Albendazole (Albenza) for Acylostoma Infection

Albendazole (Albenza) -- FDA approved but considered investigational to treat hookworms; inhibits microtubule polymerization by binding to cytoplasmic b-tubulin; by affecting intestinal cells of parasite, prevents use of nutrients by parasite, essentially starving it to death.Dosage shown is selectively toxic to parasites because binding to parasite b-tubulin occurs at a much lower concentration than binding to mammalian protein.Because drug acts locally on worms within GI tract, action is not dictated by systemic drug concentration.In children, albendazole appears superior to mebendazole for curing hookworm infestations (cure rates of ~90% for Ancylostoma and 75% for Necator using albendazole)

Adult Dose
For classic hookworm disease and eosinophilic enteritis: 400 mg PO onceFor cutaneous larva migrans: 400 mg PO qd for 3 d

Pediatric Dose
<6>6 years: Administer as in adults

Contraindications
Documented hypersensitivity

Interactions
Coadministration with carbamazepine may decrease efficacy; dexamethasone, cimetidine, and praziquantel may increase toxicity

Pregnancy
C - Safety for use during pregnancy has not been established

Precautions
Information based on use to treat patients with hydatid disease and neurocysticercosis, for which the drug is used for prolonged periods (8-30 d for neurocysticercosis and 3 mo for hydatid disease); embryotoxic and teratogenic in pregnant rats and rabbits; no adequate studies in pregnant women, but no deleterious effects were recorded among 10 cases of women who were exposed accidentally to high doses of albendazole for systemic infection during first trimester and followed to term; excreted in animal milk; whether excreted in human milk unknownPatients with abnormal liver function tests (LFTs) should be carefully evaluated before commencing therapy because drug metabolized in liver and associated with hepatotoxicity; most common adverse effect is reversible increase in serum aminotransferases (16%); abdominal pain, diarrhea, nausea, dizziness, and headache occasionally occur (just above 1%); causes reversible reductions in total WBC count in <1% of patients