From the Guidelines
Albendazole is contraindicated in patients with known hypersensitivity to the drug or other benzimidazole compounds, as well as in those with untreated hydrocephalus, and its use should be cautious in patients with liver disease, bone marrow suppression, or existing cytopenias, due to potential hepatotoxicity and reversible neutropenia 1.
Key Considerations
- Albendazole can cause hepatotoxicity, and liver enzymes should be monitored during treatment, especially in patients with pre-existing liver disease 1.
- The drug can also cause reversible neutropenia, and complete blood counts should be monitored, particularly in patients with bone marrow suppression or existing cytopenias 1.
- Patients taking cimetidine, praziquantel, or dexamethasone should be cautious, as these medications may increase albendazole plasma concentrations 1.
- Untreated hydrocephalus is a contraindication to antiparasitic therapy, and CSF diversion should be performed before starting albendazole treatment in patients with hydrocephalus 1.
Monitoring and Precautions
- Regular monitoring of liver function tests and complete blood counts is recommended during prolonged treatment courses 1.
- Patients should be closely monitored for signs of hepatotoxicity, neutropenia, and other adverse effects, and the drug should be withheld if absolute neutropenia or elevation of transaminase >5 times the upper limits of normal occurs 1.
- Alternative approaches, such as praziquantel or no anthelminthics, should be considered in patients who experience adverse effects or contraindications to albendazole 1.
From the FDA Drug Label
Albendazole tablets are contraindicated in patients with known hypersensitivity to the benzimidazole class of compounds or any components of albendazole tablets. The main contraindication for albendazole is a known hypersensitivity to the benzimidazole class of compounds or any components of albendazole tablets 2, 2, 2.
- Hypersensitivity to albendazole or its components is the primary contraindication.
- This is a direct and explicit contraindication stated in the FDA drug label.
From the Research
Albendazole Contraindication
- Albendazole is contraindicated during the first trimester of pregnancy, as stated in the study published in 1997 3.
- However, a systematic review published in 2019 found that inadvertent exposure to albendazole in the first trimester is unlikely to carry an additional risk of adverse birth outcomes 4.
- The drug is generally safe with few side effects, but liver toxicity and other side reactions may occur when used for prolonged periods or in high doses 5.
- Albendazole can cause liver injury or liver failure, with symptoms including jaundice, anorexia, and vomiting, and high levels of transaminases, which can resolve after stopping the administration of the drug 6.
- Common side effects of albendazole include diarrhea, abdominal pain, elevated levels of hepatic transaminases, dizziness, neutropenia, and alopecia 6.