What is the dosage and treatment regimen for Abendazole (albendazole) in treating parasitic worm infections?

Albendazole Dosage and Treatment Regimens for Parasitic Worm Infections

The recommended dosage of albendazole for most intestinal parasitic worm infections is 400 mg as a single oral dose, though specific regimens vary by parasite type, with some infections requiring multiple doses or longer treatment durations. 1

Standard Dosing by Parasite Type

Common Intestinal Nematodes

• Ascaris lumbricoides (roundworm): 400 mg single oral dose 1, 2
• Hookworm (Ancylostoma/Necator): 400 mg single oral dose, though 3-day course may be more effective in areas with potential resistance 1
• Enterobius vermicularis (pinworm): 400 mg single oral dose, with a repeat dose after 2 weeks to prevent reinfection 1, 3
• Trichuris trichiura (whipworm): Mebendazole 100 mg twice daily for 3 days in combination with ivermectin 200 μg/kg daily for 3 days is recommended due to lower cure rates with single-dose albendazole 1

Tapeworms

• Taenia saginata/T. solium: Niclosamide 2 g as single dose preferred for T. solium; praziquantel 10 mg/kg as single dose for T. saginata 1
• Hymenolepis nana: Praziquantel 25 mg/kg as single dose 1

Other Parasitic Infections

• Strongyloides stercoralis: Ivermectin 200 μg/kg as single dose is preferred; if unavailable, albendazole 400 mg daily for 3 days 1
• Trichinella species: Albendazole 400 mg once daily for 3 days in mild disease; longer courses needed for severe disease 1

Special Considerations

Hydatid Disease (Echinococcosis)

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

Neurocysticercosis

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

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 children or those unable to swallow tablets, a suspension formulation is available 5

Monitoring Recommendations

• For short-course therapy (1-3 days), routine monitoring is generally not required 1
• For prolonged therapy (>14 days):
  • Monitor blood counts at beginning of each 28-day cycle and every 2 weeks during therapy 4
  • Monitor liver enzymes at beginning of each 28-day cycle and at least every 2 weeks during treatment 4
  • Obtain pregnancy test in females of reproductive potential prior to therapy 4

Efficacy Considerations

• Single-dose albendazole shows high cure rates for Ascaris (>90%) and hookworm (>80%) 5, 6
• Efficacy may be reduced in areas with long-term anthelmintic exposure, suggesting potential resistance 6
• Comparative studies show albendazole generally produces better cure rates and egg reduction rates than mebendazole for most geohelminths 7, 8

Common Pitfalls to Avoid

• Failure to repeat dose after 2 weeks for pinworm infections, which is necessary to eliminate newly hatched worms 3
• Not considering potential drug resistance in areas with long-term anthelmintic exposure 6
• Using albendazole for T. solium tapeworm without first excluding neurocysticercosis 1
• Inadequate dosing duration for tissue-invasive parasites like hydatid disease or neurocysticercosis 4