(me BEN da zole)
Inhibits the formation of helminth microtubules; selectively and irreversibly blocks glucose uptake and other nutrients in susceptible adult intestine-dwelling helminths
Vd: 1-2 L/kg; to liver, fat, muscle, plasma, and hepatic cysts
Primarily feces; urine (~2%)
Time to Peak
Serum: 2-4 hours
90% to 95%
Use: Labeled Indications
Note: Not approved in the US
Treatment of Ancylostoma duodenale or Necator amiericanus (hookworms), Ascaris lumbricoides (roundworms), Enterobius vermicularis (pinworms), Strongyloides stercoralis (roundworm), Taenia solium (tapeworms), Trichuris trichiura (whipworms)
Treatment of Ancylostoma caninum (eosinophilic enterocolitis), Capillaria philippinensis (capillariasis), Giardia duodenalis (giardiasis), Mansonella perstans (filariasis), visceral larva migrans (toxocariasis)
Hypersensitivity to mebendazole or any component of the formulation
Oral: Children ≥2 years; Adolescents, and Adults:
Ancylostoma duodenale (hookworm), Necator americanus (hookworm), Ascaris lumbricoides (roundworm), Strongyloides stercoralis (roundworm), Taenia solium (tapeworms), Trichuris trichiura (whipworm), mixed infection: 100 mg twice daily for 3 days; repeat in 3 weeks if not cured with initial treatment
Enterobius vermicularis (pinworm): 100 mg as a single dose; repeat in 2 and 4 weeks (manufacturer’s labeling); treatment should include family members in close contact with patient (Med Lett, 2007)
Ancylostoma duodenale (hookworm), Ascaris lumbricoides (roundworm), Necator americanus (hookworm), Trichuris trichiura (whipworm): 500 mg as a single dose (Med Lett, 2007)
Ancylostoma caninum (eosinophilic enterocolitis): 100 mg twice daily for 3 days (Med Lett, 2007)
Capillaria philippinensis (capillariasis): 200 mg twice daily for 20 days (Med Lett, 2007)
Giardia duodenalis (giardiasis): 200 mg 3 times daily for 5 days (Canete, 2006; Chandy, 2009)
Mansonella perstans (filariasis): 100 mg twice daily for 30 days (Med Lett, 2007)
Visceral larva migrans (toxocariasis): 100-200 mg twice daily for 5 days (Med Lett, 2007)
Dosage adjustment in renal impairment: No dosage adjustment provided in manufacturer's labeling.
Dosage adjustment in hepatic impairment: No dosage adjustment provided in manufacturer's labeling; however, undergoes extensive hepatic metabolism; use with caution as systemic exposure may be increased.
Tablets may be chewed, swallowed whole, or crushed and mixed with food. Tablets may be administered with or without food.
Store at 15°C to 30°C (59°F to 86°F). Protect from light.
Aminoquinolines (Antimalarial): May decrease the serum concentration of Anthelmintics. Monitor therapy
CarBAMazepine: May decrease the serum concentration of Mebendazole. Monitor therapy
Cimetidine: May increase the serum concentration of Mebendazole. Monitor therapy
Fosphenytoin: May decrease the serum concentration of Mebendazole. Monitor therapy
MetroNIDAZOLE (Systemic): Mebendazole may enhance the adverse/toxic effect of MetroNIDAZOLE (Systemic). Particularly the risk for Stevens-Johnson syndrome or toxic epidermal necrolysis may be increased. Avoid combination
Phenytoin: May decrease the serum concentration of Mebendazole. Monitor therapy
Frequency not defined.
Central nervous system: Dizziness, drowsiness, headache, seizure
Dermatologic: Alopecia, angioedema, exanthema, itching, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Gastrointestinal: Abdominal pain, diarrhea, vomiting
Hematologic: Agranulocytosis, eosinophilia, hemoglobin decreased, leukopenia, neutropenia
Hepatic: Alkaline phosphatase increased, ALT increased, AST increased, GGT increased, hepatitis
Renal: BUN increased, cylindruria, glomerulonephritis, hematuria
Miscellaneous: Hypersensitivity reactions (anaphylactic, anaphylactoid)
Concerns related to adverse effects:
• Bone marrow suppression: Neutropenia and agranulocytosis have been reported with high doses and prolonged use.
• Hepatic impairment: Use with caution; systemic exposure may be increased with hepatic impairment.
• Hydatid disease: Not effective for hydatid disease.
Concurrent drug therapy issues:
• Metronidazole: Concomitant use with metronidazole should be avoided; may increase the risk of adverse events including Stevens-Johnson syndrome and toxic epidermal necrolysis.
• Pediatric: Experience with use in children <2 years of age is limited; convulsions in infants <1 year have been reported (rare) postmarketing.
Periodic hematologic, hepatic, and renal function; check for helminth ova in feces within 3-4 weeks following the initial therapy
Pregnancy Risk Factor
Adverse events have been observed in animal reproduction studies; adverse pregnancy outcomes have not been observed following use in pregnancy (Diav-Citrin, 2003; Gyorkos, 2006). Treatment of pinworm in pregnancy may be considered; however, the CDC suggests postponing therapy until the third trimester when possible (CDC, 2010).