What is the recommended dosage and frequency of Mebendazole (Antiparasitic medication) for treating Ascaris (Roundworm) infections?

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Mebendazole Dosing for Ascaris Infection

For ascariasis (Ascaris lumbricoides), administer mebendazole 500 mg orally as a single dose. 1, 2

Primary Dosing Recommendation

The most recent UK guidelines (2025) from the Journal of Infection recommend mebendazole 500 mg as a single oral dose for treating ascariasis. 1 This single-dose regimen is equally effective as the traditional multi-day regimen and offers superior adherence. 2

Alternative FDA-Approved Regimen

The FDA-labeled dosing provides an alternative: 100 mg (1 tablet) twice daily for 3 consecutive days. 3 This regimen applies to both adults and children, with tablets that may be chewed, swallowed, or crushed and mixed with food. 3

Clinical Efficacy Data

Both regimens demonstrate excellent efficacy:

  • Single 500 mg dose: Recommended by current international guidelines as first-line therapy 1
  • 100 mg twice daily for 3 days: Shows >99% egg reduction rates and 86.8-100% cure rates in clinical studies 4, 5, 6, 7

Research confirms that even lower single doses (75 mg) are highly effective against Ascaris, though the 500 mg single dose represents the current guideline standard. 8

Important Clinical Considerations

  • No special preparation required: Fasting or purging is unnecessary before or after treatment 3
  • Retreatment protocol: If the patient is not cured three weeks after treatment, administer a second course 3
  • Safety profile: Mebendazole is well-tolerated with minimal side effects; mild diarrhea occurs in approximately 22% of children 6
  • Alternative option: Albendazole 400 mg single dose or ivermectin 200 μg/kg single dose are equally effective alternatives 1

Practical Algorithm

  1. First-line: Administer mebendazole 500 mg PO as a single dose 1, 2
  2. If 500 mg tablets unavailable: Use 100 mg tablets twice daily for 3 consecutive days 3
  3. Follow-up: Assess cure at 3 weeks post-treatment 3
  4. If treatment failure: Repeat the same regimen 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Mebendazole Treatment for Parasitic Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Mebendazole in the treatment of helminthiasis.

Canadian Medical Association journal, 1976

Research

Treatment of soil-transmitted nematode infections in children with mebendazole.

Annals of tropical medicine and parasitology, 1978

Research

Efficacy and safety of mebendazole in children with worm infestation.

JPMA. The Journal of the Pakistan Medical Association, 1997

Research

Minimum effective doses of mebendazole in treatment of soil-transmitted helminths.

The Southeast Asian journal of tropical medicine and public health, 1997

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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