Description
Indications
Almex 400 is indicated in single and mixed infestations of-
- Hookworm (Ancylostoma, Necator)
- Roundworm (Ascaris)
- Threadworm (Enterobius)
- Whipworm (Trichuris)
- Strongyloides
- Tapeworm
- Opisthorchi
- Hydatid.
Pharmacology
Almex 400 is a broad-spectrum anthelmintic. Albendazole has insecticidal, ovoicidal and larvicidal activities. It is believed that the drug exerts its anthelmintic effect by blocking glucose uptake by susceptible worms, expending energy levels until it is insufficient to survive. After the fixation is the parasite. These events may be the result of the binding of albendazole and its metabolites and subsequent inhibition of parasite tubulin polymerization, although the drug also binds to human tubulin. Albendazole is extensively metabolized, possibly in the liver. Albendazole is poorly absorbed from the gastrointestinal tract, but rapidly undergoes extensive first-pass metabolism. The main metabolite albendazole sulfoxide has anthelmintic activity, and the plasma half-life is about 8.5 hours. It is excreted in the urine along with other metabolites.
Dosage & Administration
Adults & children over 2 years:
- 400 mg (1 tablet or 10 ml suspension) as a single dose in cases of Enterobius vermicularis, Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus.
- In cases of strongyloidiasis or taeniasis, 400 mg (1 tablet or 10 ml suspension) daily should be given for 3 consecutive days. If the patient is not cured on follow-up after three weeks, a second course of treatment is indicated.
Children of 1-2 years: Recommended dose is a single dose of 200 mg (5 ml suspension).
Children under 1 year: Not recommended.
In Hydatid disease (Echinococcosis):
Albendazole is given by mouth with meals in a dose of 400 mg twice daily for 28 days for patients weighing over 60 kg.
- A dose of 15 mg/kg body weight daily in two divided doses (to a maximum total daily dose of 800 mg) is used for patients weighing less than 60 kg.
- For cystic echinococcosis, the 28 days course may be repeated after 14 days without treatment, to a total of 3 treatment cycles.
- For alveolar echinococcosis, cycles of 28 days of treatment followed by 14 days without treatment, may need to continue for months or years.
- In giardiasis, 400 mg (1 tablet or 10 ml suspension) once daily for five days is used.
Interaction
No interaction involving Albendazole, either pharmacodynamic or pharmacokinetic, has been reported.
Contraindications
Neonates: Albendazole is not normally used in neonates.
Children: Reduction of the dose from 400 mg to 200 mg may be indicated in children weighing less than 10 kg but there are no grounds for a general reduction in dosage to children.
Pregnant woman: Albendazole should not be given during pregnancy or women thought to be pregnant. No information is available on placental transfer.
Concurrent disease: There is no evidence to suggest that dose should be altered in renal, hepatic or cardiac failure.
Side Effects
Gastrointestinal disturbances, headache, dizziness, changes in liver enzymes, rarely reversible alopecia; rash, fever, blood disorders including leucopenia and pancytopenia reported; allergic shock if cyst leakage; convulsion and meningism in cerebral disease.
Pregnancy & Lactation
US FDA Pregnancy category of Albendazole is C. So, Albendazole should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.
Precautions & Warnings
Breastfeeding; excluding pregnancy before commencing therapy; blood counts and liver function tests before treatment and again during each cycle. Albendazole should only be used to treat Echinococcosis under strict medical supervision and with regular monitoring of serum transaminase levels, as well as leucocyte and platelet counts.
Therapeutic Class
Anthelmintic
Storage Conditions
Keep in a dry place, away from light and heat. Keep out of the reach of children.
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