Albendazole
A benzimidazole anthelmintic for gut roundworms and for tapeworm cysts in the brain (neurocysticercosis) and liver (hydatid disease).
Drug card
- How it works
- Binding worm β-tubulin so microtubules cannot form and glucose uptake fails
- Used for
- Neurocysticercosis (pork tapeworm larvae in the brain)
- Hydatid cysts (dog tapeworm) in liver, lung or peritoneum
- Roundworm, hookworm and whipworm (mass treatment)
- Lymphatic filariasis, with ivermectin or DEC
- Known for
- Raised liver enzymes, rarely acute liver failure
- Bone marrow suppression, aplastic anemia, agranulocytosis
- Its name
- -bendazole means a benzimidazole anthelmintic
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does albendazole work?
Albendazole binds β-tubulin at its colchicine-sensitive site and blocks microtubule assembly, cutting the parasite's glucose uptake. It is poorly absorbed and is converted to albendazole sulfoxide, the active metabolite, before reaching the circulation; a fatty meal raises sulfoxide levels up to about 5-fold. The sulfoxide reaches tissue cysts.
Like other benzimidazole anthelmintics: Benzimidazoles bind β-tubulin in worm cells, at its colchicine-sensitive site, and stop it polymerizing into microtubules. Without microtubules the worm's intestinal cells cannot take up glucose, glycogen stores run down, ATP runs short, and the worm is immobilized and dies. Mebendazole stays mostly in the gut; albendazole is poorly absorbed too, but its active sulfoxide metabolite reaches tissue cysts.
Uses
What is albendazole used for?
- Neurocysticercosis (pork tapeworm larvae in the brain)
- Hydatid cysts (dog tapeworm) in liver, lung or peritoneum
- Roundworm, hookworm and whipworm (mass treatment)
- Lymphatic filariasis, with ivermectin or DEC
Side effects
Side effects of albendazole
- Raised liver enzymes, rarely acute liver failureKnown forSerious
- Bone marrow suppression, aplastic anemia, agranulocytosisKnown forSerious
- Abdominal pain
- Nausea and vomiting
- Headache
- Dizziness and vertigo
- Reversible hair loss
- Seizures and raised brain pressure as cysts dieSerious
- Retinal damage when cysts lie in the retinaSerious
- Harm to the fetus (seen in animal studies)Serious
- Stevens-Johnson syndromeSerious
- Acute kidney injurySerious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Check blood counts and liver enzymes at the start of each 28-day cycle and every 2 weeks; stop if they change significantly.
- It may harm the fetus: rule out pregnancy first and use contraception during treatment and for 3 days after.
- For neurocysticercosis, give steroids and anticonvulsants, and look for retinal cysts before starting.
- Dexamethasone, praziquantel and cimetidine raise albendazole sulfoxide levels.
Good to know: Its active sulfoxide reaches tissue cysts, so albendazole, unlike mebendazole, treats tapeworm larvae in the brain and liver. WHO gives it in mass treatment of school-age children.
Remember it
A way to remember it
Benzimidazoles starve the worm: no microtubules, no glucose.
By stopping β-tubulin from forming microtubules, they leave the worm's gut cells unable to take up glucose; its glycogen and ATP run out and it dies.
Written for biofideX
Its name
-bendazole means benzimidazole anthelmintic
Albendazole and mebendazole stop worms building microtubules. Omeprazole is also a benzimidazole but ends in -prazole.
- Every drug name stem
Its class
Benzimidazole anthelmintics
Other benzimidazole anthelmintics with a card:
Easily mixed up with avermectins, azole antifungals and colchicine.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Albendazole tablets: label (DailyMed)
- Albendazole (NCI Thesaurus)
- Soil-transmitted helminth infections (WHO)
- Lymphatic filariasis (WHO)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Antifungals and antiparasitics
Albendazole is one of 14 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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