Albendazole Should Be Taken With Food, Not Specifically at Night
Albendazole must be administered with a fatty meal to maximize absorption, but there is no requirement or benefit to restricting administration to nighttime. The timing of administration should be determined by when the patient can reliably consume a high-fat meal, not by the time of day. 1, 2, 3
Why Food Matters More Than Time of Day
The critical factor for albendazole efficacy is co-administration with dietary fat, not the circadian timing of the dose. The evidence demonstrates:
High-fat meals increase albendazole bioavailability by 4.5-fold compared to fasting administration, with area under the curve (AUC) and maximum concentration (Cmax) doubling when taken with high-fat versus low-fat breakfast. 4, 5
For tissue parasites (neurocysticercosis, hydatid disease), taking albendazole with fatty meals is essential because systemic absorption determines therapeutic success; inadequate fat intake leads to subtherapeutic drug levels and treatment failure. 1, 3
For intestinal helminths, fatty meal administration remains recommended even though intraluminal effects are the primary mechanism, because consistent absorption improves overall efficacy. 1, 2
Practical Dosing Schedule
Albendazole should be divided into twice-daily doses when treating tissue parasites, with each dose taken with a meal:
For neurocysticercosis: 15 mg/kg/day divided into two doses (maximum 1200 mg/day) taken with breakfast and dinner for 10–14 days. 2, 3
For hydatid disease: 400 mg twice daily with meals for 28-day cycles. 1
For intestinal helminths: Single 400 mg dose or 400 mg daily for 3 days, each dose taken with any fatty meal. 1, 2
The twice-daily schedule is supported by pharmacokinetic data showing albendazole sulfoxide has a half-life of 10–15 hours, making twice-daily administration more rational than three-times-daily dosing. 6
What Constitutes an Adequate Fatty Meal
A high-fat meal should contain sufficient fat to trigger bile release and enhance drug solubilization—research protocols used breakfasts with substantial fat content to demonstrate maximal absorption. 4, 5
Avoid liquid paraffin (mineral oil) during albendazole therapy because it significantly impairs absorption by coating the gastrointestinal tract and interfering with fat-soluble drug uptake. 3
Common Pitfall: Nighttime Dosing Misconception
There is no evidence that nighttime administration improves albendazole efficacy or reduces side effects. The misconception may arise from:
- Confusion with other antiparasitic drugs that have circadian-dependent activity
- Misinterpretation of twice-daily dosing (morning and evening) as requiring nighttime-only administration
- Anecdotal practices not supported by pharmacokinetic or clinical data
The only timing consideration is ensuring each dose coincides with a fatty meal, which for most patients means breakfast and dinner rather than a single nighttime dose. 1, 2, 3