Albendazole Dosing for Deworming in Children
Standard Deworming Dose
For children over 24 months of age, the recommended dose is albendazole 400 mg as a single oral dose for common intestinal worms (roundworm, hookworm, pinworm). 1, 2, 3
Age-Specific Dosing Guidelines
Children Over 24 Months
- Single dose: 400 mg for most common parasitic infections including:
- This dose can be given as a crushed tablet mixed with water if needed 4
- Should be taken with food to enhance absorption 4
Children 12-24 Months
- Consultation with a specialist is required before treatment due to limited safety and efficacy data in this age group 2, 3
Children Under 12 Months
- Albendazole is generally not recommended for routine deworming in infants under 12 months 2
Weight-Based Dosing for Specific Conditions
For certain serious parasitic infections requiring prolonged treatment (neurocysticercosis, hydatid disease):
- Children weighing ≥60 kg: 400 mg twice daily with meals 4
- Children weighing <60 kg: 15 mg/kg/day divided into two doses with meals (maximum 800 mg total daily dose) 4
Extended Treatment Regimens
Some parasites require multiple days of treatment:
- Hookworm (complete treatment): 400 mg daily for 3 days 1
- Strongyloidiasis: 400 mg twice daily for 3-7 days (though ivermectin is preferred) 1
- Trichuriasis (whipworm): Consider mebendazole as first-line, as albendazole monotherapy has low cure rates (27-60%) 2
- Visceral larva migrans (Toxocara): 400 mg twice daily for 5 days 2
Important Administration Guidelines
- Always administer with food to maximize drug absorption 4
- Tablets may be crushed or chewed and swallowed with water 4
- For treatment courses exceeding 14 days, monitor for hepatotoxicity and leukopenia 2
- Consider retreatment after 2-8 weeks for helminthic infections where residual worms may develop into adults 2
Critical Safety Considerations
Before administering albendazole:
- Obtain pregnancy test in females of reproductive potential 4
- Exclude Loa loa infection in children who have traveled to endemic regions before combining with ivermectin 1
- For neurocysticercosis, always provide concomitant steroids and anticonvulsants to prevent neurological complications 4
Common Pitfalls to Avoid
- Do not use for T. solium (pork tapeworm) intestinal infection unless neurocysticercosis has been excluded; niclosamide is preferred 1
- Single-dose albendazole has limited efficacy against Trichuris (whipworm), with cure rates of only 27-60% 2
- For Hymenolepis nana (dwarf tapeworm), praziquantel 25 mg/kg single dose is more effective than albendazole 5, 3
- Monitor blood counts and liver enzymes at the beginning of each treatment cycle and every 2 weeks during prolonged therapy 4
Real-World Effectiveness Note
While the WHO recommends biannual single-dose albendazole for mass deworming programs 6, recent evidence suggests that in some populations, single-dose treatment may not adequately clear Ascaris infections, with reinfection rates returning to baseline by 12-16 weeks 7. However, the standard 400 mg single dose remains the recommended approach for individual treatment and mass deworming campaigns 1, 2, 3.