Mebendazole Dosing Recommendations
The recommended dosing regimen for mebendazole varies by parasite type, with the standard treatment for whipworm (Trichuris trichiura) being 100 mg twice daily for 3 days, often combined with ivermectin for better efficacy. 1, 2
Dosing by Parasite Type
- Whipworm (Trichuris trichiura): Mebendazole 100 mg twice daily for 3 days, often combined with ivermectin 200 μg/kg once daily for 3 days to improve cure rates 1
- Ascariasis (Ascaris lumbricoides): Either 100 mg twice daily for 3 days or a single 500 mg dose 2
- Pinworm (Enterobius vermicularis): Single 100 mg dose 3
- Hookworm infections: 100 mg twice daily for 3 days, though multiple-dose regimens show significantly higher cure rates (98%) compared to single-dose treatments (13%) 4
- Trichinellosis (Trichinella sp.): 100 mg twice daily for 3 days for mild disease 3
Efficacy Considerations
- For severe symptomatic trichuriasis, the standard 100 mg twice daily for 3 days regimen may require repeated courses to achieve complete parasite eradication 5
- Low cure rates are seen in heavy whipworm infections; combination treatment with ivermectin improves cure rates 1
- For hookworm infections, the multiple-dose regimen (100 mg twice daily for 3 days) is significantly more effective than single-dose treatment 4
- Four-day regimens (100 mg twice daily) have shown higher cure rates (89.3%) for trichuriasis compared to three-day regimens (65.6%) 6
Alternative Treatments
- Albendazole is an alternative for many parasitic infections:
Special Populations
- Children: For a 14 kg child, the recommended dose of mebendazole is 100 mg twice daily for 3 days 2
- Severe infections: May require repeated courses of treatment or extended dosing schedules 5
Administration Guidelines
- Complete the full course of mebendazole treatment even if symptoms improve before completion 2
- Consider measures to control diarrhea before administering mebendazole in patients with severe symptomatic infections 5
- Re-treatment may be necessary in areas with high reinfection rates 2
Safety Profile
- Mebendazole is generally well-tolerated with minimal side effects 5, 8
- Common mild adverse events include abdominal pain, headache, and diarrhea 4
The most recent evidence strongly supports using the multiple-dose regimen of mebendazole (100 mg twice daily for 3 days) for most helminth infections to achieve optimal cure rates and reduce egg counts effectively.