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Flubendazole

Flubendazole is a broad-spectrum anthelmintic medication belonging to the benzimidazole class, similar to albendazole and mebendazole. It is used to treat a variety of parasitic worm infections, particularly intestinal helminths. Flubendazole is less commonly used than other benzimidazoles but remains an important option in certain clinical and veterinary settings. This article provides a detailed overview of flubendazole, referencing authoritative sources such as the British National Formulary (BNF)Lippincott Textbook of Pharmacology, and Lange Basic & Clinical Pharmacology. We will explore its mechanism of action, uses, dosage, side effects, precautions, drug interactions, and generic names in pharmacy.

Flubendazole exerts its antiparasitic effects through the following mechanisms:

  1. Microtubule Inhibition:
    • Binds to beta-tubulin in parasitic cells, inhibiting microtubule polymerization (Lippincott).
    • Disrupts glucose uptake and intracellular transport, leading to energy depletion and parasite death (Lange).
  2. Selective Toxicity:
    • Higher affinity for parasite tubulin than human tubulin, minimizing host toxicity (BNF).
  3. Broad-Spectrum Activity:
    • Effective against a wide range of intestinal helminths, including roundworms, whipworms, and pinworms.

Flubendazole is indicated for:

  1. Intestinal Helminth Infections:
    • Roundworms (Ascaris lumbricoides)Whipworms (Trichuris trichiura), and Pinworms (Enterobius vermicularis): Single-dose or short-course treatment (BNF).
  2. Off-Label Uses:
    • Investigated for giardiasis and filariasis, though not widely adopted (Lippincott).
    • Used in veterinary medicine for parasitic infections in animals (Lange).

Dosage varies by infection type and patient age. Always follow prescribing guidelines:

Adults and Children Over 2 Years:

  • Intestinal Helminths: 100 mg twice daily for 3 days (BNF).
  • Pinworms: 100 mg single dose, repeated after 2–3 weeks if reinfection occurs.

Administration Tips:

  • Take with food to enhance absorption and reduce gastrointestinal side effects.
  • Tablets may be crushed or chewed for children or patients with difficulty swallowing.

Flubendazole is generally well-tolerated, but potential side effects include:

Common:

  • Gastrointestinal: Abdominal pain, nausea, diarrhea.
  • Dizziness or headache.

Rare but Serious:

  • Hepatotoxicity: Elevated liver enzymes (Lippincott).
  • Hematologic Effects: Leukopenia, agranulocytosis (BNF).
  • Hypersensitivity Reactions: Rash, angioedema.

Before using flubendazole, consider:

  • Pregnancy: Avoid in the first trimester; use only if benefits outweigh risks (BNF Category: C).
  • Breastfeeding: Limited data; use with caution.
  • Hepatic Impairment: Monitor liver function tests during prolonged therapy.
  • Hygiene Measures: Wash bedding and clothing to prevent reinfection, especially in pinworm cases (Lange).

Flubendazole interacts with:

  1. CYP450 Inhibitors (e.g., cimetidine):
    • Increase flubendazole levels, enhancing efficacy and toxicity risk (BNF).
  2. CYP450 Inducers (e.g., carbamazepine, phenytoin):
    • Reduce flubendazole levels, decreasing effectiveness (Lippincott).
  3. Metronidazole:
    • Avoid concurrent use due to rare reports of Stevens-Johnson syndrome (Lange).

Generic Names in Pharmacy

  • Flubendazole (active ingredient)
  • Common brand names: Flumoxal®, Fluvermal®

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