Albendazole Dosing in Pediatric Patients
For most common parasitic infections in children over 24 months of age, administer a single dose of 400 mg albendazole; for children under 24 months (8-24 months), use 200 mg as a single dose. 1, 2, 3
Standard Dosing by Age and Weight
Children ≥24 Months or ≥60 kg
- Single-dose infections (hookworm, ascariasis, pinworm, whipworm): 400 mg as a single dose 4, 1
- Extended treatment (strongyloidiasis, trichinellosis): 400 mg once daily for 3 days 4, 1
- Severe infections (neurocysticercosis, hydatid disease): 15 mg/kg/day divided twice daily (maximum 800 mg/day total) for 8-30 days depending on indication 2
Children 8-24 Months
- 200 mg as a single dose for common helminth infections 3
- This lower dose achieves excellent cure rates: 100% for Ascaris and hookworm, 83% for Trichuris 3
- Expert consultation recommended for empirical treatment of asymptomatic eosinophilia in children 12-24 months 1
Children <60 kg (for severe infections)
- 15 mg/kg/day divided into two doses with meals (maximum total daily dose 800 mg) 2
- Duration: 28-day cycles for hydatid disease; 8-30 days for neurocysticercosis 2
Infection-Specific Dosing
Common Intestinal Helminths
- Hookworm, Ascaris, Pinworm: 400 mg single dose (>24 months) 4, 1
- Repeat dosing: Consider second dose after 2-8 weeks for certain helminth infections to treat residual worms that matured to adults 1
Strongyloidiasis
- 400 mg once daily for 3 days 4, 1
- Note: Ivermectin is more effective (83% cure rate vs 45% for albendazole) but albendazole remains an alternative 5
Giardiasis (Alternative Treatment)
- 400 mg once daily for 5 days achieves 95% cure rate 6
- Single doses of 600-800 mg show lower efficacy (62-75%) 6
Loiasis (High Microfilarial Loads)
- 400-800 mg daily for 10-28 days when diethylcarbamazine cannot be used 4
- 800 mg dosing recommended for treatment failures 4
Administration Guidelines
Critical administration points:
- Always administer with food to improve absorption 1, 7, 2
- Fatty meals specifically enhance absorption 7
- Tablets may be crushed or chewed and swallowed with water 2
Safety Monitoring
For Treatment Courses >14 Days
- Monitor hepatic transaminases at baseline and every 2 weeks during treatment 1, 7, 2
- Monitor complete blood counts at baseline and every 2 weeks for leukopenia 1, 7, 2
For Neurocysticercosis
- Administer corticosteroids (oral or IV) during first week to prevent cerebral hypertensive episodes 2
- Provide anticonvulsant therapy as required 2
Pregnancy Testing
- Obtain pregnancy test in females of reproductive potential before initiating therapy 2
Common Pitfalls to Avoid
- Do not underdose young children: The 200 mg dose for children 8-24 months is evidence-based and highly effective 3
- Do not forget food: Absorption is significantly reduced without concurrent food intake 1, 7, 2
- Do not skip monitoring: For extended courses, hepatotoxicity and bone marrow suppression can occur without proper surveillance 1, 7
- Do not use albendazole alone for strongyloidiasis when ivermectin is available—ivermectin shows superior efficacy 5