Albendazole

About Albendazole

Albendazole is labeled for parenchymal neurocysticercosis, active lesions in brain tissue caused by the larval form of the pork tapeworm Taenia solium, and for cystic hydatid disease of the liver, lung and peritoneum caused by the dog tapeworm Echinococcus granulosus. It is taken with meals, and the dose depends on weight: 400 mg twice a day for people weighing 60 kg or more, or 15 mg per kg a day in two doses, up to 800 mg a day, for those under 60 kg. Neurocysticercosis is treated for 8 to 30 days. Hydatid disease is treated in 28-day cycles, each followed by 14 days without the drug, for three cycles. In neurocysticercosis it appears to work as well in children as in adults, and anyone who has trouble swallowing the tablets whole, particularly children, may crush or chew them and then drink some water.

As parasites in the brain die, the inflammation can cause seizures, raised pressure in the skull and other neurological symptoms, so corticosteroids are considered for the first week of neurocysticercosis treatment and seizure medicines are given as needed; the eyes are examined for lesions in the retina beforehand. People treated for hydatid disease who are at risk of neurocysticercosis are checked first, because treatment can uncover it. Albendazole can suppress the bone marrow, and deaths have occurred, so blood counts are checked at the start of each 28-day cycle and every 2 weeks, more often in liver disease; liver enzymes are checked before each cycle and at least every 2 weeks, and acute liver failure of uncertain cause has been reported. The only contraindication is allergy to albendazole or other benzimidazole drugs. In hydatid disease the common side effects are raised liver enzymes, abdominal pain, nausea, vomiting and reversible hair loss; in neurocysticercosis, headache, nausea and vomiting.

Albendazole can harm an unborn baby, so a pregnancy test comes before the first dose, and effective birth control is used during treatment and for 3 days after the last dose. Dexamethasone and praziquantel raise blood levels of its active form, albendazole sulfoxide, while cimetidine raises it in bile and cyst fluid; theophylline levels are checked during and after treatment. The Orange Book lists Albenza, the original brand, as discontinued; generic tablets are sold, and one maker packs them in bottles of two.

Taking Albendazole

How to take it

With meals, usually twice a day, for the days or cycles prescribed. Swallow the tablet whole, or crush or chew it and then drink water if you have trouble swallowing it. Finish the course even if you feel better.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

In the original container, tightly closed, at room temperature, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Dexamethasone and praziquantel raise blood levels of its active form, cimetidine raises it in bile and cyst fluid, and theophylline levels are checked during and after treatment. Tell the prescriber about every medicine and supplement you take, including steroids and seizure medicines.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Albendazole differs from pharmacy to pharmacy

With Albenza discontinued, albendazole is sold as generic 200 mg tablets, but it is not a medicine every pharmacy keeps in stock, so a pharmacy may need to order it, and quotes vary with how it is packed. One maker supplies bottles of two tablets, so a long course can mean many packs.

Quantities can be large: at 400 mg twice a day, each 28-day hydatid cycle takes four tablets a day, and treatment runs three cycles, so the price per tablet matters more than the dispensing fee. A neurocysticercosis course is shorter, and its length, from 8 to 30 days, sets the quantity.

Ways to pay less for Albendazole without insurance

• Before treatment starts, ask the pharmacy to confirm it can supply the full quantity, so doses are not interrupted.
• For hydatid disease, ask whether each 28-day cycle can be filled separately, since each new cycle follows blood and liver tests.
• Ask the prescriber to write the exact quantity for your weight-based dose and treatment length.
• Compare quotes from more than one pharmacy; for a long course, the price per tablet matters most.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Albendazole

1. 1.When are my blood counts and liver tests due during treatment?
2. 2.Should I take a steroid or a seizure medicine with it, and for how long?
3. 3.Can my child’s tablets be crushed or chewed?
4. 4.What birth control should I use, and for how long after my last dose?

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