Thiabendazole

Pronunciation: THIGH-uh-BEND-uh-zole
Class: Benzimidazole

Trade Names:
Mintezol
- Tablets, chewable 500 mg

Pharmacology

Inhibits helminth-specific enzyme fumarate reductase; suppresses egg or larval production and may inhibit subsequent development of eggs or larvae that are passed in the stool.

Pharmacokinetics

Absorption

Thiabendazole is rapidly absorbed. T _max is within 1 to 2 h.

Metabolism

Thiabendazole is almost completely metabolized to the 5-hydroxy form, which appears in the urine as glucuronide or sulfate conjugates.

Elimination

In 48 h, about 5% of a thiabendazole dose is recovered from feces and 90% from urine.

Indications and Usage

Treatment of strongyloidiasis (threadworm infection), cutaneous larva migrans (creeping eruption), and visceral larva migrans alone or in conjunction with enterobiasis (pinworm). Secondary therapy for uncinariasis (hookworm: Necator americanus and Ancylostoma duodenale ), trichuriasis (whipworm), and ascariasis (large roundworm); alleviation of symptoms of trichinosis during invasive phase.

Contraindications

Standard considerations.

Dosage and Administration

PO 1.5 g/dose twice daily (max, 3 g/day).

PO 10 mg/lb/dose (22 mg/kg/dose) (max, 3 g/day).

Two doses daily for 2 successive days (may repeat for some indications).

Two doses daily for 2 to 4 successive days.

Two doses daily for 7 successive days.

Storage/Stability

Store at room temperature.

Drug Interactions

Thiabendazole may increase serum concentrations of theophylline to potentially toxic levels.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypotension.

CNS

Dizziness; fatigue; drowsiness; giddiness; headache; numbness; hyperirritability; seizures; collapse.

EENT

Tinnitus; abnormal sensation in eyes; xanthopsia; blurring of vision; drying of mucous membranes; appearance of live ascaris in mouth and nose.

GI

Anorexia; nausea; vomiting; diarrhea; epigastric distress.

Genitourinary

Hematuria; enuresis; malodor of urine; crystalluria.

Hematologic

Transient leukopenia.

Hepatic

Jaundice; cholestasis; parenchymal liver damage, transient rise in cephalin flocculation and AST.

Miscellaneous

Hypersensitivity reaction (pruritus, fever, facial flush, chills, conjunctival injection (red eye), angioedema, anaphylaxis, skin rashes, erythema multiforme, lymphadenopathy).

Precautions

Pregnancy

Category C .

Lactation

Unknown.

Children

Safety and efficacy in children weighing less than 13.6 kg (30 lb) not established.

Mixed infections with Ascaris lumbricoides

Thiabendazole may cause these worms to migrate. Drug should not be used prophylactically.

Supportive therapy

Anemic, dehydrated, or malnourished patients may need concomitant therapy to reverse these conditions.

Overdosage

Symptoms

Transient visual disturbances, psychic alterations.

Patient Information

• Instruct patient to take medicine with food. No special diets are needed.
• Advise patient that all family members should be treated and that treatment may need to be repeated in 7 days to prevent reinfection.
• Instruct patient to bathe daily and to launder bed linens, clothes, and towels daily. Instruct patient on proper technique for hygiene and hand-washing.
• Advise patient to avoid consuming excessive amounts of caffeine-containing beverages, such as coffee.
• Instruct patient to inform health care provider immediately of any symptoms of hypersensitivity or overdosage.
• Advise patient that drug can cause drowsiness and dizziness and to use caution while driving or performing other tasks requiring mental alertness.

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