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Albendazole
 
 
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Albendazole, marketed as Albenza, Eskazole, or Zentel, is a member of the benzimidazole
Benzimidazole

Benzimidazole is a heterocyclic aromatic organic compound. This bicyclic compound consists of the fusion of benzene and imidazole. The most prominent benzimidazole compound in nature is N-ribosyl-dimethylbenzimidazole, which serves as an axial ligand for cobalt in Cyanocobalamin....
 compounds used as a drug
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 indicated for the treatment of a variety of worm
Worm

A worm is a common name given to a diverse group of invertebrate animals that have a long, soft body and no legs. There are hundreds of thousands of species of worms, 2,700 of these are earthworms....
 infestations. Although this use is widespread in the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
, the FDA has not approved albendazole for this indication. It is marketed by GlaxoSmithKline
GlaxoSmithKline

GlaxoSmithKline plc is a United Kingdom-based pharmaceutical industry, biological, and healthcare company. GSK is the world's second largest pharmaceutical company and a research-based company with a wide portfolio of pharmaceutical products covering anti-infectives, central nervous system, respiratory, gastro-intestinal/metabolic,...
.

s effective against:


Tapeworm/cestodes



In Africa
Africa

Africa is the world's second-largest and second most-populous continent, after Asia. At about 30.2 million km? including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area....
, albendazole (donated by GlaxoSmithKline
GlaxoSmithKline

GlaxoSmithKline plc is a United Kingdom-based pharmaceutical industry, biological, and healthcare company. GSK is the world's second largest pharmaceutical company and a research-based company with a wide portfolio of pharmaceutical products covering anti-infectives, central nervous system, respiratory, gastro-intestinal/metabolic,...
) is being used to treat lymphatic filariasis as part of efforts to stop transmission
Transmission (medicine)

In medicine, transmission is the passing of a disease from an infected individual or group to a previously uninfected individual or group.The microorganisms that cause disease may be transmitted from one person to another by one or more of the following means:...
 of the disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
.






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Albendazole, marketed as Albenza, Eskazole, or Zentel, is a member of the benzimidazole
Benzimidazole

Benzimidazole is a heterocyclic aromatic organic compound. This bicyclic compound consists of the fusion of benzene and imidazole. The most prominent benzimidazole compound in nature is N-ribosyl-dimethylbenzimidazole, which serves as an axial ligand for cobalt in Cyanocobalamin....
 compounds used as a drug
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 indicated for the treatment of a variety of worm
Worm

A worm is a common name given to a diverse group of invertebrate animals that have a long, soft body and no legs. There are hundreds of thousands of species of worms, 2,700 of these are earthworms....
 infestations. Although this use is widespread in the United States
United States

The United States of America is a Federal government constitutional republic comprising U.S. state and a federal district. The country is situated mostly in central North America, where its Contiguous United States and Washington, D.C., the Capital districts and territories, lie between the Pacific Ocean and Atlantic Oceans, Borders of the U...
, the FDA has not approved albendazole for this indication. It is marketed by GlaxoSmithKline
GlaxoSmithKline

GlaxoSmithKline plc is a United Kingdom-based pharmaceutical industry, biological, and healthcare company. GSK is the world's second largest pharmaceutical company and a research-based company with a wide portfolio of pharmaceutical products covering anti-infectives, central nervous system, respiratory, gastro-intestinal/metabolic,...
.

Uses

It is effective against:

Flatworms


Flukes/trematodes
  • Hookworm
    Hookworm

    The hookworm is a parasitic worm nematode worm that lives in the small intestine of its host, which may be a mammal such as a dog, cat, or human....
    s


Tapeworm/cestodes
  • Echinococcosis
    Echinococcosis

    Echinococcosis, also known as hydatid disease, hydatid cyst, unilocular hydatid disease or cystic echinococcosis, is a potentially fatal parasitic disease that can affect many animals, including wildlife, commercial livestock and humans....


Nematodes

  • Roundworms
  • Whipworm
    Whipworm

    The human whipworm , is a roundworm, which causes trichuriasis when it infects a human large intestine. The name whipworm refers to the shape of the worm; they look like whips with wider "handles" at the posterior end....
    s
  • Threadworms or pinworm
    Pinworm

    The pinworm , also known as threadworm is a parasitic roundworm of the phylum Nematoda....
    s


In Africa
Africa

Africa is the world's second-largest and second most-populous continent, after Asia. At about 30.2 million km? including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area....
, albendazole (donated by GlaxoSmithKline
GlaxoSmithKline

GlaxoSmithKline plc is a United Kingdom-based pharmaceutical industry, biological, and healthcare company. GSK is the world's second largest pharmaceutical company and a research-based company with a wide portfolio of pharmaceutical products covering anti-infectives, central nervous system, respiratory, gastro-intestinal/metabolic,...
) is being used to treat lymphatic filariasis as part of efforts to stop transmission
Transmission (medicine)

In medicine, transmission is the passing of a disease from an infected individual or group to a previously uninfected individual or group.The microorganisms that cause disease may be transmitted from one person to another by one or more of the following means:...
 of the disease
Disease

A disease or medical condition is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and Medical signs....
. In sub-Saharan Africa, albendazole is used in conjunction with ivermectin
Ivermectin

Ivermectin is a broad-spectrum antiparasitic medication.It is sold under brand names Stromectol in the United States, Mectizan in Canada by Merck & Co....
, and elsewhere in the world, the medicine
Medication

A pharmaceutical drug, also referred to as medicine or medicament, can be loosely defined as any substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease....
 is used in combination with diethylcarbamazine
Diethylcarbamazine

Diethylcarbamazine is an anthelmintic medication that does not resemble other antiparasitic compounds. It is a synthetic organic compound which is highly specific for several parasites and does not contain any toxic metallic elements....
.

Mode of action

As a vermicidal, albendazole causes degenerative alterations in the tegument
Tegument

Tegument may refer to:* Integumentary system* Viral tegument...
 and intestinal cells of the worm by binding to the colchicine
Colchicine

Colchicine is a toxic natural product and secondary metabolite, originally extracted from plants of the genus Colchicum . Originally used to treat rheumatic complaints and especially gout, it was also prescribed for its cathartic and emetic effects....
-sensitive site of tubulin
Tubulin

Tubulin is one of several members of a small family of globular proteins. The most common members of the tubulin family are a-tubulin and ?-tubulin, the proteins that make up microtubules....
, thus inhibiting its polymerization or assembly into microtubules. The loss of the cytoplasmic microtubules leads to impaired uptake of glucose by the larval and adult stages of the susceptible parasites, and depletes their glycogen
Glycogen

Glycogen is a polysaccharide of glucose which functions as the secondary short term energy storage in animal cells. It is made primarily by the liver and the muscles, but can also be made by the brain and stomach....
 stores. Degenerative changes in the endoplasmic reticulum
Endoplasmic reticulum

The endoplasmic reticulum is a eukaryote organelle that forms an interconnected network of tubules, vesicle , and cisternae within cell . The lacey membranes of the endoplasmic reticulum were first seen by Keith R....
, the mitochondria of the germinal layer, and the subsequent release of lysosome
Lysosome

Lysosomes are organelles that contain digestive enzymes . Some biologists say they can only be found in animal cells, but there is new evidence that supports that they may exist in plant cells....
s result in decreased production of adenosine triphosphate
Adenosine triphosphate

This article is about the chemical used by cells as an energy carrier. For other uses, see ATP .Adenosine-5'-triphosphate is a multifunctional nucleotide, and plays an important role in cell biology as a coenzyme that is the "molecule unit of currency" of intracellular energy transfer....
 (ATP), which is the energy required for the survival of the helminth. Due to diminished energy production, the parasite is immobilized and eventually dies.

Albendazole also has been shown to inhibit the enzyme fumarate reductase
Fumarate reductase

Fumarate reductase is the enzyme that converts fumaric acid to succinic acid, it is important in microbial metabolism as a means for anaerobic respiration....
, which is helminth-specific. This action may be considered secondary to the effect on the microtubules due to the decreased absorption of glucose. This action occurs in the presence of reduced amounts of nicotinamide-adenine dinucleotide in reduced form (NADH), which is a coenzyme
Coenzyme

Many enzymes require a cofactor for catalytic activity, accelerating the transformation of a specific substrate to a particular product. The inactive protein, without the cofactor is called an apoenzyme, while the complete enzyme with cofactor is the holoenzyme....
 involved in many cellular oxidation-reduction reactions.

Albendazole has larvicidal effects in necatoriasis
Necatoriasis

Necatoriasis is the condition of infection by Necator hookworms.References...
 and ovicidal effects in ascariasis
Ascariasis

Ascariasis is a human disease caused by the parasite roundworm Ascaris lumbricoides. Perhaps as many as one quarter of the world's people are infected, and ascariasis is particularly prevalent in tropics and in areas of poor hygiene....
, ancylostomiasis
Ancylostomiasis

Ancylostomiasis is the condition of infection by Ancylostoma hookworms....
, and trichuriasis
Trichuriasis

Trichuriasis is a parasitic disease caused by infection of the large intestine by a parasite whipworm ....
.

Dosage

Hydatid disease:

  • Patients 60 kg or greater: 400 mg twice daily, with meals.
  • Patients less than 60 kg: 15 mg/kg/day given in divided doses twice daily with meals (maximum total daily dose 800 mg).
  • Treatment interval: 28-day cycle followed by a 14-day albendazole-free interval, for a total of 3 cycles.


NOTE: When administering albendazole in the pre- or post-surgical setting, optimal killing of cyst contents is achieved when 3 courses of therapy have been given.

Neurocysticerosis:

  • Patients 60 kg or greater: 400 mg twice daily, with meals.
  • Patients less than 60 kg: 15 mg/kg/day given in divided doses twice daily with meals (maximum total daily dose 800 mg).
  • Treatment interval: 8-30 days.


Note: Patients being treated for neurocysticercosis should receive appropriate steroid and anticonvulsant therapy as required. Oral or intravenous corticosteroids should be considered to prevent cerebral hypertensive episodes during the first week of treatment.

Side effects

This medication may cause
  • Dizziness, headache, fever, nausea, vomiting, or temporary hair loss.


In rare cases it may cause persistent sore throat, severe headache, seizures, vision problems, yellowing eyes or skin, dark urine, stomach pain, easy bruising, mental/mood changes, very stiff neck, change in amount of urine. Allergic reactions are also possible.

CBC and hepatic functions have to be obtained regulary in patiants receiving Albendazole.

Contraindications

  • Hypersensitivity to the benzimidazole class of compounds.


Pregnancy class

D (Australia) - Do not take when pregnant, and do not become pregnant for one month after taking this drug....

See also

  • Mebendazole
    Mebendazole

    Mebendazole or MBZ, marketed as Ovex, Vermox, Antiox, is a benzimidazole drug that is used to treat infestations by worms including pinworms, roundworms, tapeworms, hookworms, and whipworms....
  • Eradication of infectious disease
  • Neglected diseases
    Neglected Diseases

    The neglected diseases are a group of tropical disease which are especially endemic in low-income populations in developing regions of Africa, Asia, and the Americas....


External links