What is the recommended dose of albendazole (anti-parasitic medication) for pediatric patients?

Albendazole Dosing in Pediatric Patients

For children over 24 months of age, the standard dose is 400 mg as a single dose for most common parasitic infections including hookworm, pinworm, and ascariasis. 1, 2, 3

Standard Dosing by Age Group

Children Over 24 Months

• Single-dose therapy: 400 mg as a single dose for hookworm, ascariasis, enterobiasis (pinworm), and trichinellosis 1, 2, 3
• Extended therapy: 400 mg daily for 3-21 days depending on the specific parasite 3
• Albendazole should be taken with food to improve absorption 4

Children Under 24 Months (12-24 months)

• Expert consultation is required before administering albendazole for asymptomatic eosinophilia in this age group due to limited safety and efficacy data 2, 3
• For children 8-24 months with documented helminth infections, a dose of 200 mg as a single dose has been studied and shown to be effective and safe 5

Weight-Based Dosing for Specific Conditions

For neurocysticercosis and hydatid disease in children weighing less than 60 kg:

• 15 mg/kg/day divided into two doses (maximum 800 mg total daily dose) 4
• Duration: 8-30 days for neurocysticercosis; 28-day cycles for hydatid disease 4

Infection-Specific Dosing

Common Intestinal Helminths

• Hookworm: 400 mg single dose 1
• Pinworm (Enterobius): 400 mg single dose 1
• Ascariasis (roundworm): 400 mg single dose 1

Complex Parasitic Infections

• Trichinellosis (mild): 400 mg once daily for 3 days 1
• Visceral larva migrans (Toxocara): 400 mg twice daily for 5 days 3
• Ocular toxocariasis: 400 mg twice daily for 3-14 days depending on severity 3
• Capillariasis: 400 mg twice daily for 21 days with monitoring 3
• Giardiasis: 400 mg once daily for 5 days (95% cure rate) 6

Immunocompromised Patients

• Microsporidiosis: 7.5 mg/kg twice daily until immune reconstitution 2, 7

Administration Guidelines

• Tablets may be crushed or chewed and swallowed with water 4
• Always administer with food to enhance absorption 4
• Fatty meals further improve absorption for extended treatment courses 7

Monitoring Requirements

For treatment courses longer than 14 days, the following monitoring is essential:

• Liver enzymes (transaminases) at baseline and every 2 weeks 7, 3, 4
• Complete blood counts at baseline and every 2 weeks to monitor for leukopenia 7, 4
• Liver function tests specifically for capillariasis treatment 3

Retreatment Considerations

• Repeat dosing after 2-8 weeks may be necessary for certain helminth infections to treat residual worms that have matured into adults 2, 3
• For Loeffler syndrome without identified organism, retreatment 1 month after resolution of pulmonary symptoms is recommended 3

Special Clinical Situations

Neurocysticercosis

• Concomitant corticosteroids (oral or intravenous) should be administered to prevent cerebral hypertensive episodes during the first week of treatment 4
• Anticonvulsant therapy should be provided as required 4

Pregnancy Testing

• Obtain pregnancy test in females of reproductive potential prior to initiating therapy 4

Common Pitfalls to Avoid

• Do not underdose based on age alone - children over 24 months require the full 400 mg dose, not weight-based reductions for common infections 1, 2
• Do not skip monitoring for extended courses - hepatotoxicity and bone marrow suppression can occur 7, 4
• Do not administer without food - bioavailability is significantly reduced on an empty stomach 4
• Do not assume single-dose efficacy for all parasites - some infections require multi-day regimens 3