(me BEN da zole)
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet Chewable, Oral:
Emverm: 100 mg [contains fd&c yellow #6 (sunset yellow), saccharin sodium]
Brand Names: U.S.
Inhibits the formation of helminth microtubules; selectively and irreversibly blocks glucose uptake and other nutrients in susceptible adult intestine-dwelling helminths
Oral: Poor; 5% to 10%; increased with food (Dayan 2003)
Vd: 1 to 2 L/kg; to liver, fat, muscle, plasma, and hepatic cysts
Primarily feces (as unchanged drug and primary metabolite); urine (~2%)
Time to Peak
Serum: Variable (0.5 to 6 hours)
3 to 6 hours
90% to 95%
Special Populations: Hepatic Function Impairment
Plasma levels may be increased.
Use: Labeled Indications
Intestinal nematode infection: Treatment of Ancylostoma duodenale or Necator americanus (hookworms), Ascaris lumbricoides (roundworms), Enterobius vermicularis (pinworms), and Trichuris trichiura (whipworms) in single or mixed infections.
Hypersensitivity to mebendazole or any component of the formulation
Ancylostoma duodenale or Necator americanus (hookworm): Oral:
Manufacturer’s labeling: 100 mg twice daily for 3 days; repeat in 3 weeks if not cured with initial treatment
Alternate dosing: 500 mg as a single dose (Parasitic Infections 2013)
Ascariasis (roundworm): Oral:
Manufacturer’s labeling: 100 mg twice daily for 3 days; repeat in 3 weeks if not cured with initial treatment.
Alternate dosing: 500 mg as a single dose (Parasitic Infections 2013)
Enterobiasis (pinworm): Oral: 100 mg as a single dose; repeat in 3 weeks if not cured with initial treatment.
Trichuriasis (whipworm): Oral: 100 mg twice daily for 3 days; repeat in 3 weeks if not cured with initial treatment.
Capillariasis (off-label use): Oral: 200 mg twice daily for 20 days (CDC 2012). Additional data may be necessary to further define the role of mebendazole in this condition.
Echinococcus, cystic (off-label use): Oral: 40 to 50 mg/kg/day in 3 divided doses for 3 to 6 months (CDC 2014; Franchi 1999). Additional data may be necessary to further define the role of mebendazole in this condition.
Trichinellosis (Trichinella spiralis) (off-label use): Oral: 200 to 400 mg 3 times daily for 3 days, followed by 400 to 500 mg 3 times daily for 10 days (CDC 2016). Additional data may be necessary to further define the role of mebendazole in this condition.
Trichostrongyliasis (off-label use): Oral: 100 mg twice daily for 3 days (Farahmandian 1977)
Toxocariasis (off-label use): Oral: 100 to 200 mg twice daily for 5 days (CDC 2013). Additional data may be necessary to further define the role of mebendazole in this condition.
Refer to adult dosing.
Intestinal nematode infection (hookworm, pinworm, roundworm, whipworm): Children ≥2 years and Adolescents: Oral: Refer to adult dosing.
Capillariasis (off-label use): Limited data available: Children and Adolescents: Oral: Refer to adult dosing.
Trichinellosis (off-label use): Limited data available: Children and Adolescents: Oral: Refer to adult dosing.
Toxocariasis (off-label use): Children and Adolescents: Oral: Refer to adult dosing.
Dosing: Renal Impairment
There are no dosage adjustments provided in the manufacturer's labeling.
Dosing: Hepatic Impairment
There are no dosage adjustments provided in the manufacturer's labeling; however, undergoes extensive hepatic metabolism; use with caution as systemic exposure may be increased.
Oral: Administer with or without food. Tablets may be chewed, swallowed whole, or crushed and mixed with food.
Store at 20°C to 25°C (68°F to 77°F).
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.
Gastrointestinal: Abdominal pain, anorexia, diarrhea, flatulence, nausea, vomiting
<1% (Limited to important or life-threatening): Abnormal hepatic function tests, agranulocytosis, alopecia, anaphylaxis, angioedema, decreased ejaculate volume (Parasitic Infections 2013), dizziness, glomerulonephritis, hepatitis, hypersensitivity reaction, leukopenia (Parasitic Infections 2013), neutropenia, seizure, skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Concerns related to adverse effects:
• Bone marrow suppression: Neutropenia and agranulocytosis have been reported rarely 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:
• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.
• Pediatric: Experience with use in children <2 years of age is limited; convulsions have been reported postmarketing in pediatric patients <1 year.
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. Based on available data, 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 2016).
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience abdominal pain, lack of appetite, flatulence, nausea, vomiting, or diarrhea. Have patient report immediately to prescriber seizures (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.
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- Drug class: anthelmintics