Side Effects and Precautions of Mebendazole

Like all medications, mebendazole can cause side effects, although not everyone experiences them. It’s important to be aware of both common and serious side effects, and to know when to seek medical attention.

What are the common side effects of mebendazole?

• Diarrhea
• Stomach pain or discomfort
• Nausea
• Vomiting
• Loss of appetite

These side effects are usually mild and resolve on their own. However, if they persist or become severe, it’s advisable to consult your healthcare provider.

Are there any serious side effects to watch out for?

While rare, some people may experience serious side effects that require immediate medical attention. These include:

• Seizures
• Severe skin reactions (rash, hives)
• Difficulty breathing or swallowing
• Fever, sore throat, chills, or other signs of infection

If you experience any of these symptoms, seek emergency medical care immediately.

Important Precautions and Considerations for Mebendazole Use

Before starting mebendazole treatment, it’s essential to inform your healthcare provider about certain factors that could affect your treatment or increase your risk of side effects.

What should patients disclose to their doctor before taking mebendazole?

• Any allergies to mebendazole or its ingredients
• All current medications, including prescription, over-the-counter, vitamins, and herbal supplements
• History of stomach or liver disease
• Pregnancy status or plans to become pregnant
• Breastfeeding status

Your doctor may need to adjust your treatment plan or monitor you more closely based on this information.

Preventing Reinfection and Spreading of Worm Infections

While mebendazole effectively treats worm infections, it’s crucial to take steps to prevent reinfection and avoid spreading the infection to others.

How can patients prevent reinfection and protect others?

• Wash hands and fingernails thoroughly with soap, especially before eating and after using the toilet
• Follow any additional preventive measures recommended by your healthcare provider
• Ensure all family members or close contacts are treated if necessary
• Maintain good personal hygiene and sanitation practices

These measures, combined with proper medication use, can significantly reduce the risk of reinfection and transmission.

Proper Storage and Disposal of Mebendazole

Correct storage and disposal of mebendazole are important for maintaining its effectiveness and ensuring safety.

How should mebendazole be stored?

• Keep the medication in its original container
• Store at room temperature
• Keep away from excess heat and moisture
• Keep out of reach of children

What is the proper way to dispose of unused mebendazole?

Unused or expired mebendazole should be disposed of properly to prevent accidental ingestion by children or pets. Do not flush the medication down the toilet. Instead, use a medicine take-back program if available in your area, or follow FDA guidelines for safe disposal of medications.

Mebendazole in the Treatment of Other Parasitic Infections

While mebendazole is primarily used for treating common worm infections, it has shown efficacy in treating other parasitic infections as well.

Can mebendazole be used to treat tapeworm infections?

Yes, mebendazole is sometimes used off-label to treat infections caused by tapeworms. However, this use should only be under the direct supervision of a healthcare provider, as the dosage and duration of treatment may differ from its use in other worm infections.

It’s important to note that mebendazole may be prescribed for other uses not listed here. Always consult your healthcare provider or pharmacist for more information about the specific use of this medication in your case.

Drug Interactions and Special Considerations with Mebendazole

Understanding potential drug interactions and special considerations is crucial for safe and effective use of mebendazole.

What medications may interact with mebendazole?

While mebendazole generally has few drug interactions, it’s important to inform your healthcare provider about all medications you’re taking. Some drugs that may interact with mebendazole include:

• Cimetidine (Tagamet): This antacid medication may increase the blood levels of mebendazole, potentially enhancing both its effects and side effects.
• Metronidazole (Flagyl, in Pylera): This antibiotic may interact with mebendazole, requiring closer monitoring for potential side effects.

Your doctor may need to adjust dosages or monitor you more closely if you’re taking these medications concurrently with mebendazole.

Are there special considerations for certain patient groups?

Certain groups of patients may require special consideration when using mebendazole:

• Pregnant women: The safety of mebendazole during pregnancy hasn’t been fully established. Use during pregnancy should only occur if the potential benefit justifies the potential risk to the fetus.
• Breastfeeding mothers: It’s not known if mebendazole passes into breast milk. Consult your healthcare provider before using mebendazole while breastfeeding.
• Patients with liver disease: Mebendazole is metabolized in the liver, so patients with liver disease may require dose adjustments or closer monitoring.
• Children: The safety and effectiveness of mebendazole in children under 2 years of age haven’t been established for some types of infections.

Always inform your healthcare provider about any relevant medical conditions or concerns before starting mebendazole treatment.

Monitoring Treatment Efficacy and Follow-up Care

Proper follow-up care is essential to ensure the effectiveness of mebendazole treatment and to address any ongoing issues.

How can patients determine if mebendazole treatment is effective?

The effectiveness of mebendazole treatment can be assessed in several ways:

• Symptom improvement: Many patients experience relief from symptoms such as abdominal pain, diarrhea, or visible worms in stool within a few days of starting treatment.
• Follow-up stool tests: Your healthcare provider may recommend follow-up stool tests to confirm the elimination of the parasites.
• Physical examination: In some cases, a physical exam may be performed to check for signs of ongoing infection.

If your symptoms persist or worsen after completing the prescribed course of mebendazole, it’s crucial to contact your healthcare provider promptly.

What follow-up care might be necessary after mebendazole treatment?

Follow-up care after mebendazole treatment may include:

• Repeat doses: For some types of infections, a second dose of mebendazole may be recommended after 2-3 weeks to ensure complete eradication of the parasites.
• Family treatment: In cases of highly contagious infections like pinworms, treatment of all household members may be necessary to prevent reinfection.
• Environmental measures: Your healthcare provider may recommend additional steps, such as washing bedding and clothing in hot water, to eliminate any lingering parasites in the environment.
• Nutritional support: In cases of severe or chronic infections, nutritional supplementation may be recommended to address any deficiencies caused by the parasites.

Always follow your healthcare provider’s instructions for follow-up care to ensure the best possible outcome from your mebendazole treatment.

Understanding the Broader Impact of Worm Infections and Their Treatment

While mebendazole effectively treats individual cases of worm infections, it’s important to understand the broader impact of these parasitic diseases on public health and global communities.

How do worm infections affect public health globally?

Worm infections, also known as helminthiases, are a significant public health concern, particularly in developing countries. These infections can lead to:

• Malnutrition and impaired physical growth in children
• Cognitive impairment and reduced educational achievement
• Decreased work productivity in adults
• Complications during pregnancy
• Increased susceptibility to other infections

The World Health Organization (WHO) estimates that over 1.5 billion people are infected with soil-transmitted helminths worldwide, highlighting the global significance of these infections.

What role does mebendazole play in global health initiatives?

Mebendazole, along with other anthelmintic drugs, plays a crucial role in global deworming programs. These initiatives aim to reduce the burden of worm infections, particularly in school-aged children in endemic areas. Some key aspects of these programs include:

• Mass drug administration: Regular administration of anthelmintic drugs like mebendazole to entire at-risk populations
• Integration with other health interventions: Combining deworming with other public health measures like vitamin A supplementation
• Health education: Promoting hygiene practices and sanitation to prevent reinfection
• Monitoring and evaluation: Assessing the impact of these programs on health and development indicators

These global health initiatives have shown significant success in reducing the prevalence and intensity of worm infections in many regions, demonstrating the importance of accessible and effective treatments like mebendazole.

Future Directions in Anthelmintic Treatment and Research

While mebendazole and other current anthelmintic drugs are effective, ongoing research aims to improve treatment options and address challenges in worm control.

What are some emerging areas of research in anthelmintic treatment?

Several promising areas of research are being explored to enhance the treatment and control of worm infections:

• New drug development: Researchers are working on novel anthelmintic compounds to address issues of drug resistance and improve efficacy.
• Combination therapies: Studies are investigating the potential benefits of combining different anthelmintic drugs to enhance effectiveness and reduce the risk of resistance.
• Vaccine development: Efforts are underway to develop vaccines against various helminth infections, which could provide long-term protection.
• Improved diagnostics: Research is focused on developing more sensitive and specific diagnostic tools to detect low-intensity infections and monitor treatment efficacy.
• Environmental interventions: Studies are exploring innovative approaches to interrupt parasite transmission cycles in the environment.

These research directions hold promise for improving the management of worm infections and reducing their global health impact in the future.

How might future developments impact the use of mebendazole?

As research progresses, the role of mebendazole in treating worm infections may evolve:

• Enhanced formulations: New formulations of mebendazole may be developed to improve its absorption and efficacy.
• Targeted use: As new drugs become available, mebendazole may be used more selectively for specific types of infections or in combination with other treatments.
• Resistance monitoring: Ongoing surveillance for drug resistance may inform guidelines for mebendazole use in different regions.
• Integration with new technologies: Mebendazole treatment may be combined with new diagnostic tools or delivery systems to enhance its effectiveness in control programs.

Despite potential future developments, mebendazole is likely to remain an important tool in the fight against worm infections due to its established safety profile and effectiveness against multiple parasite species.

Mebendazole: MedlinePlus Drug Information

pronounced as (me ben’ da zole)

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Mebendazole is used to treat several types of worm infections. Mebendazole (Vermox) is used to treat roundworm and whipworm infections. Mebendazole (Emverm) is used to treat pinworm, whipworm, roundworm, and hookworm infections. Mebendazole is in a class of medications called anthelmintics. It works by killing the worms.

Mebendazole comes as a chewable tablet. When mebendazole (Emverm) is used to treat whipworm, roundworm, and hookworm it is usually taken twice a day, in the morning and evening, for 3 days. When mebendazole (Emverm) is used to treat pinworm, it is usually taken as a single (one-time) dose. Mebendazole (Vermox) is usually taken as a single (one-time) dose. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take mebendazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking mebendazole (Emverm) chewable tablets, you may chew the tablets, swallow them whole, or crush and mix them with food.

You should thoroughly chew mebendazole (Vermox) chewable tablets; do not swallow the tablet whole. However, if you cannot chew the tablet, you may place the tablet on a spoon and add a small amount of water (2 to 3 mL) onto the tablet using a dosing syringe. After 2 minutes, the tablet will absorb the water and become a soft mass that should be swallowed.

If your condition does not improve or gets worse, call your doctor.

Mebendazole is also sometimes used to treat infections caused by tapeworms. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking mebendazole,

• tell your doctor and pharmacist if you are allergic to mebendazole, any other medications, or any of the ingredients in mebendazole chewable tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements you are taking or plan to take. Be sure to mention any of the following: cimetidine (Tagamet) or metronidazole (Flagyl, in Pylera). Your doctor may need to monitor you carefully for side effects.
• tell your doctor if you have or have ever had stomach or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking mebendazole, call your doctor.
• you should know that in addition to your treatment with mebendazole, you will need to take steps to prevent reinfection and infection of other people. You should wash your hands and fingernails with soap often, especially before eating and after using the toilet. Talk to you doctor about other measures to prevent reinfection and spread of the infection to others. Be sure to carefully follow the instructions provided by your doctor.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Mebendazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• stomach pain, discomfort, or swelling
• nausea
• vomiting
• loss of appetite

Some side effects can be serious.

If you experience any of these symptoms call your doctor immediately or get emergency medical treatment:

• seizures
• rash
• hives
• shortness of breath
• difficulty breathing or swallowing
• fever, sore throat, chills, or other signs of infection

Mebendazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www. poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• diarrhea
• stomach pain, discomfort, or swelling
• nausea
• vomiting

• Emverm^®
• Vermox^®

Last Revised – 06/15/2017

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Mebendazole – LiverTox – NCBI Bookshelf

Last Update: September 18, 2021.

OVERVIEW

Introduction

Mebendazole is an anthelmintic agent used commonly for roundworm (pinworm and hookworm) infections, trichinosis, capillariasis and toxocariasis and other parasitic worm infections. Mebendazole when given for prolonged periods in high doses has been associated with elevations in serum enzyme levels, and rare instances of acute, clinically apparent liver injury have been linked to its use.

Background

Mebendazole (me ben’ da zole) is a benzimidazole anthelmintic similar in structure and mechanism of action to thiabendazole and albendazole. The benzimidazoles act by selective binding to beta-tubulin of parasitic worms, causing their immobilization and death. Mebendazole and albendazole share similar anthelmintic activity, mebendazole generally being preferred for treatment of pinworm and roundworm infections, and albendazole (because it is better absorbed) for systemic parasitic infections such as echinococcosis and cysticercosis. Mebendazole was approved for use in the United States in 1974 and is indicated for therapy of common parasitic worm infections. Mebendazole is available generically and under the brand names Emverm and Vermox in 100 mg and 500 mg chewable tablets. The usual dose is 100 or 500 mg once (pinworm) or varying doses for 3 days (whipworm, hookworm and roundworm infections), or varying doses for longer periods, depending upon the indication. Side effects with single dose regimens are uncommon, but can include gastrointestinal upset, fever, headache, nausea, vomiting and diarrhea. With more extended therapy, gastrointestinal symptoms are the most frequent side effects and rare but potentially severe adverse effects include neutropenia, hypersensitivity reactions, hepatitis, angioedema, Stevens Johnson syndrome and toxic epidermal necrolysis.

Hepatotoxicity

Mebendazole when given in typical doses has not been associated with serum enzyme elevations, although the duration of therapy is usually short and monitoring for enzyme elevations has rarely been reported. With high dose therapy (which is now rarely used with the availability of albendazole), elevations in serum aminotransferase levels (2 to 10 times normal) can occur, but are usually well tolerated. There have been rare reports of acute liver injury due to mebenazole, particularly when it is given repeatedly or in higher doses. The onset is usually with fever and malaise within days of starting or restarting therapy. The pattern of serum enzyme elevations is typically hepatocellular, and jaundice is uncommon. The abnormalities usually resolve rapidly with stopping therapy. Signs of hypersensitivity (rash, fever and eosinophilia) are typical and liver biopsy may show granulomas.

Likelihood score: D (possible cause of clinically apparent liver injury with extended therapy).

Mechanism of Injury

Mebendazole acts by binding tubulin in parasitic worms, which it does with greater avidity than the tubulin in mammalian cells, but some of the toxicity of the benzimidazoles may be related to this tubulin-binding activity. In most instances of clinically apparent liver injury, hypersensitivity appears to be the cause.

Outcome and Management

Mebendazole is usually well tolerated and the liver injury reported with its use has been mild and self-limited in course. Patients with hypersensitivity and acute liver injury attributed to mebendazole should avoid repeat exposure. It is unknown whether there is cross sensitivity with other benzimidazoles (such as albendazole), but there probably is and switching to another class of anthelmintic agents is appropriate if therapy is still needed.

Drug Class: Anthelmintic Agents

CASE REPORT

Case 1. Acute liver injury due to mebendazole.(1)

A 52 year old Belgian man was treated with mebendazole (100 mg twice daily) for 3 days for suspected ascariasis. Fourteen days later the course was repeated, but within 2 days of restarting mebendazole he developed fever (39 ^oC), diarrhea, poor appetite and fatigue. Because of the fever, he was given a 5 day course of cefuroxime, but remained febrile and symptomatic and was then found to have elevations in serum aminotransferase levels, with normal serum bilirubin and alkaline phosphatase (Table). He had eosinophilia (18%: absolute count 2,286/μL). Tests for hepatitis A, B and C were negative. He had low levels of antinuclear antibody (ANA: 1:40) and smooth muscle antibody (SMA: 1:160), but total globulin levels were normal. Ultrasound of the abdomen was negative. Stools were negative for ova and parasites. A liver biopsy showed multiple granulomas with multinucleate cells and active inflammation. There were no ova or helminths visualized and special stains for mycobacteria were negative. He improved rapidly without further therapy and 3 months later serum enzymes were normal.

Key Points

Laboratory Values

CHEMICAL FORMULA AND STRUCTURE

CITED REFERENCE

1.

Colle I, Naegels S, Hoorens A, Hautekeete M. Granulomatous hepatitis due to mebendazole. J Clin Gastroenterol. 1999;28:44–5. [PubMed: 9916665]

ANNOTATED BIBLIOGRAPHY

References updated: 18 September 2021

• Zimmerman HJ. Anthelminthics. Hepatic injury from antimicrobial agents. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 626-8.

  (Expert review of hepatotoxicity of anthelmintics written in 1999; mebendazole produces hepatic injury in dogs and occasionally in humans by uncertain mechanisms).

• Keiser J, McCarthy J, Hotez PJ. Chemotherapy of helminth infections. In, Brunton LL, Hilal-Dandan R, Knollman BC, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 13th ed. New York: McGraw-Hill, 2018, pp. 1001-7.

  (Textbook of pharmacology and therapeutics).

• Polzin DJ, Stowe CM, O’Leary TP, Stevens JB, Hardy RM. Acute hepatic necrosis associated with the administration of mebendazole to dogs. J Am Vet Med Assoc. 1981;179:1013–6. [PubMed: 7341557]

  (Four of 10 Dachshunds treated with mebendazole [22 mg/kg for 3-5 days] developed acute hepatitis 8-10 days after stopping therapy [bilirubin 14.2 mg/dL, ALT 17 times ULN, Alk P 8 times ULN], and two died of multiorgan failure, autopsy showing centrolobular coagulative necrosis).

• Swanson JF, Breider MA. Hepatic failure following mebendazole administration to a dog. J Am Vet Med Assoc. 1982;181:72–3. [PubMed: 7107495]

  (4 year old Labrador Retriever developed liver injury [bilirubin 8.1 mg/dL, ALT 8 times ULN, Alk P 5 times ULN] starting 3 days after a second course of mebendazole [22 mg/kg], autopsy showing centrolobular hepatic necrosis).

• Seitz R, Schwerk W, Arnold R. Z Gastroenterol. 1983;21:324–9. [Hepatocellular drug reaction caused by mebendazole therapy in cystic echinococcosis] German. [PubMed: 6613213]

  (76 year old man with Echinococcal cysts of liver developed rash 49 days after starting mebendazole [~29 mg/kg/day], with ALT 250 U/L but normal bilirubin and Alk P; positive rechallenge to low dose [ALT 403 U/L]).

• Junge U, Mohr W. Z Gastroenterol. 1983;21:736–8. [Mebendazole-hepatitis] German. [PubMed: 6666188]

  (Among 29 patients with echinococcosis treated with mebendazole, 1 developed hepatitis; 53 year old woman noted dark urine 2 months after starting therapy [bilirubin 2.1 mg/dL, ALT 475 U/L, Alk P 270 U/L]; biopsy showing spotty necrosis, resolving in 1.5 months; positive rechallenge [ALT 400 U/L, Alk P 358 U/L]).

• Mousa AM, Rudwan MA, Marafi AA, Muhtaseb SA, Dajani AI. Human cystic hydatid disease: treatment with interrupted courses of mebendazole. J Trop Med Hyg. 1986;89:257–64. [PubMed: 3795326]

  (10 patients with echinococcal cysts were treated with high doses of mebendazole [1800 mg/day] for up to 18 weeks; a 37 year old woman with multiple cysts developed jaundice at 11 days that became cholestatic but ultimately resolved; few details given and referred to as “amoebic hepatitis”).

• Bekhti A, Pirotte J. Hepatotoxicity of mebendazole. Relationship with serum concentrations of the drug. Gastroenterol Clin Biol. 1987;11:701–3. [PubMed: 3692093]

  (47 year old woman with hydatid cysts in the liver developed persistent elevations in ALT [60-400 U/L] and Alk P [207 U/L] without jaundice during a third course of mebendazole given in high doses [4.5-6.0 g daily], ALT levels correlated with serum mebendazole levels, normalized with stopping and rose again with rechallenge apparently without symptoms or jaundice).

• Colle I, Naegels S, Hoorens A, Hautekeete M. Granulomatous hepatitis due to mebendazole. J Clin Gastroenterol. 1999;28:44–5. [PubMed: 9916665]

  (52 year old man treated with mebendazole for 3 days on two occasions 2 weeks apart developed fever during the second course and then found to have bilirubin 1.0 mg/dL, ALT 466 U/L, Alk P normal, 18% eosinophils and liver biopsy showing granulomas; no jaundice and rapid recovery: Case 1).

• Reuter S, Jensen B, Buttenschoen K, Kratzer W, Kern P. Benzimidazoles in the treatment of alveolar echinococcosis: a comparative study and review of the literature. J Antimicrob Chemother. 2000;46:451–6. [PubMed: 10980173]

  (35 patients with alveolar echinococcosis were treated with either mebendazole or albendazole for 12-79 months; no severe side effects, but one patient was switched from albendazole to mebendazole because of ALT elevations).

• Keiser J, Utzinger J. Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. JAMA. 2008;299:1937–48. [PubMed: 18430913]

  (Systematic review of efficacy and safety of albendazole, mebendazole and pyrantel pamoate as therapy of Ascaris lumbricoides [roundworm], hookworm and whipworm; mebendazole was well tolerated in most studies, no significant adverse events were reported).

• Drugs for parasitic infections. Treat Guidel Med Lett. 2013;11 Suppl:e1–31.

  (Thorough description of drugs for parasitic infections in adults and children as well as a table of their major side effects; mebendazole can be used for ascariasis, pinworm, hookworm, whipworm, trichinellosis, and several less common parasitic infections; no hepatic related side effects mentioned).

• Mandal S, Mandal MD. Human cystic echinococcosis: epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects. Asian Pac J Trop Med. 2012;5:253–60. [PubMed: 22449514]

  (Review of human enchinococcal cyst disease, its epidemiology, clinical manifestations, diagnosis, prevention and treatment which includes direct aspiration and surgery on the cysts and medical therapy with either mebendazole, albendazole or ivermectin often with praziquantel; no discussion of side effects).

• Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. Gastroenterology. 2015;148:1340–52. [PMC free article: PMC4446235] [PubMed: 25754159]

  (Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, no cases were attributed to mebendazole or other anthelminthic medications).

• Silber SA, Diro E, Workneh N, Mekonnen Z, Levecke B, Steinmann P, Umulisa I, et al. Efficacy and Safety of a single-dose mebendazole 500 mg chewable, rapidly-disintegrating tablet for Ascaris lumbricoides and Trichuris trichiura infection treatment in pediatric patients: a double-blind, randomized, placebo-controlled, phase 3 study. Am J Trop Med Hyg. 2017;97:1851–1856. [PMC free article: PMC5805036] [PubMed: 29016336]

  (Among 295 children [ages 1 to 15 years] with hookworm infection treated with mebendazole [single 500 mg chewable tablet] vs placebo, cure rates were 84% vs 11% for Ascaris lumbricoides and 34% vs 8% for Trichuris trichiuria, while adverse events arose in 6.3% vs 5.7%, mostly mild-to-moderate abdominal pain or distension, with no serious adverse events or deaths).

• Palmeirim MS, Ame SM, Ali SM, Hattendorf J, Keiser J. Efficacy and safety of a single dose versus a multiple dose regimen of mebendazole against hookworm infections in children: a randomised, double-blind trial. EClinicalMedicine. 2018 Jul;1:7–13. [PMC free article: PMC6537524] [PubMed: 31193620]

  (Among 185 children with hookworm infestation [Ancylostoma duodenale] treated with mebendazole in a dose of 100 mg twice daily for 3 days vs a single 500 mg dose, cure rates were 98% vs 13%, while adverse events were similar consisting of mild-to-moderate abdominal pain, diarrhea and headache).

• Cañete R, Brito K, Brito I, Semper A, Gonzalez ME. Effectiveness and tolerability of 3-day mebendazole treatment of Giardia duodenalis infection in adults and children: two prospective, open-label phase IV trials. Curr Ther Res Clin Exp. 2018;89:43–47. [PMC free article: PMC6370949] [PubMed: 30792825]

  (Among 522 children and 423 adults with giardia duodenalis infection treated in two open-label trials of a 3-day regimen of mebendazole [100 mg twice daily] in Cuba, cure rates were 86% and 93% and adverse events were abdominal pain [6% in both groups], nausea and vomiting [in 2-3% of children]).

• Palmeirim MS, Bosch F, Ame SM, Ali SM, Hattendorf J, Keiser J. Efficacy, safety and acceptability of a new chewable formulation versus the solid tablet of mebendazole against hookworm infections n children: An open-label, randomized controlled trial. EClinicalMedicine. 2020;27:100556. [PMC free article: PMC7599302] [PubMed: 33150325]

  (Among 397 children [ages 3 to 12 years] with hookworm treated with a single dose of mebendazole in a solid vs chewable tablet form [500 mg], cure rates were similar [71% vs 69%] and adverse events were uncommon and mostly mild fever, headache, abdominal pain and nausea; no mention of hepatoxicity).

Mebendazole – description of the substance, pharmacology, use, contraindications, formula

Contents

• Structural formula

• Russian name

• English name

• Latin name

• chemical name

• Gross formula

• Pharmacological group of the substance Mebendazole

• Nosological classification

• CAS code

• pharmachologic effect

• Characteristic

• Pharmacology

• The use of the substance Mebendazole

• Contraindications

• Use during pregnancy and lactation

• side effects of mebendazole

• Interaction

• Overdose

• Dosage and administration

• Precautionary measures

• Trade names with the active substance mebendazole

Structural formula

Russian name

Mebendazole

English name

Mebendazole

Latin name

Mebendazolum ( genus 9 0062 Mebendazoli)

Chemical name

(5-Benzoyl-1H-benzimidazol-2-yl)carbamic acid methyl ester

Molecular formula

C ₁₆ H ₁₃ N ₃ O ₃

Pharmacological group of the substance Mebendazole

Antihelminthics

Nosological classification

ICD-10 code list

• B67 Echinococcosis

• B67. 8 Hepatic echinococcosis, unspecified

• B68 Teniasis

• B75 Trichinosis

• B76 Hookworm infection

• B77 Ascariasis

• B78 Strongyloidiasis

• B79 Trichuriasis

• B80 Enterobiasis

• B81. 1 Intestinal capillariasis

• B81.4 Intestinal helminthiases of mixed etiology

• B83.1 Gnathostomiasis

CAS code

31431-39-7

Pharmacological action

Pharmacological action –

anthelmintic .

Description

Broad spectrum anthelmintic agent. Whitish-yellowish powder, slightly soluble (less than 0.05%) in water, aqueous solutions of mineral acids, alcohol and chloroform, well – in formic acid. Molecular weight 295.29.

Pharmacology

Interferes with the synthesis of cellular tubulin, disrupts the utilization of glucose and inhibits the formation of ATP in helminths.

Slowly and incompletely (5-10% of the dose) absorbed from the gastrointestinal tract. T _1/2 – 2.5-5.5 hours. In the blood, 90% binds to proteins. Unevenly distributed throughout the organs. Accumulates in adipose tissue, liver, helminth larvae. In the liver, it is biotransformed to a 2-amino derivative. More than 90% of the dose is excreted unchanged in the feces.

Application of the substance Mebendazole

Enterobiasis, ascariasis, hookworm infections, strongyloidiasis, trichuriasis, multiple nematodosis, echinococcosis, teniasis, alveococcosis, capillariasis, gnathostomiasis, trichinosis, mixed helminthiases.

Contraindications

Hypersensitivity, ulcerative colitis, Crohn’s disease, liver failure, pregnancy, lactation, children under 2 years of age.

Use in pregnancy and lactation

FDA fetal category C.

Stop breastfeeding during treatment.

Side effects of the substance Mebendazole

Dizziness, nausea, abdominal pain. When used in high doses for a long time: vomiting, diarrhea, headache, increased activity of hepatic transaminases, hypercreatinemia, leukopenia, anemia, eosinophilia, hair loss, hematuria, cylindruria, allergic reactions (skin rash, urticaria, angioedema).

Interactions

Carbamazepine and other inducers of metabolism decrease, while cimetidine increases tissue concentration.

Overdose

Symptoms: nausea, vomiting, diarrhea, abdominal pain. With prolonged use in high doses: reversible liver dysfunction, hepatitis, neutropenia.

Treatment: gastric lavage, enemas, activated charcoal; there is no specific antidote.

Dosage and Administration

Int. For enterobiasis: adults and children over 10 years old – 100 mg once, children 2-10 years old – 25-50 mg once. In the case of a high probability of re-invasion – again after 2-4 weeks at the same doses. It is recommended that all family members be treated simultaneously.

For ascariasis, trichuriasis, ankylostomiasis, teniosis, strongyloidiasis and mixed helminthiases: 100 mg in the morning and evening for 3 days.

For trichinosis: 200-400 mg 3 times a day for 3 days, and from the 4th to the 10th – 400-500 mg 3 times a day.

For echinococcosis: 500 mg twice a day for the first 3 days and 3 times a day for the next 3 days. In the future, the dose is increased to the maximum (at the rate of 25-30 mg / kg / day) in 3-4 doses.

Precautions

Mandatory periodic examination of anal and stool swabs after the end of treatment: therapy is considered effective in the absence of helminths or their eggs for 7 consecutive days. It is necessary to avoid joint use with alcohol and fatty foods, laxatives. The picture of peripheral blood, liver and kidney function should be monitored.

Trade names with the active substance Mebendazole

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Lek. form
All lek. substance-powder forms tablets

Dosage
All dosages 100 mg No dosage

Manufacturer
All manufacturers AVBA RUS JSC Kadila Pharmaceuticals Ltd. SHAANSI HANJIANG PHARMACEUTICAL GROUP CO.,LTD

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Vermox (mebendazole) side effects, warnings, uses

Vermox

• Generic Name: Mebendazole
• Brand Name: Vermox

• Overview
• Consumer Information
• Professional Information
• Related Resources

Vermox 9 Side Effects Center0053

Medical Editor: John P. Cunha, DO, FACOEP

What is Vermox?

Vermox (mebendazole) is an “anthelminthic” or antihelminthic medicine used to treat infections caused by worms such as whipworm, pinworm, roundworm, and hookworm. Vermox is also used to treat infections caused by more than one of these worms at the same time. The Vermox brand name is no longer available in the US. Generic versions may be available.

What are the side effects of Vermox?

Common side effects of vermox (mebendazole) include:

• stomach/abdominal pain,
• vomiting,
• diarrhea,
• fever ,
• Headache,
• dizziness, or
• drowsiness .

Dosage for Vermox

The dose of mebendazole for children and adults in the treatment of whipworms, ascaris and hookworms is 1 tablet in the morning and evening for 3 consecutive days. The dose for treating pinworms is 1 tablet taken once.

acetaminophen same as ibuprofen

What drugs, substances or additives interact with Vermox?

Mebendazole may interact with anticonvulsants. Tell your doctor about all medicines you are taking.

Vermox during pregnancy and lactation

During pregnancy, mebendazole should only be used as directed. It is not known if this drug passes into breast milk. Consult your doctor before breastfeeding.

More Information

Our Vermox (Mebendazole) Side Effects Treatment Center provides a comprehensive overview of available drug information about the potential side effects of this medication.

This is not a complete list of side effects and they may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

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Consumer Information Vermox

Get emergency medical help if you have signs of an allergic reaction : hives; labored breathing; swelling of the face, lips, tongue, or throat.

Call your doctor right away if you have:

• signs of bone marrow depression – sudden weakness or feeling unwell, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing, lungs bruising or bleeding; or
• severe skin reaction – swelling of the face or tongue; sores around the eyes, nose, mouth, or genitals; hives or a skin rash that spreads and causes blistering and peeling.

Common side effects may include:

• nausea, vomiting, anorexia, diarrhea;
• abdominal pain, gas; or
• rash.

This is not a complete list of side effects and they may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Vermox (Mebendazole)

which mg contains lorazepam

Learn More ‘ About Vermox Professional

SIDE EFFECTS

Clinical Studies

Because clinical trials are conducted under a wide range of conditions, the frequency of adverse reactions observed in clinical trials of a medicinal product cannot be directly compared with the frequency in clinical trials of another medicinal product. means and may not reflect the performance observed in practice.

The safety of mebendazole was evaluated in 6276 subjects who participated in 39 clinical trials for the treatment of single or mixed parasitic infections of the gastrointestinal tract. In these trials, the formulations, dosages, and duration of treatment with mebendazole varied. Adverse reactions reported in subjects treated with mebendazole during 39 clinical trials are shown in Table 2 below.

Table 2: Adverse reactions reported in subjects treated with mebendazole during 39clinical trials*

Adverse reactions)

rexia

Abdominal pain

Diarrhea

Flatulence

Nausea

Vomiting

Diseases of the skin and subcutaneous tissues

Rash

* Includes mebendazole preparations, dosages and duration of treatment, except for VERMOX 100 mg tablets.

Post-Marketing Experience

The following adverse reactions have been reported in adult and pediatric patients after marketation of mebendazole preparations and dosages other than VERMOX 100 mg chewable tablets. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Table 3: Adverse reactions identified during post-marketing experience with mebendazole *

90 330

		Diseases of the blood and lymphatic system	Agranulocytosis, neutropenia
Diseases of the immune system	Hypersensitivity, including anaphylactic reactions.
Diseases of the nervous system	Seizures, dizziness
Diseases of the liver and biliary tract	Hepatitis, abnormal liver tests
Diseases of the kidneys and urinary tract	Glomerulonephritis
Diseases of the skin and subcutaneous tissues	Toxic epidermal necrolysis, Stevens-Johnson syndrome, exanthema, angioedema, urticaria, alopecia
* Includes mebendazole preparations, dosages and duration of treatment, excluding VERMOX 100 mg chewable tablets. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website