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Drugs, Supplies and Delivery
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:
- 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).
- Selective Toxicity:
- Higher affinity for parasite tubulin than human tubulin, minimizing host toxicity (BNF).
- Broad-Spectrum Activity:
- Effective against a wide range of intestinal helminths, including roundworms, whipworms, and pinworms.
Flubendazole is indicated for:
- Intestinal Helminth Infections:
- Roundworms (Ascaris lumbricoides), Whipworms (Trichuris trichiura), and Pinworms (Enterobius vermicularis): Single-dose or short-course treatment (BNF).
- 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:
- CYP450 Inhibitors (e.g., cimetidine):
- Increase flubendazole levels, enhancing efficacy and toxicity risk (BNF).
- CYP450 Inducers (e.g., carbamazepine, phenytoin):
- Reduce flubendazole levels, decreasing effectiveness (Lippincott).
- 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®
