Albendazole Dosing in Children
For children over 24 months of age, the standard dose of albendazole is 400 mg as a single dose for most common parasitic infections, and this should be administered with food to enhance absorption. 1, 2, 3
Age-Specific Dosing Guidelines
Children Over 24 Months
- Single-dose regimen: 400 mg orally as a single dose for common helminth infections including hookworm, ascariasis, and enterobiasis 1, 2, 4
- Extended regimens: 400 mg daily for 3 days for strongyloidiasis and certain other parasitic infections 1, 2
- Prolonged therapy: 400 mg twice daily for 21 days for specific infections like capillariasis, with monitoring of liver function and complete blood count 1, 4
Children 12-24 Months
- Expert consultation is required before administering albendazole for empirical treatment of asymptomatic eosinophilia in this age group 1, 4
- Limited evidence exists for safety and efficacy in this younger age range 4
Infection-Specific Dosing
High Efficacy (Single Dose)
- Ascariasis: 400 mg single dose achieves 100% cure rate 5
- Hookworm: 400 mg single dose achieves approximately 98-100% cure rate 5
Moderate Efficacy (Extended Regimen Required)
- Trichuriasis (Whipworm): Requires mebendazole 100 mg twice daily plus ivermectin 200 μg/kg once daily for 3 days, as albendazole monotherapy has poor cure rates (27-60%) 4, 6, 7
- Giardiasis: 400 mg daily for 3 days achieves only 50% cure rate; tinidazole is more effective 8
Specialized Infections
- Visceral larva migrans (Toxocara): 400 mg twice daily for 5 days 4
- Neurocysticercosis: Extended courses with higher doses may be necessary 2
Critical Administration Guidelines
Food Requirement
- Always administer with food, preferably a fatty meal (approximately 40 grams of fat), as this increases plasma concentrations of the active metabolite (albendazole sulfoxide) up to 5-fold compared to fasted state 3
Monitoring Requirements
- For treatment courses exceeding 14 days: Monitor for hepatotoxicity and leukopenia 2, 4
- For 21-day regimens: Check liver function tests and complete blood count 1, 4
Repeat Dosing
- For certain helminth infections: Consider repeat dosing at 2-8 weeks to treat residual worms that have matured into adults 1, 4
- For enterobiasis (pinworm): Repeat dose after 2 weeks 1
Common Pitfalls to Avoid
- Do not use albendazole alone for Trichuris infections when high cure rates are needed; combination therapy with mebendazole and ivermectin is superior 1, 4, 7
- Do not administer without food, as bioavailability is significantly reduced in fasted state 3
- Do not use in children under 12 months without specialist consultation 1
- Screen for Loa loa in patients from endemic regions before combining with ivermectin to avoid serious adverse reactions 1
Pharmacokinetic Considerations
- The active metabolite (albendazole sulfoxide) has an elimination half-life of 8-12 hours 4, 3
- Albendazole is 70% protein-bound and widely distributed, including to CSF and cyst fluid 3
- The drug may induce its own metabolism with prolonged use, resulting in approximately 20% lower plasma concentrations after 4 weeks of treatment 3