Side Effects of a 5-Day Course of Albendazole 450mg Daily
The most common side effects of a 5-day course of albendazole 450mg daily include gastrointestinal symptoms (nausea, vomiting, abdominal pain), headache, and mild elevations in liver enzymes, with serious adverse effects being rare during short-term treatment. 1, 2
Common Side Effects
- Gastrointestinal disturbances: Nausea, vomiting, and abdominal pain are among the most frequent side effects, occurring in 4-6% of patients 2
- Headache: Reported in approximately 1-11% of patients taking albendazole 2
- Dizziness: Occurs in about 1% of patients 2
Hepatic Effects
- Elevated liver enzymes: Mild to moderate elevations occur in approximately 16% of patients, though this is more common with longer treatment courses 2
- Transaminase elevations: These typically return to normal after discontinuation of therapy 2
- Severe hepatotoxicity: While rare with short-term therapy, cases of drug-induced liver injury have been reported, particularly with prolonged use 3, 4, 5
Hematologic Effects
- Leukopenia: Can occur in up to 10% of patients, though this is more common with treatment courses longer than 14 days 1, 2
- Bone marrow suppression: Rare with short courses but can include granulocytopenia, pancytopenia, or agranulocytopenia 2, 6
Neurological Effects
- Increased intracranial pressure: This is primarily a concern in patients with neurocysticercosis due to inflammatory reactions from parasite death 1, 2
- Seizures: May occur in patients with neurocysticercosis as a result of treatment 1
Dermatologic Effects
- Reversible alopecia: Reported in approximately 2% of patients, more common with prolonged treatment 2, 6
- Hypersensitivity reactions: Including rash and urticaria (less than 1%) 2
Important Considerations for Short-Term Use
- Short courses (5 days) for intestinal helminth infections generally have minimal side effects compared to longer treatment courses 1
- Monitoring of liver function is not routinely required for short-term therapy unless there is pre-existing liver disease 2
- Taking albendazole with fatty meals can improve absorption and potentially increase efficacy 7
Risk Factors for Increased Side Effects
- Pre-existing liver disease: Increases risk of hepatotoxicity 2
- History of bone marrow disorders: May increase risk of hematologic adverse effects 2
- Previous adverse reaction to benzimidazole compounds: Contraindication to albendazole use 2
When to Seek Medical Attention
- Development of jaundice, severe abdominal pain, or unusual fatigue may indicate liver injury 5
- Fever with signs of infection could indicate bone marrow suppression 6
- Severe skin reactions or signs of hypersensitivity require immediate medical attention 2
While most patients tolerate short-term albendazole therapy well, awareness of potential side effects is important for early recognition and management of adverse reactions.