Albendazole Dosing for Intestinal Parasites
For intestinal parasites, albendazole should be administered as a single 400 mg oral dose for most common intestinal helminths including ascariasis (roundworm), hookworm, and pinworm infections. 1
Dosing Recommendations by Parasite Type
Standard Dosing
- Ascariasis (roundworm): 400 mg orally as a single dose 1
- Enterobiasis (pinworm): 400 mg orally as a single dose 1
- Hookworm infections: 400 mg orally as a single dose 1
- Trichuriasis (whipworm): 400 mg orally as a single dose, though efficacy is lower (48% cure rate) 1, 2
Extended Dosing
- Strongyloidiasis: 400 mg daily for 3 days 1, 3
- Taenia spp. (tapeworm): 400 mg daily for 3 days 2
- Hymenolepis nana (dwarf tapeworm): 400 mg daily for 3 days 2
Administration Guidelines
- Albendazole should be taken with food to enhance absorption 4
- Tablets may be crushed or chewed and swallowed with water if needed 4
- For empirical treatment of suspected parasitic infection without specific diagnosis, especially with eosinophilia: albendazole 400 mg as a single dose plus ivermectin 200 μg/kg as a single dose 1
Special Population Considerations
Weight-Based Dosing
- Adults and children ≥60 kg: 400 mg standard dose 1, 4
- Children <60 kg: 15 mg/kg/day (maximum 400 mg) 4
- Children ≥2 years: Same dose as adults (400 mg) 1
- Children 12-24 months: Consult with specialist before treatment 1
- Children <12 months: Not recommended for routine deworming 1
Pregnancy
- Pregnant women should avoid albendazole if possible 1
- Pyrantel pamoate is preferred for pinworm infections during pregnancy 1
- If treatment is necessary, defer until after first trimester unless benefits outweigh risks 1
- Pregnancy testing is recommended before initiating therapy 4
Monitoring and Safety Considerations
- For short-term treatment (single dose), routine monitoring is not typically required 1
- For treatment courses >14 days, monitor for:
Treatment Efficacy
- Ascariasis: 95% cure rate 2
- Hookworm: 78% overall cure rate (92% for A. duodenale, 75% for N. americanus) 2
- Enterobiasis (pinworm): 98% cure rate 2
- Trichuriasis: 48% cure rate (lower efficacy) 2
- Strongyloidiasis: 62% cure rate 2
- Taenia spp.: 85% cure rate 2
- Hymenolepis nana: 68% cure rate 2
Follow-Up
- Clinical follow-up in 2-4 weeks is recommended for most intestinal helminths 1
- For strongyloidiasis, at least three stool examinations over three months following treatment 1
- Consider repeat stool examination and alternative treatment for persistent symptoms or suspected treatment failure 1
Common Pitfalls to Avoid
- Inadequate diagnosis before treatment
- Incomplete household treatment (especially for pinworm)
- Insufficient hygiene measures to prevent reinfection
- Inappropriate drug selection for specific parasites
- Inadequate follow-up
- Failure to recognize emerging resistance 1