Albendazole

Pronunciation: pronunciation varies by local usage.

Generic name: albendazole
Drug class: Synthetic benzimidazole anthelmintic
Form: Tablet, film coated
Route: Oral
Legal status: Prescription-only medicine

Availability and supply rules vary by country

Trade names by country: United States

What albendazole is and how it works

Albendazole is an oral antiparasitic medicine that binds to β-tubulin in susceptible parasites, inhibiting microtubule polymerization and depleting glucose and ATP stores. It is used to treat certain tapeworm-larval tissue infections: parenchymal neurocysticercosis due to Taenia solium and cystic hydatid disease of liver, lung, and peritoneum due to Echinococcus granulosus. (1)

Treatment requires specialist supervision, including monitoring for bone marrow suppression and liver toxicity. For neurocysticercosis, steroid and anticonvulsant therapy is given as appropriate to help prevent inflammatory complications. A pregnancy test is recommended before starting for those who could become pregnant, and effective contraception is needed. Your prescriber will arrange an eye exam before treating neurocysticercosis to rule out ocular cysticercosis.

Mechanism of action: how albendazole works

Albendazole is a benzimidazole anthelmintic that binds to parasite β-tubulin, inhibiting microtubule polymerization and depleting glucose and ATP stores. (1)

What albendazole is used for

Parenchymal neurocysticercosis

Albendazole is indicated for the treatment of parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm, Taenia solium. (1)

Cystic hydatid disease

Albendazole is indicated for the treatment of cystic hydatid disease of the liver, lung, and peritoneum caused by the larval form of the dog tapeworm, Echinococcus granulosus. (1)

Before taking albendazole

Do not take / not appropriate for

Known hypersensitivity to the benzimidazole class of compounds or any component of albendazole tablets is a contraindication. Tell your prescriber if this applies to you. (all indications) (1)
For neurocysticercosis, your prescriber must arrange a retinal examination to rule out ocular cysticercosis before treatment starts, because of the risk of inflammatory retinal damage — this is your prescriber's responsibility to arrange. (neurocysticercosis) (1)

Tell your clinician about

If you are pregnant or may become pregnant; a pregnancy test is recommended before starting treatment.
All current medications, especially dexamethasone, praziquantel, cimetidine, theophylline, or any anticonvulsants.
Any history of liver problems, blood disorders, or bone marrow suppression.
Any signs of infection, bleeding, or bruising before starting treatment.
If you have a history of sensitivity to benzimidazole medicines.

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How to take albendazole

Albendazole is taken by mouth with meals. Dosing is weight-based: for patients weighing 60 kg or more, 400 mg twice daily; for those weighing less than 60 kg, 15 mg/kg/day given in two divided doses, with a maximum total daily dose of 800 mg.
Duration depends on the condition: for hydatid disease, a 28-day treatment cycle is followed by a 14-day albendazole-free interval, for a total of 3 cycles; for neurocysticercosis, treatment lasts 8 to 30 days.
For neurocysticercosis, your prescriber will give steroid (corticosteroid) and anticonvulsant therapy as appropriate to help prevent seizures, increased intracranial pressure, and focal neurologic deficits.
Do not change the dose, duration, or cycle schedule yourself. All treatment must be supervised by a specialist.

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Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)

Missed dose

No specific missed-dose instruction was found in the current researched label. If a dose is missed, contact the prescribing clinician for advice.

Overdose

The source reviewed for this page states that symptomatic therapy and general supportive measures are recommended for overdose. If you suspect an overdose, contact your prescriber, poison control, or emergency services promptly for advice. (1)

Side effects

Adverse reactions vary by indication. Common side effects include headache, abnormal liver enzymes, abdominal pain, nausea, vomiting, reversible hair loss, dizziness, and fever. Serious risks include bone marrow suppression and hepatotoxicity.

Liver enzyme elevation (hepatotoxicity)

What to notice: Detected through blood tests during routine monitoring.

What to do: Liver enzymes are monitored at least every 2 weeks; the prescriber will manage. Report any symptoms suggesting liver problems. (1)

Headache

What to notice: Persistent or worsening headache, especially in neurocysticercosis.

What to do: Inform the treatment team; headache may require assessment for raised intracranial pressure. (1)

Abdominal pain, nausea, vomiting

What to notice: Mild to moderate stomach discomfort; frequency up to 6%.

What to do: Take with food; tell the prescriber if symptoms are severe or persistent. (1)

Reversible alopecia (hair loss)

What to notice: Thinning or loss of hair, reported in about 2% of hydatid disease patients.

What to do: This is usually temporary; discuss with the clinician if concerned. (1)

Dizziness or fever

What to notice: Mild dizziness or elevated temperature.

What to do: Monitor and report if bothersome or accompanied by other symptoms. (1)

Raised intracranial pressure (in neurocysticercosis)

What to notice: These are known complications during neurocysticercosis treatment.

What to do: Seek immediate medical attention; this is a known complication during neurocysticercosis treatment and is managed with corticosteroids. (1)

Bone marrow suppression

What to notice: This is a condition usually detected through routine blood count monitoring.

What to do: Contact the healthcare team urgently; these symptoms may indicate bone marrow suppression which can be fatal. (1)

Severe hepatotoxicity

What to notice: Liver problems are usually detected through routine blood testing.

What to do: Contact the healthcare team immediately; your treating clinician will decide whether albendazole needs to be discontinued if liver enzymes exceed twice the upper limit of normal. (1)

Hypersensitivity reaction

What to do: Seek prompt medical assessment for any symptoms you think may be an allergic or hypersensitivity reaction. The evaluating clinician will determine whether treatment continues or is discontinued. (1)

Serious warnings

Bone marrow suppression (granulocytopenia/pancytopenia) — emergency

Symptoms: This is a condition usually detected through routine blood count monitoring.

Action: Seek emergency medical care immediately. Blood counts are monitored during treatment because fatalities have been reported; the evaluating specialist will advise whether treatment should continue or be discontinued. (1)

Hepatotoxicity (liver damage) — emergency

Symptoms: Liver problems are usually detected through routine blood testing.

Action: Seek emergency medical attention. Liver enzymes are monitored every 2 weeks; your treating clinician will decide whether the medicine needs to be stopped. (1)

Increased intracranial pressure or seizures (neurocysticercosis) — emergency

Symptoms: These are known complications during neurocysticercosis treatment.

Action: Seek emergency care. Steroid therapy is used concurrently to reduce this risk, but emergent symptoms require immediate evaluation. (1)

Interactions

Medicine or test	Effect	Action
Dexamethasone	Dexamethasone increases albendazole sulfoxide (active metabolite) concentrations by about 56%.	Tell your prescriber if you are taking dexamethasone. The sources reviewed for this page state this increases albendazole's active metabolite concentration by about 56%; no specific dose-adjustment instruction was found. (1)
Praziquantel	Praziquantel increases albendazole sulfoxide mean maximum concentration and AUC by about 50%.	Tell your prescriber if you are taking praziquantel. The sources reviewed for this page state this increases albendazole's active-metabolite peak concentration and overall exposure by about 50%. (1)
Cimetidine	Cimetidine increases albendazole sulfoxide concentrations in bile and cyst fluid by about 2-fold.	Tell your prescriber if you are taking cimetidine. The sources reviewed for this page state this increases albendazole's active-metabolite concentration in bile and cyst fluid by about 2-fold. (1)
Theophylline	Albendazole induces cytochrome P450 1A. The sources reviewed for this page state that theophylline plasma levels should be monitored during and after treatment.	Tell your prescriber if you are taking theophylline. Theophylline plasma levels should be monitored during and after albendazole treatment. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy and females of reproductive potential

Albendazole was embryotoxic in animal studies. A pregnancy test is recommended for females of reproductive potential before starting treatment. Effective contraception must be used during treatment and for 3 days after the final dose. If pregnancy occurs, inform the prescriber immediately. (1)

Breastfeeding

No specific breastfeeding guidance was captured in this research pass. Consult a clinician: the decision to use albendazole while breastfeeding must balance the need for treatment against potential risk.

Children and adolescents

Pediatric use is not separately defined beyond weight-based dosing. No minimum age cutoff was found in the researched label. Dosing for children weighing less than 60 kg follows the 15 mg/kg/day formula. Specialist guidance is required. (1)

Hepatic impairment

Albendazole can affect the liver; liver enzymes are monitored at least every 2 weeks during treatment. (1)

Monitoring

Before starting

Confirm the diagnosis and indication; for neurocysticercosis, perform a retinal exam to exclude ocular cysticercosis.
A pregnancy test is recommended for females of reproductive potential.
Baseline blood counts (CBC) and liver enzymes (transaminases).
Review all concurrent medications for interactions (dexamethasone, praziquantel, cimetidine, theophylline, anticonvulsants).
Plan appropriate adjunctive therapy: corticosteroids and anticonvulsants for neurocysticercosis.

During treatment

Monitor blood counts at the beginning of each 28-day treatment cycle and every 2 weeks while on therapy.
Liver enzymes are monitored at least every 2 weeks; your treating clinician will decide whether to discontinue albendazole if liver enzymes exceed twice the upper limit of normal.
For neurocysticercosis, watch for signs of increased intracranial pressure or seizures; ensure steroid compliance.
Assess for signs of bone marrow suppression (infection, bleeding, bruising) and hepatotoxicity.
Confirm contraceptive compliance in females of reproductive potential.

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Storage

Follow the instructions on the pharmacy label, or ask your pharmacist.

Professional information

Clinician-facing context only. Use the current local indication, dosing table, and monitoring protocols. This page reflects the US FDA label only; UK/EU SmPC was not verified.

United States (FDA label)

Indication: Neurocysticercosis and hydatid disease

Dose summary: For patients >=60 kg: 400 mg orally twice daily with meals. For patients <60 kg: 15 mg/kg/day in two divided doses (max 800 mg/day). Hydatid disease: 28-day cycle followed by 14-day break, repeated for 3 cycles. Neurocysticercosis: 8-30 days. Steroid and anticonvulsant therapy given as appropriate for neurocysticercosis. (1)

Other regions (including UK/EU)

Indication: Any albendazole use

Dose summary: No UK/EU-specific SmPC was identified in this research pass. Do not assume dosing or indications match the US label. Consult local prescribing information.

Renal context: Unknown; refer to local label.

Mechanism of action

Hepatic guidance

Albendazole can cause hepatotoxicity; liver enzymes must be monitored every 2 weeks. The treating clinician should discontinue albendazole if enzymes exceed 2x ULN.

Overdose note

In case of overdose, symptomatic therapy and general supportive measures are recommended. (1)

Frequently asked questions

Why do I need blood tests while taking albendazole?

Albendazole can cause serious side effects, including bone marrow suppression and liver damage. Regular blood tests help detect these problems early so they can be managed before they become severe. (1)

Can I become pregnant while on albendazole?

Pregnancy should be avoided during treatment. A pregnancy test is recommended before starting for those who could become pregnant, and effective contraception must be used during treatment and for 3 days after the final dose. Albendazole was embryotoxic (harmful to the developing embryo) in animal studies; the sources reviewed for this page did not establish specific human pregnancy outcome data. (1)

Why do I need to take steroids with albendazole for neurocysticercosis?

The dying parasites can cause inflammation in the brain, leading to seizures or increased pressure. Steroids reduce this inflammation and help prevent these complications. (1)

What is the mechanism of action of albendazole?