Za Pharmacy
Drugs, Supplies and Delivery
Mebendazole
Mebendazole is a broad-spectrum anthelmintic medication used to treat parasitic worm infections. It is a cornerstone therapy for intestinal helminthiasis, including infections caused by roundworms, pinworms, hookworms, and whipworms. This article provides a detailed overview of mebendazole, 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.
Mebendazole 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).
Mebendazole is indicated for:
- Intestinal Helminth Infections:
- Pinworms (Enterobius vermicularis): Single-dose treatment.
- Roundworms (Ascaris lumbricoides), Hookworms (Ancylostoma duodenale, Necator americanus), and Whipworms (Trichuris trichiura): 3-day course (BNF).
- Off-Label Uses:
- Hydatid disease (caused by Echinococcus granulosus) and capillariasis, though albendazole is often preferred (Lippincott).
Dosage varies by infection type and patient age. Always follow prescribing guidelines:
Adults and Children Over 2 Years:
- Pinworms: 100 mg single dose, repeated after 2 weeks if reinfection occurs.
- Roundworms, Hookworms, Whipworms: 100 mg twice daily for 3 days (BNF).
Administration Tips:
- Tablets may be chewed, swallowed whole, or crushed with food.
- Fatty meals enhance absorption (Lange).
Mebendazole is generally well-tolerated, but potential side effects include:
Common:
- Gastrointestinal: Abdominal pain, diarrhea, nausea.
- Dizziness or headache.
Rare but Serious:
- Hepatotoxicity: Elevated liver enzymes (Lippincott).
- Hematologic Effects: Neutropenia, agranulocytosis (BNF).
- Hypersensitivity Reactions: Rash, angioedema.
Before using mebendazole, consider:
- Pregnancy: Avoid in the first trimester; use only if benefits outweigh risks (BNF Category: C).
- Breastfeeding: Low systemic absorption minimizes risk; generally considered safe.
- Hepatic Impairment: Monitor for toxicity due to altered metabolism.
- Hygiene Measures: Wash bedding and clothing to prevent reinfection, especially in pinworm cases (Lange).
Mebendazole interacts with:
- CYP450 Inhibitors (e.g., cimetidine):
- Increase mebendazole levels, enhancing efficacy and toxicity risk (BNF).
- CYP450 Inducers (e.g., carbamazepine, phenytoin):
- Reduce mebendazole levels, decreasing effectiveness (Lippincott).
- Metronidazole:
- Avoid concurrent use due to rare reports of Stevens-Johnson syndrome (Lange).
Generic Names in Pharmacy
- Mebendazole (active ingredient)
- Common brand names: Vermox®, Ovex®, Emverm®
