What is the recommended dose of albendazole (anti-parasitic medication) for treating parasitic infections?

Recommended Dose of Albendazole for Parasitic Infections

The standard dose of albendazole for most common parasitic infections in adults is 400 mg as a single oral dose, though specific parasites may require different dosing regimens based on the type of infection and patient factors. 1

Standard Dosing for Common Parasitic Infections

Single Dose Regimens

• Albendazole 400 mg as a single oral dose is recommended for:
  • Ascariasis (roundworm) 1, 2
  • Hookworm infections (initial treatment) 1, 2
  • Enterobiasis (pinworm) 1

Multiple Day Regimens

• Hookworm infections (complete treatment): Albendazole 400 mg daily for 3 days 1
• Strongyloidiasis (normal immunity): Ivermectin 200 μg/kg single dose is preferred, but albendazole 400 mg twice daily for 3-7 days can be used as an alternative 1, 3
• Strongyloidiasis (immunocompromised): More intensive regimens required; seek specialist advice 1
• Whipworm (Trichuris trichiura): Mebendazole is preferred, but albendazole can be used 1

Special Situations

Neurocysticercosis

• For patients ≥60 kg: 400 mg twice daily with meals for 8-30 days 4
• For patients <60 kg: 15 mg/kg/day in divided doses twice daily with meals (maximum 800 mg daily) 4
• Concurrent steroid therapy is recommended to prevent cerebral hypertensive episodes 4

Hydatid Disease

• For patients ≥60 kg: 400 mg twice daily with meals 4
• For patients <60 kg: 15 mg/kg/day in divided doses twice daily with meals (maximum 800 mg daily) 4
• Treatment consists of 28-day cycles followed by a 14-day albendazole-free interval, for a total of 3 cycles 4

Microsporidiosis

• For disseminated, non-ocular infection: 7.5 mg/kg body weight (maximum 400 mg/dose) twice daily until immune reconstitution 1

Loiasis

• Albendazole 400 mg daily for 10-28 days for high microfilarial loads or when diethylcarbamazine treatment is not feasible 1
• Higher doses of 800 mg daily may be used in case of treatment failure 1

Important Administration Guidelines

• Albendazole should be taken with food to increase absorption 4
• Tablets may be crushed or chewed and swallowed with water if needed 4
• For empirical treatment of asymptomatic eosinophilia in travelers/migrants, a single dose of albendazole 400 mg plus ivermectin 200 μg/kg is recommended 1

Monitoring and Safety

• Monitor blood counts at the beginning of each 28-day cycle and every 2 weeks during therapy 4
• Monitor liver enzymes at the beginning of each 28-day cycle and at least every 2 weeks during treatment 4
• Pregnancy testing is recommended for females of reproductive potential prior to therapy due to potential embryo-fetal toxicity 4
• Discontinue albendazole if clinically significant decreases in blood cell counts or elevations in liver enzymes occur 4

Pediatric Considerations

• For children with microsporidiosis: Albendazole 7.5 mg/kg body weight (maximum 400 mg/dose) twice daily 1
• For empirical treatment of asymptomatic eosinophilia in children >24 months: Single dose of albendazole 400 mg 1
• For children 12-24 months with eosinophilia: Consult with a specialist before treatment 1

Common Pitfalls to Avoid

• Always exclude Loa loa in people who have traveled to endemic regions BEFORE treating with ivermectin 1
• For T. solium (pork tapeworm) intestinal infection, niclosamide is preferred over praziquantel unless neurocysticercosis has been excluded 1
• For schistosomiasis, repeat treatment at 8 weeks as eggs and immature schistosomulae are relatively resistant to initial treatment 1
• Albendazole may interact with dexamethasone, praziquantel, cimetidine, and theophylline, potentially requiring dose adjustments 4