What is the recommended dose of Albendazole (albendazole) for treating parasitic infections?

Recommended Dosing 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 require different dosing regimens based on the type of infection and patient factors. 1

Standard Adult Dosing by Infection Type

Single Dose Regimens (400 mg)

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

Multiple Day Regimens

• Neurocysticercosis:

  • Adults ≥60 kg: 400 mg twice daily with meals for 8-30 days 3
  • Adults <60 kg: 15 mg/kg/day in divided doses twice daily with meals (maximum 800 mg/day) 3

• Hydatid disease:

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

• Strongyloidiasis: 400 mg twice daily for 3-7 days (though ivermectin is preferred first-line) 1, 4

• Loiasis: 400 mg daily for 10-28 days, especially for high microfilarial loads or when diethylcarbamazine is not feasible 5, 1

  • Higher doses of 800 mg daily may be used in case of treatment failure 5, 1

• Visceral larva migrans (Toxocariasis): 400 mg twice daily for 5 days 5, 4

Special Situations

Empirical Treatment

• For empirical treatment of asymptomatic eosinophilia in travelers/migrants: single dose of albendazole 400 mg plus ivermectin 200 μg/kg 1, 4

Administration Guidelines

• Albendazole should be taken with food to increase absorption 3
• Tablets may be crushed or chewed and swallowed with water 3

Monitoring Recommendations

• Monitor blood counts at the beginning of each 28-day cycle of therapy and every 2 weeks during treatment 3
• Monitor liver enzymes (transaminases) at the beginning of each 28-day cycle and at least every 2 weeks during treatment 3
• Obtain a pregnancy test in females of reproductive potential prior to therapy 3

Important Precautions

• For neurocysticercosis, concomitant steroid and anticonvulsant therapy should be given to prevent neurological symptoms 5, 3
• Use caution with steroids in cases where strongyloidiasis is suspected, as they may precipitate hyperinfection syndrome 4
• Always exclude Loa loa in people who have traveled to endemic regions before treating with ivermectin 1, 4

Common Pitfalls to Avoid

• Failure to adjust dosing based on patient weight (especially for those <60 kg) 3
• Not taking medication with food, which can reduce absorption 3
• Inadequate duration of treatment for certain parasites like neurocysticercosis or hydatid disease 3
• Not monitoring for bone marrow suppression, which can occur especially in patients with liver disease 3