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®