mebendazole

Therapeutic Classification: anthelmintics

REMS

Treatment of:
- Whipworm (trichuriasis),
- Pinworm (enterobiasis),
- Roundworm (ascariasis),
- Common hookworm,
- American hookworm.

Inhibits the uptake of glucose and other nutrients by susceptible helminths.

Therapeutic effects:

Death of parasites and eggs.

Spectrum:

Active against:
- Trichuris trichiura (whipworm),
- Enterobius vermicularis (pinworm),
- Ascaris lumbricoides (common roundworm),
- Ancylostoma duodenale (common hookworm),
- Necator americanus (American hookworm).

Absorption: Minimally (2–10%) absorbed after oral administration.

Distribution: To liver, fat muscle, plasma, and hepatic cysts.

Metabolism/Excretion: >95% eliminated in feces. Absorbed drug is mostly metabolized by the liver; small amounts excreted unchanged by the kidneys.

Half-Life: 2.5–9 hr (↑ in hepatic impairment).

(blood levels)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	0.5–7 hr	unknown

Contraindicated in:

Hypersensitivity.

Use Cautiously in:

Hepatic impairment;
OB: Should only be used during second or third trimesters of pregnancy if potential maternal benefit justifies potential fetal risk;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children <2 yr (safety and effectiveness not established).

Most side effects and adverse reactions are seen with high-dose therapy only

Derm: rash, urticaria

GI: ↑liver enzymes (high dose, long-term therapy), abdominal pain, diarrhea

Hemat: agranulocytosis, neutropenia

Neuro: SEIZURES

Misc: ANGIOEDEMA

Drug-drug:

Cimetidine may ↑ levels.

Enterobiasis

PO (Adults and Children ≥2 yr): 100 mg as a single dose; if not cured in 3 wk, given another 100–mg single dose.

Trichuriasis, Ascariasis, or Hookworm

PO (Adults and Children ≥2 yr): 100 mg twice daily for 3 days; if not cured in 3 wk, give a 2nd course of treatment.

Chewable tablets: 100 mg
Tablets: 100 mg

Pinworm: Perianal examinations should be performed to detect the presence of adult worms in the perianal area, and cellophane tape swabs of the perianal area should be taken before and starting 1 wk after treatment to detect the presence of ova. Swabs should be taken each morning before defecation or bathing for at least 3 days. Patients are not considered cured unless perianal swabs have been negative for 7 days.
Roundworm: Stool examinations should be monitored before and 1–3 wk after treatment.

Lab Test Considerations:

May cause transient increase in serum BUN, AST, ALT, and alkaline phosphatase levels. Liver function tests should be monitored periodically during long-term therapy.
- CBC should be monitored before therapy and 2–3 times a wk from day 10–25 and weekly thereafter in patients receiving high-dose or long-term therapy. Mebendazole may cause reversible leukopenia and thrombocytopenia.
- May cause decreased serum hemoglobin concentrations.

No special diets, fasting, laxatives, or enemas are required before administration of mebendazole.
PO: Mebendazole tablets may be chewed, swallowed whole, or crushed and mixed with food. Patients on high-dose therapy should take tablets with high-fat meals to increase absorption.
Pinworm: All members of the household should be treated concurrently, with treatment repeated in 2–3 wk.
Hookworm and Whipworm: Patient may be required to take an iron supplement daily during treatment and for 6 mo after treatment if anemia occurs.

Instruct patient to take medication exactly as directed and to continue medication for full course of therapy, even if feeling better. If a dose is missed, take as soon as remembered; if on 2 doses/day schedule, space missed dose and next dose 4–5 hr apart or double next dose. A 2nd course of therapy may be required.
- Advise patient of hygienic precautions to minimize reinfection (wash hands with soap before eating and after using the toilet, disinfect toilet daily, keep hands away from mouth, wash all fruits and vegetables, wear shoes).
- May cause dizziness. Caution patient to avoid driving or activities requiring alertness until response to medication is known.
- Advise patient to consult health care professional if no improvement is seen within a few days.
- Emphasize the importance of follow-up exams to determine effectiveness, especially with high-dose therapy.
Pinworm: Instruct patient to wash (do not shake) all bedding, undergarments, towels, and nightclothes after treatment to prevent reinfection.

Resolution of the signs and symptoms of infection or when stool specimens and perianal swabs are negative. Length of time for complete resolution depends on the parasite.

NDC Code

12578- Janssen Pharmaceutica NV
- 12578-618-
  - 12578-618-00- 20 kg in 1 DRUM (12578-618-00)

50458- Janssen Pharmaceuticals, Inc.
- 50458-675- VERMOX
  - 50458-675-20- 200 TABLET, CHEWABLE in 1 BOTTLE (50458-675-20)

51927- Professional Compounding Centers of America
- 51927-0336-
  - 51927-0336-0- 1 kg in 1 BOTTLE (51927-0336-0)

53104- Cipla Ltd.
- 53104-7510-
  - 53104-7510-1- 25 kg in 1 DRUM (53104-7510-1)

59285- Optimus Drugs Private Limited
- 59285-011-
  59285-011-01- 50 kg in 1 DRUM (59285-011-01)

60592- KALCHEM INTERNATIONAL INC.
- 60592-247-
  60592-247-10- 1000 g in 1 BOTTLE (60592-247-10)

62991- LETCO MEDICAL, LLC
- 62991-1544-
  62991-1544-1- 25 g in 1 JAR (62991-1544-1)

62991- LETCO MEDICAL, LLC
- 62991-1544-
  62991-1544-2- 100 g in 1 JAR (62991-1544-2)

62991- LETCO MEDICAL, LLC
- 62991-1544-
  62991-1544-3- 500 g in 1 JAR (62991-1544-3)

62991- LETCO MEDICAL, LLC
- 62991-1544-
  62991-1544-5- 1000 g in 1 JAR (62991-1544-5)

64896- Amneal Pharmaceuticals LLC
- 64896-669- Emverm
  64896-669-30- 1 BLISTER PACK in 1 CARTON (64896-669-30) / 1 TABLET, CHEWABLE in 1 BLISTER PACK

69766- MSN Life Sciences Private Limited
- 69766-038-
  - 69766-038-01- 50 kg in 1 DRUM (69766-038-01)

69766- MSN Life Sciences Private Limited
- 69766-038-
  69766-038-02- 20 kg in 1 DRUM (69766-038-02)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-01- 1000 g in 1 CONTAINER (71052-168-01)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-02- 20000 g in 1 CONTAINER (71052-168-02)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-05- 50 g in 1 CONTAINER (71052-168-05)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-10- 100 g in 1 CONTAINER (71052-168-10)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-25- 25 g in 1 CONTAINER (71052-168-25)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-50- 500 g in 1 CONTAINER (71052-168-50)

71052- DARMERICA, LLC
- 71052-168-
  71052-168-55- 5000 g in 1 CONTAINER (71052-168-55)

72643- SOLARA ACIVE PHARMA SCIENCES LIMITED
- 72643-035-
  72643-035-02- 5 kg in 1 DRUM (72643-035-02)

72643- SOLARA ACIVE PHARMA SCIENCES LIMITED
- 72643-035-
  72643-035-03- 10 kg in 1 DRUM (72643-035-03)

72643- SOLARA ACIVE PHARMA SCIENCES LIMITED
- 72643-035-
  72643-035-08- 20 kg in 1 DRUM (72643-035-08)

72643- SOLARA ACIVE PHARMA SCIENCES LIMITED
- 72643-035-
  72643-035-09- 15 kg in 1 DRUM (72643-035-09)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-01- 1 g in 1 BOTTLE (73212-103-01)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-05- 5 g in 1 BOTTLE (73212-103-05)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-10- 10 g in 1 BOTTLE (73212-103-10)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-11- 50 g in 1 BOTTLE (73212-103-11)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-12- 100 g in 1 BOTTLE (73212-103-12)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-13- 500 g in 1 BAG (73212-103-13)

73212- Qingdao Biopeptek Co., Ltd.
- 73212-103-
  73212-103-14- 1000 g in 1 BAG (73212-103-14)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-01- 5000 g in 1 DRUM (73377-260-01)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-02- 5960 g in 1 DRUM (73377-260-02)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-03- 4040 g in 1 DRUM (73377-260-03)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-04- 100 g in 1 JAR (73377-260-04)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-05- 500 g in 1 JAR (73377-260-05)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-06- 1000 g in 1 JAR (73377-260-06)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-07- 1160 g in 1 JAR (73377-260-07)

73377- AX Pharmaceutical Corp
- 73377-260-
  73377-260-08- 310 g in 1 JAR (73377-260-08)

82891- Evereen Shanghai Biotechnology Ltd.
- 82891-028-
  82891-028-01- 1 kg in 1 BAG (82891-028-01)

82891- Evereen Shanghai Biotechnology Ltd.
- 82891-028-
  82891-028-02- 20 kg in 1 DRUM (82891-028-02)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-1- 1 g in 1 BAG (85512-2115-1)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-2- 5 g in 1 BAG (85512-2115-2)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-3- 10 g in 1 BAG (85512-2115-3)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-4- 50 g in 1 BAG (85512-2115-4)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-5- 100 g in 1 BAG (85512-2115-5)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-6- 500 g in 1 BAG (85512-2115-6)

85512- Qingdao Qinzeyuan Biotechnology Co., Ltd
- 85512-2115-
  85512-2115-7- 1000 g in 1 BAG (85512-2115-7)

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