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Pronunciation
(me BEN da zole)
U.S. Brand Names
Generic Available
Yes
Canadian Brand Names
Pharmacologic Category
Use: Labeled Indications
Treatment of pinworms (Enterobius vermicularis), whipworms (Trichuris trichiura), roundworms (Ascaris lumbricoides), and hookworms (Ancylostoma duodenale)
Pregnancy Risk Factor
C
Lactation
Excretion in breast milk unknown/use caution
Breast-Feeding Considerations
Since only 2% to 10% of mebendazole is absorbed, it is unlikely that it is excreted in breast milk in significant quantities.
Contraindications
Hypersensitivity to mebendazole or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Bone marrow suppression: Neutropenia and agranulocytosis have been reported with high doses and prolonged use.
Disease-related concerns:
• Hydatid disease: Not effective for hydatid disease.
Special populations:
• Pediatrics: Safety and efficacy have not been established in children <2 years of age.
Adverse Reactions
Frequency not defined.
Cardiovascular: Angioedema
Central nervous system: Fever, dizziness, headache, seizure
Dermatologic: Rash, itching, alopecia (with high doses)
Gastrointestinal: Abdominal pain, diarrhea, nausea, vomiting
Hematologic: Neutropenia (sore throat, unusual fatigue)
Neuromuscular & skeletal: Unusual weakness
Drug Interactions
Aminoquinolines (Antimalarial): May decrease the serum concentration of Anthelmintics. Risk C: Monitor therapy
Carbamazepine: May decrease the serum concentration of Mebendazole. Risk D: Consider therapy modification
Phenytoin: May decrease the serum concentration of Mebendazole. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Food: Mebendazole serum levels may be increased if taken with food.
Mechanism of Action
Selectively and irreversibly blocks glucose uptake and other nutrients in susceptible adult intestine-dwelling helminths
Pharmacodynamics/Kinetics
Absorption: 2% to 10%
Distribution: To serum, cyst fluid, liver, omental fat, and pelvic, pulmonary, and hepatic cysts; highest concentrations found in liver; relatively high concentrations found in muscle-encysted Trichinella spiralis larvae; crosses placenta
Protein binding: 95%
Metabolism: Extensively hepatic
Half-life elimination: 1-11.5 hours
Time to peak, serum: 2-4 hours
Excretion: Primarily feces; urine (5% to 10%)
Dosage
Children ?2 years and Adults: Oral:
Pinworms: 100 mg as a single dose; may need to repeat after 2 weeks; treatment should include family members in close contact with patient
Whipworms, roundworms, hookworms: One tablet twice daily, morning and evening on 3 consecutive days; if patient is not cured within 3-4 weeks, a second course of treatment may be administered
Capillariasis: 200 mg twice daily for 20 days
Dosing adjustment in hepatic impairment: Dosage reduction may be necessary in patients with liver dysfunction
Hemodialysis: Not dialyzable (0% to 5%)
Administration: Oral
Tablets may be chewed, swallowed whole, or crushed and mixed with food.
Monitoring Parameters
Check for helminth ova in feces within 3-4 weeks following the initial therapy
Dietary Considerations
Tablet can be crushed and mixed with food, swallowed whole, or chewed.
Patient Education
Do not take any new medication during therapy unless approved by prescriber. Take exactly as directed for full course of medication. Tablets may be chewed, swallowed whole, or crushed and mixed with food. Increase dietary intake of fruit juices. All family members and close friends should also be treated. To reduce possibility of reinfection, wash hands and scrub nails carefully with soap and hot water before handling food, before eating, and before and after toileting. Keep hands out of mouth. Disinfect toilet daily and launder bed linens, undergarments, and nightclothes daily with hot water and soap. Do not go barefoot and do not sit directly on grass or ground. May cause abdominal pain, nausea, or vomiting (small, frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help); or hair loss (reversible). Report skin rash or itching, unusual fatigue or sore throat, unresolved diarrhea or vomiting, or CNS changes. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness
Mental Health: Effects on Psychiatric Treatment
Carbamazepine may decrease the effects of mebendazole; may rarely cause neutropenia; use caution with clozapine and carbamazepine
Nursing: Physical Assessment/Monitoring
Since worm infestations are easily transmitted, all persons sharing same household should be treated. Teach proper use, transmission prevention, side effects/appropriate interventions, and adverse reactions to report.
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, chewable: 100 mg
Pricing: U.S. (www.drugstore.com)
Chewable (Mebendazole)
100 mg (1): $13.99
References
de Silva N, Guyatt H, and Bundy D, “Anthelmintics. A Comparative Review of Their Clinical Pharmacology,” Drugs, 1997, 53(5):769-88.
“Drugs for Parasitic Infections,” Med Lett Drugs Ther, 1998, 40(1017):1-12.
Hotez PJ, “Hookworm Disease in Children,” Pediatr Infect Dis J, 1989, 8(8):516-20.
International Brand Names
Lexi-Comp.com
Last full review/revision August 2008
Content last modified August 2008
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