Mebendazole

Definition
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Benzimidazole-type anthelmintic.

Half-life
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1,5-5,5 h (metabolites).

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Pharmacodynamics (Effect)
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Inhibition of the polymerization of the tubulin structures of the cytoskeleton with inhibition of glucose uptake and the subsequent glycogen processing of the parasites (point of attack: fumarate reductase in the intestine)

Indication
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Inoperable or not radically operable forms of Echinococcus cysticus infections(dog tapeworm) and Echinococcus alveolaris infections(fox tapeworm), preoperative support of surgical therapy, trichinosis, treatment attempt for strongyloidosis, cutaneous larva migrans.

Limited indication
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Children < 14 years (high dose), liver diseases.

Dosage and method of use
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See Table 1.

Undesirable effects
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Allergic reactions, gastrointestinal complaints (massive infestation and discharge of parasites), BB changes, fever attacks, liver function disorders, hair loss.

Interactions
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Cimetidine increases the mebendazole level, the insulin effect is increased, phenytoin reduces the mebendazole effect.

Contraindication
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Pregnancy (teratogenic!), lactation, children < 12 months (risk of seizures).

Preparations
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Vermox, Surfont

Patientinformation
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Remember! Take tablets after meals!

Tables
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Doses of Mebendazole

Indication	Dosage
duodenal ancylostoma	2 times/day 100 mg over 3 days
Ascaris lumbricoides	2 times/day 100 mg over 3 days
Enterobius vermicularis	100 mg as ED, Wdh. after 14 days or 2 times/day 100 mg over 3 days
Echinococcus cysticus and granulosus	2 times/day 500 mg for 3 days, then 3 times/day 500 mg over 3 days, then 3 times/day 13-20 mg/kg bw for 4-6 weeks
Echinococcus alveolaris and multilocularis	see above, therapy duration up to 2 years
Necator americanus	2 times/day 100 mg over 3 days
Toxocara spp.	2 times/day 100-200 mg over 5 days
Trichinella spp.	Adults: 4 times/day 20 mg/kg bw for 14 days (plus glucocorticoids) Children: 3 times/day 200-400 mg over 3-6 days, then 3 times/day 400-500 mg over 10 days
Trichostrongylus	2 times/day 100 mg over 5 days
trichuris trichiura	600 mg/day over 1-3 days or 2 times/day 100 mg over 3 days