Albendazole (Zentel) is used to treat neurocysticercosis and cystic hydatid diseases caused by Echinococcus granulosus. In hydatid cystic disease, it prevents the recurrence of the disease, causes a reduction in the cyst size, and death of the hydatid cysts [Ref].

Albendazole Uses:

• Ascaris lumbricoides (roundworm);

• Ancylostoma caninum ;

• Ancylostoma duodenale and Necator americanus (hookworms);

• Cutaneous larva migrans;

• Enterobius vermicularis (pinworm);

• Giardia duodenalis (giardiasis);

• Gnathostoma spinigerum;

• Gongylonemasp;

• Mansonella perstans (filariasis);

• Oesophagostomum bifurcum;

• Opisthorchis sinensis (liver fluke);

• Trichinella spiralis(Trichinellosis); and

• Visceral larva migrans (toxocariasis).

It also has activity against the liver fluke Clonorchis Sinensis, Giardia lamblia, Cysticercus cellulosae, and Echinococcus multilocularis. Albendazole is also used for the treatment of intestinal microsporidiosis ( Encephalitozoon intestinalis), disseminated microsporidiosis (E.hellem, E.cuniculi, E.intestinalis, Pleistophora sp, Trachipleistophora sp, Brachiola vesicularum), and ocular microsporidiosis (E. hellem, E. cuniculi, Vittaforma corneae ).

How to take albendazole for deworming?

• It should be administered with a high-fat meal.
• Children may also crush the tablet and take it with water or with food.
• The dose should be repeated after 14 days for eradication as the larvae hatch.

Albendazole Contraindications:

• Allergy to albendazole or benzimidazoles or any component of the formulation

Warnings and precautions

• Suppression of bone marrow
  • Rarely do fatalities result from granulocytosis or granulocytopenia.
  • Hematologic toxicities are more common in patients with liver disease.
  • Cytopenia should be stopped in all patients.
• ELevations in liver enzymes
  • Albendazole could cause reversible elevations of the hepatic enzymes.
  • LFTs above the normal limit should be stopped.
  • Once the liver function tests are normal, therapy may be restarted.
  • Patients with abnormal baseline LFTs or hepatic-hydatid cysts, are particularly at risk.

Concerns about diseases:

• Neurocysticercosis:
  • To prevent intracranial hypertension, the patient should be given steroids and antiepileptics before being treated for neurocysticercosis. This will reduce inflammation and prevent seizures.
  • During the first week of therapy, antiepileptics can be administered.

Albendazole (Zentel) Dosage in Adults:

Zentel dose in neurocysticercosis:

• Less than 60 kg:

  • For 8–30 days, administer 15 mg/kg/day in two divided doses (maximum: 800 mg/day).

• 60 kgs or more:

  • For 8 to 30 days, take 800 mg twice daily.

Note: Give concurrent anticonvulsant and steroid therapy during the first week of therapy.

Zentel dose in Hydatid cysts:

• Less than 60 kg:

  • 15 mg/kg/day divided into two doses (up to 800 mg/day)

• 60 kgs or more:

  • 800 mg/day in 2 divided doses

Note: Administer dose for three 28-day cycles with a 14-day drug-free interval in between each cycle.

Zentel dose in Ancylostoma caninum , Round worms (Ascaris lumbricoides), Hookworms (Ancylostoma duodenale), and Necator americanus (hookworm): 

• 400 mg taken orally in one dosage

Zentel dose in Clonorchis sinensis (Chinese liver fluke): 

• 7 days at 10 mg/kg/day taken orally

For the treatment of Cutaneous larva migrans: 

• 3 days of taking 400 mg orally once every day.

Zentel dose in Enterobius vermicularis (pinworm) infections: 

• 400 mg taken orally in one dose.
• The dosage can be taken again in two weeks.

Zentel dose in Giardia duodenalis (giardiasis): 

• 400 mg taken orally once each day for five days.

Zentel dose in Gnathostoma spinigerum:

• For 21 days, take 800 mg twice a day orally.

Zentel dose in Gongylonemiasis: 

• 400 mg taken orally once each day for three days

Zentel dose in Mansonella perstans: 

• 800 mg taken orally twice day for ten days.

Oesophagostomum bifurcum: 

• 400 mg orally as a single dose.

For the treatment of Trichinellosis (Trichinella spiralis): 

• 800 mg used orally twice day for eight to fourteen days.
• Give  steroids for severe symptoms

Toxocariasis (Visceral Larva migrans): 

• For five days, take 800 mg twice day by mouth.

Cysticercus cellulosae: 

• 800 mg used orally twice day for eight to thirty days.
• It may be repeated as necessary.

Zentel dose in disseminated microsporidiosis: 

• 800 mg/day orally in 2 divided doses

Zentel dose in Echinococcus granulosus (tapeworm): 

• 800 mg used orally twice daily for 1-6 months.

Zentel dose in Intestinal microsporidiosis ( E. intestinalis):

• For 21 days, take 800 mg twice day orally.

Zentel dose in Ocular microsporidiosis: 

• 800 mg/day orally in 2 divided doses, in combination with fumagillin.

Albendazole (Zentel) dose in children:

Albendazole dose in Neurocysticercosis (Taenia solium):

(Note: Patients with neurocysticercosis should receive steroids and anticonvulsants during the first week of therapy)

• Less than 60 kg:

  • For 8–30 days, administer 15 mg/kg/day in two divided doses (maximum: 800 mg/day).

• 60 kgs or more:

  • 400 mg twice daily for eight to thirty days

Albendazole dose in Hydatid disease (Echinococcus granulosus):

• Less than 60 kg:

  • 15 mg/kg/day in 2 divided doses (maximum: 800 mg/day) for 28-days followed by a 14-day albendazole-free interval.
  • Three cycles of the therapy should be given

• 60 kgs or more:

  • 400 mg twice daily.
  • The 28-day cycle should be followed by a 14-day albendazole-free interval, for a total of 3 cycles

Zentel dose in Ancylostoma caninum , round worm (ascariasis), hookworm, and whipworm (trichuriasis) infections:

• 400 mg as a single dose

Zentel dose in Ascariasis:

• Children 12 months to 2 years: 200 mg as a single dose

Zentel dose in Capillariasis:

• 400 mg daily for 10 days

Zentel dose in Clonorchis sinensis or Chinese liver fluke: 

• 10 mg/kg/day for seven days.

Zentel (Albendazole) dose in cutaneous larva migrans:

• 400 mg once daily for three days.

Zentel (Albendazole) dose in Enterobius vermicularis or pinworm):

• a single 400 mg dose which should be repeated after 2 weeks

Zentel dose in Filariasis or Mansonella perstans ):

• For 10 days, take 400 mg twice daily.

Zentel dose in Filariasis or Wuchereria Bancroft, microfilaria reduction or suppression: 

• 400 mg in a single dose, either with ivermectin or diethylcarbamazine.

Zentel (Albendazole) dose in Giardiasis (Giardia duodenalis):

Children: 10 mg/kg each day for five days.

Adults: Once daily for five days at 400 mg

Zentel dose in Gnathostoma spinigerum (Gnathostomiasis):

• For 21 days, take 400 mg twice daily.

Zentel dose in Gongylonema sp (Gongylonemiasis):

• 400 mg once daily for three days.

Zentel dose in microsporidia infection in HIV-exposed/positive infants and children:

• 15 mg/kg/day divided into two doses (up to 800 mg/day) With the start of HAART, continued until immunological reconstitution

Zentel dose in microsporidiosis in non-HIV patients:

• Disseminated infection:

  • 400 mg twice daily

• Intestinal infection:

  • For 21 days, 400 mg twice every day.

• Ocular infection:

  • 400 mg combined with fumagillin thrice daily

Zentel dose in Strongyloidiasis ( Strongyloides stercoralis): 

• Twice day for seven days at 400 mg

Zentel dose in Trichinellosis ( Trichinella spiralis ):

• For 8–14 days, take 400 mg twice day.

Zentel dose in visceral larva migrans ( Toxocariasis ): 

• 5 days at twice the recommended dose

Albendazole Dose in renal disease:

• In patients with renal illness, there is no need to alter the dose.

Albendazole Dose in liver disease:

• Those who have liver illness run the chance of experiencing negative effects.
• The manufacturer does not, however, advise individuals with liver problems to change their dose.
• Liver enzymes should be monitored at least every two weeks while on therapy.

How to take Albendazole?

• It should be taken with a high-fat meal. If required, the tablet can be chewed or crushed and swallowed with water.
• Patients being treated for neurocysticercosis with albendazole should receive steroids and anticonvulsants during the first week of therapy.
• If patients have difficulty swallowing, tablets may be crushed or chewed, then swallowed with a drink of water.

Albendazole in Pregnancy - Risk Factor C​​​​​​​

• Animal studies have shown that Albendazole is teratogenic.
• A pregnancy test is required before you start therapy.
• If pregnancy is confirmed, it should be stopped immediately
• Patients are advised to not become pregnant within one month of treatment with albendazole.

Use during breastfeeding:

• Albendazole shouldn't be used by nursing mothers. The drug's potential for excretion into breast milk is unknown.

Side effects of Albendazole (Severe):

• hepatic failure,
• renal failure, and
• rhabdomyolysis

Albendazole side effects (Moderate):

• Elevated hepatic enzymes,
• hepatitis, and
• blurred vision

Zentel Side effects (Mild):

• diarrhea,
• drowsiness, and
• asthenia

Monitoring Parameters:

• After treatment, a stool examination should be done for 3 weeks to look for ova and parasites. Retreatment may be required if the stool test is positive.
• Monitor CBC and LFTs every two weeks during therapy. Patients with liver disease may require more frequent monitoring.
• Patients with neurocysticercosis should undergo an ophthalmologic examination.
• Female patients should have a pregnancy test done prior to the start of treatment.

Albendazole mechanism of action:

• Albendazole sulfuride is the active metabolite.
• It causes:
  • Degeneration of cytoplasmic micrules in intestinal, tegmental and larval helminths and helminths;
  • Depletes glycogen,
  • Reduces glucose uptake and secretion of cholinesterase.
  • This can lead to the accumulation of desecration materials within cells.
  • This causes depletion and immobilization of the parasites, which ultimately leads to death.

Drug Absorption: When consumed along with a fatty meal, absorption is low.

Distribution: Well inside hydatid cysts and cerebrospinal fluid

Protein binding is 70%

Metabolism: The active metabolite of albendazole is produced after substantial first-pass hepatic metabolism.

Half-life elimination is 8-12 hours

It takes 2 to 5 hours to achieve peak serum levels.

Excretion is primarily via Urine and feces

Albendazole Brand Names in Pakistan:

ACURE (PHARMIX LABORATORIES (PRIVATE) LIMITED)

Tablets : 200 mg :

2 tablets pack : Rs. 15.40

---

ALBA (PAKHEIM INTERNANATIONAL PHARMA)

Tablets : 200 mg :

2 tablets pack : Rs. 15.00

---

ALBAGEN (GENERA PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 15.00

10 tablets pack : Rs. 50.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.40

---

ALBEN (BRYON PHARMACEUTICALS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 17.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.40

---

ALBENDIX (NEO MEDIX)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

Suspension : 200mg/5ml :

10 ml pack : Rs. 16.00

---

ALBENDO (DAVIS PHARMACEUTICAL LABORATORIES)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

---

ALBENZA (PARAMOUNT PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 17.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 19.00

---

ALIZ (GLITZ PHARMA)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

---

ALOVAC (SIZA INTERNATIONAL (PVT) LTD)

Tablets : 200 mg :

6 tablets pack : Rs. 35.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

ALWORM (ALSON PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

---

ANTHEL (MEDERA PHARMACEUTICALS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

---

BENDA (PHARMEDIC (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 14.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 18.00

---

BENDAZOL (STANLEY PHARMACEUTICALS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

Suspension : 200mg/5ml :

10 ml pack : Rs. 17.00

---

BENDOLE (PHARMAWISE LABS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 10.00

10 atblets pack : Rs. 50

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

DESENZ (WEBROS PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 8.20

---

GIBENDA (NIMRALL LABORATORIES)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

10 tablets pack : Rs. 50.00

---

NENZOLE (NENZA PHARMACEUTICALS (PVT) LIMITED)

Tablets : 200 mg :

2 tablets pack : Rs. 13.00

Suspension : 200mg/5ml :

10 ml pack : Rs. 15.00

---

ROBIAZOLE (ZINTA PHARMACEUTICALS INDUSTRIES)

Tablets : 200 mg :

2 tablets pack : Rs. 10.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 11.00

---

VALOPALAC (VALOR PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 10.00

10 tablets pack : Rs. 50.00

---

VAPALAC (VALOR PHARMACEUTICALS)

Tablets : 200 mg :

10 tablets pack : Rs. 50.00

---

VERID (CANDID PHARMACEUTICALS)

Tablets : 200 mg :

2 tablets pack : Rs. 13.00

---

WORCYT (QINTAR PHARMACUTICALS)

Tablets : 200 mg :

10 tablets pack : Rs. 100.00

---

WORMED (MEDICRAFT PHARMACEUTICALS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 18.00

---

WORMGO (MEDICEENA PHARMA (PVT) LTD)

Tablets : 200 mg :

10 tablets pack : Rs. 100.00

Suspension : 200mg/5ml :

10 ml pack : Rs. 18.00

---

WORMOCID (DELTA PHARMA (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 17.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 19.00

---

XEDOL (XENON PHARMACEUTICALS (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 13.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 15.00

---

ZAVIC (HARMANN PHARMACEUTICAL LABORATORIES (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 16.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

ZENTEL (GLAXOSMITHKLINE)

Tablets : 200 mg :

2 tablets pack : Rs. 20.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 22.00

---

ZEPAR (Shaigan Pharmaceuticals (PVT) LTD)

Tablets : 200 mg :

2 tablets pack : Rs. 17.00

Suspension : 100mg/5ml :

10 ml pack : Rs. 19.00

---

AIMED (RAKAPOSHI PHARMACEUTICAL (PVT) LTD)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

ALBENSEL (SELMORE AGENCIES)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

ALMED (RAAZEE THERAPUTICS (PVT) LTD)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

BAZOLE (NEUTRO PHARMA (PVT) LTD)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

INTESTINIL (SAPIENT PHARMA)

Suspension : 100mg/5ml :

10 ml pack : Rs. 25.00

---

POLYWORM (POLYFINE CHEMPHARMA (PVT) LTD)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

WORMNOR (WAHABSONS PHARMA)

Suspension : 100mg/5ml :

10 ml pack : Rs. 19.00

---

XANTINIL (MIRACLE PHARMACEUTICALS(PVT) LTD)

Suspension : 100mg/5ml :

10 ml pack : Rs. 16.00

---

ZOLIVE (OLIVE LABORATORIES)

Suspension : 100mg/5ml :

10 ml pack : Rs. 17.00

---

LEVAZOL (UNIVET PHARMACEUTICALS)

Powder : 6g/25g , Levamisole : 3g/25g :

100 g powder pack :  Rs. 360.00

250 g powder pack : Rs. 855.00

25 g powder pack : Rs. 95.00

Albendazole Brand Names (International):

• ABZ
• Acure
• Albatel
• Alben
• Alben-VC
• Albentel
• Albenza
• Albenzol
• Albex
• Albezole
• Alfuca
• Almex
• Alminth
• Alzental
• Alzol
• Andazol
• Ascarol
• Bendex-400
• Benzol
• Bruzol
• CB-400
• Ceprazol
• Ciclopar
• Dalben
• Digezanol
• Emanthal
• Eskasole
• Eskazole
• Fintel
• Gascop
• Helmiben
• Helmidazole
• Hyemex
• Labenda
• Lomsin
• Lurdex
• Mebenix
• Mesin-C
• Nemozole
• Pantex
• Paranthil
• Rotopar
• Sioban
• Thelban
• Tilminth
• Valbazen Vet
• Vastus
• Vemizol
• Vermin Plus
• Vetoben
• Zeben
• Zela
• Zendal
• Zentel