What is the use of Vermox (Mebendazole)?

From the Guidelines

Vermox, also known as mebendazole, should be used at a dosage of 100 mg twice daily in combination with ivermectin 200 μg/kg once daily for 3 days to treat whipworm infections, as this combination has been shown to improve cure rates, especially in heavy infections. This recommendation is based on the most recent and highest quality study available, which prioritizes morbidity, mortality, and quality of life as the outcome 1.

Key Points to Consider

• The prepatent period for whipworm infections is 60-70 days, and the mode of transmission is through the faeco-oral route 1.
• Clinical presentation can range from asymptomatic to significant morbidity in children, including anemia, dysentery, rectal prolapse, and impaired growth and cognitive development 1.
• Investigations should include concentrated stool microscopy or faecal PCR to diagnose whipworm infections 1.
• Treatment with mebendazole alone may result in low cure rates, especially in heavy infections, making the combination with ivermectin a more effective approach 1.

Important Considerations for Treatment

• The combination of mebendazole and ivermectin is recommended for the treatment of whipworm infections, with mebendazole given at 100 mg twice daily and ivermectin at 200 μg/kg once daily for 3 days 1.
• It is essential to consider the potential for low cure rates with mebendazole alone and the importance of combination therapy in achieving better outcomes 1.
• Good hygiene practices, including thorough handwashing, keeping fingernails short, changing bedding regularly, and washing clothes and towels in hot water, are crucial in preventing the spread of infection and ensuring maximum effectiveness of treatment.

Side Effects and Special Considerations

• Common side effects of mebendazole may include mild abdominal pain, diarrhea, or nausea.
• Vermox should not be used in children under 2 years without medical supervision, and pregnant women should consult healthcare providers before use as safety during pregnancy has not been fully established.

From the FDA Drug Label

Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed infections. Efficacy rates derived from various studies are shown in the table below: Pinworm (enterobiasis)Whipworm (trichuriasis)Common Roundworm (ascariasis)Hookworm Cure rates mean95%68%98%96% Egg reduction mean—93%99%99%

Vermox (mebendazole) is used to treat:

• Pinworm (enterobiasis)
• Whipworm (trichuriasis)
• Common Roundworm (ascariasis)
• Hookworm Cure rates for these infections are:
• Pinworm: 95%
• Whipworm: 68%
• Common Roundworm: 98%
• Hookworm: 96% 2

From the Research

Overview of Vermox

• Vermox, also known as mebendazole, is a benzimidazole carbamate compound used to treat parasitic infections 3.
• It is commonly used to treat soil-transmitted helminthiasis (STH) and enterobiasis, but its spectrum of activity is broader and includes some protozoa, nematodes, and cestodes 3.

Efficacy of Vermox

• Mebendazole has been shown to be effective against Ascaris, Trichuris, and hookworm infections, with cure rates ranging from 15% to 95% depending on the parasite and dosage 4, 5.
• A randomized controlled trial comparing mebendazole and albendazole found that both drugs were highly effective against Ascaris, with cure rates of over 97% 5.
• Mebendazole was also found to be effective against Trichuris, but with lower cure rates, and was inferior to albendazole in curing hookworm infections 5.

Comparison with Other Drugs

• Mebendazole has been compared to other anthelminthic drugs, including albendazole, levamisole, and pyrantel pamoate, and has been found to have varying levels of efficacy against different parasites 4, 5.
• Albendazole was found to be more efficacious than mebendazole against hookworm infections, while mebendazole was more effective against Trichuris 5.

Safety and Side Effects

• Mebendazole is generally considered safe, with few side effects reported 6, 5.
• However, high doses or prolonged use of mebendazole can lead to liver toxicity and other side reactions 6.
• Mebendazole has also been found to be well-tolerated in patients with HIV infection and pulmonary tuberculosis, and can be used in combination with other drugs to treat concurrent parasitic infections 7.