Mebendazole Treatment for Parasitic Infections
Recommended Dosing by Infection Type
For pinworm (enterobiasis), give mebendazole 100 mg as a single oral dose, repeated after 2 weeks. 1 This regimen applies equally to both adults and children. 2, 3
For other helminth infections, the dosing varies:
Whipworm (Trichuriasis)
- 100 mg twice daily (morning and evening) for 3 consecutive days 1
- This achieves cure rates of 86-95% depending on treatment duration 4, 5
- Alternative single-dose 500 mg mebendazole shows 27.6% cure rate but 72.9% egg reduction 6
Roundworm (Ascariasis)
- 100 mg twice daily (morning and evening) for 3 consecutive days 1
- Alternative single-dose 500 mg achieves 92.6% cure rate 6
- The 3-day regimen shows 86.8% cure rate with >99% egg reduction 4
Hookworm Infection
- 100 mg twice daily (morning and evening) for 3 consecutive days 1
- The conventional 600 mg total dose (100 mg twice daily × 3 days) achieves 91.4% cure rate with 99.5% egg reduction 7
- Single 300 mg dose shows only 16.1% cure rate, making it inadequate 7
Important Clinical Considerations
Administration
- The tablet may be chewed, swallowed whole, or crushed and mixed with food 1
- No special procedures such as fasting or purging are required 1
Treatment Failure Management
- If the patient is not cured 3 weeks after treatment, administer a second course 1
- Treatment failure is rare and usually indicates reinfection rather than drug resistance 2
Monitoring Requirements
- Monitor for hepatotoxicity and leukopenia if treatment extends beyond 14 days 8, 2
- This is particularly relevant for infections requiring prolonged therapy beyond standard regimens 8
Alternative First-Line Agent
Albendazole is generally preferred over mebendazole for most helminth infections because it offers simpler dosing:
- Albendazole 400 mg single dose (repeated in 2 weeks for pinworm) is effective for roundworm, hookworm, and pinworm 8, 2
- For trichinellosis, albendazole is first-line with mebendazole as the alternative 9, 3
Common Pitfalls to Avoid
- Do not use single-dose mebendazole for hookworm - the 3-day regimen is essential for adequate cure rates 7
- Do not skip the repeat dose for pinworm - the second dose at 2 weeks is necessary to eradicate newly hatched worms 2, 1
- Do not assume treatment failure without waiting 3 weeks - adequate time must elapse before reassessing cure 1