Mebendazole Dosage for Parasitic Infections
For most common intestinal nematode infections, mebendazole should be dosed at 100 mg twice daily for 3 days in adults, or 500 mg as a single dose for ascariasis. 1
Standard Dosing by Infection Type
Ascariasis (Roundworm)
- Single dose: 500 mg orally once 1
- Alternative: 100 mg twice daily for 3 days 2
- Cure rates of 86.8% achieved with standard regimens 2
Hookworm (Ancylostoma/Necator)
- 600 mg total dose (100 mg twice daily for 3 days) 3
- This regimen achieves 91.4% cure rate with 99.5% egg reduction 3
- Single 300 mg dose is inadequate (only 16.1% cure rate) and should be avoided 3
- Important caveat: Albendazole 400 mg single dose with repeat in 2 weeks is now preferred over mebendazole for hookworm 4
Trichuriasis (Whipworm)
- 100 mg twice daily for 3 days 5, 2
- For severe symptomatic infections, repeat courses may be necessary 5
- Single-dose regimens (even up to 600 mg) show lower cure rates in heavy infections, likely due to diarrhea reducing drug absorption 6
- Alternative single dose: 600 mg once can be considered for public health programs, though cure rates are lower in heavy infections 6
Taeniasis (Tapeworm - T. solium/T. saginata)
- 300 mg twice daily for 3 days 7
- Patients typically eliminate proglottids within 48 hours 7
- Critical warning: For T. solium specifically, praziquantel 10 mg/kg single dose is preferred, but exclude neurocysticercosis first 1
Pediatric Dosing
- Children: 50 mg twice daily for 3 days for nematode infections 2
- Equally effective in light and heavy infections 2
Key Clinical Considerations
When Mebendazole Is NOT First-Line
- Hookworm: Albendazole is now preferred (400 mg single dose, repeat in 2 weeks) 4
- Strongyloidiasis: Ivermectin 200 μg/kg is strongly preferred; mebendazole is not recommended 8
- Tapeworm (T. solium): Use praziquantel instead unless neurocysticercosis excluded 1
Common Pitfalls
- Inadequate dosing for hookworm: Single 300 mg dose fails in >80% of cases; always use the full 3-day regimen 3
- Severe trichuriasis with diarrhea: Control diarrhea before treatment, as it reduces drug absorption and cure rates 5
- Heavy whipworm infections: May require repeat courses despite standard dosing 5