Albendazole Disease Interactions

Reversible leukopenia has been reported during albendazole therapy. Rarely, granulocytopenia or pancytopenia have resulted in death. Therapy with albendazole should be administered cautiously in patients with predisposition to myelosuppression. Clinical monitoring of hematopoietic function prior to each cycle of albendazole and every two weeks during therapy is recommended. Albendazole can be continued with a modest, non- progressive decrease in leukocyte count and absolute neutrophil count.

Albendazole is converted to its biologically active metabolite and further metabolized to an inactive form by the liver. Biliary excretion of albendazole is the primary route of elimination and biliary obstruction results in increased albendazole serum concentration and AUC. Metabolism and therapeutic activity may be altered in patients with hepatic impairment. Elevated liver transaminase levels have been reported in 16% of patients receiving albendazole. Therapy with albendazole should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of hepatic function is recommended prior to initiation of each cycle of albendazole and at least every two weeks during therapy. Patients with elevated liver enzyme test results are at increased risk for hepatotoxicity and bone marrow suppression. Discontinue therapy if liver enzymes are significantly increased or if a clinically significant decrease in blood cell counts occur.

Albendazole therapy of neurocysticercosis can induce an inflammatory response within the CNS that precipitates seizures and cerebral hypertension. Therapy with albendazole for neurocysticercosis should be administered cautiously in patients with or predisposition to seizures. The use of corticosteroids during the first week of therapy to prevent cerebral hypertension and anticonvulsant therapy as required is recommended.

The pharmacokinetics of albendazole in patients with impaired renal function have not been studied. Caution is advised if used in these patients.