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Pronunciation:

(me BEN da zole)

U.S. Brand Names:

Vermox®

Generic Available:

Yes

Canadian Brand Names:

Vermox®

Use:

Treatment of pinworms (Enterobius vermicularis), whipworms (Trichuris trichiura), roundworms (Ascaris lumbricoides), and hookworms (Ancylostoma duodenale)

Pregnancy Risk Factor:

Lactation:

Excretion in breast milk unknown/use caution

Contraindications:

Hypersensitivity to mebendazole or any component of the formulation

Warnings/Precautions:

Pregnancy and children <2 years of age are relative contraindications since safety has not been established; not effective for hydatid disease

Adverse Reactions:

Frequency not defined.

Cardiovascular: Angioedema

Central nervous system: Fever, dizziness, headache, seizure

Dermatologic: Rash, itching, alopecia (with high doses)

Gastrointestinal: Abdominal pain, diarrhea, nausea, vomiting

Hematologic: Neutropenia (sore throat, unusual fatigue)

Neuromuscular & skeletal: Unusual weakness

Overdosage/Toxicology:

Symptoms of overdose include abdominal pain and altered mental status. Treatment is supportive.

Drug Interactions:

Decreased effect: Anticonvulsants such as carbamazepine and phenytoin may increase metabolism of mebendazole

Ethanol/Nutrition/Herb Interactions:

Food: Mebendazole serum levels may be increased if taken with food.

Mechanism of Action:

Selectively and irreversibly blocks glucose uptake and other nutrients in susceptible adult intestine-dwelling helminths

Pharmacodynamics/Kinetics:

Absorption: 2% to 10%

Distribution: To serum, cyst fluid, liver, omental fat, and pelvic, pulmonary, and hepatic cysts; highest concentrations found in liver; relatively high concentrations found in muscle-encysted Trichinella spiralis larvae; crosses placenta

Protein binding: 95%

Metabolism: Extensively hepatic

Half-life elimination: 1-11.5 hours

Time to peak, serum: 2-4 hours

Excretion: Primarily feces; urine (5% to 10%)

Dosage:

Children and Adults: Oral:

Pinworms: 100 mg as a single dose; may need to repeat after 2 weeks; treatment should include family members in close contact with patient

Whipworms, roundworms, hookworms: One tablet twice daily, morning and evening on 3 consecutive days; if patient is not cured within 3-4 weeks, a second course of treatment may be administered

Capillariasis: 200 mg twice daily for 20 days

Dosing adjustment in hepatic impairment: Dosage reduction may be necessary in patients with liver dysfunction

Hemodialysis: Not dialyzable (0% to 5%)

Monitoring Parameters:

Check for helminth ova in feces within 3-4 weeks following the initial therapy

Dietary Considerations:

Tablet can be crushed and mixed with food, swallowed whole, or chewed.

Patient Education:

Inform prescriber of all prescriptions, OTC medications, or herbal products you are taking, and any allergies you have. Do not take any new medication during therapy unless approved by prescriber. Take exactly as directed for full course of medication. Tablets may be chewed, swallowed whole, or crushed and mixed with food. Increase dietary intake of fruit juices. All family members and close friends should also be treated. To reduce possibility of reinfection, wash hands and scrub nails carefully with soap and hot water before handling food, before eating, and before and after toileting. Keep hands out of mouth. Disinfect toilet daily and launder bed linens, undergarments, and nightclothes daily with hot water and soap. Do not go barefoot and do not sit directly on grass or ground. May cause abdominal pain, nausea, or vomiting (small, frequent meals, frequent mouth care, sucking lozenges, or chewing gum may help); or hair loss (reversible). Report skin rash or itching, unusual fatigue or sore throat, unresolved diarrhea or vomiting, or CNS changes. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Consult prescriber if breast-feeding.

Dental Health: Effects on Dental Treatment:

No significant effects or complications reported

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

No information available to require special precautions

Mental Health: Effects on Mental Status:

May cause dizziness

Mental Health: Effects on Psychiatric Treatment:

Carbamazepine may decrease the effects of mebendazole; may rarely cause neutropenia; use caution with clozapine and carbamazepine

Dosage Forms:

Tablet, chewable: 100 mg

International Brand Names:

Adco-Wormex® (ZA); Anthelmin® (BR); Anti-Worm® (NL); Bantenol® (ES); Banworm® (AU); Benda® (TH); Bendrax® (BR); Big-Ben (TH); Boots Threadworm Treatment® (GB); Camben® (BD); Cipex® (ZA); Crisdazol® (BR); Dazomet® (AR); Diacor® (CL); Divermil® (BR); Docmebenda® (BE); Drivermide® (TH); D-Worm® (ZA); Eraverm® (BR); Ermox® (BD); Fel-6® (DO); Fugacar® (TH); Gamax® (CO); Gavox® (ID); G-Mebendazole® (BD); Kindelmin® (BR); Lomper® (ES); Madicure® (NL); Masaworm® (TH); Meba® (TH); Meben® (BD, TH); Mebendan® (ES); Mebenda-P (TH); Mebendazol Agrand® (AR); Mebendazol® (AR, BR, CL, EC); Mebendazol Duncan® (AR); Mebendazol Ecar® (CO); Mebendazole Riva® (RO); Mebendazole® (RO, TH); Mebendazol Fabra® (AR); Mebendazol Genfar® (EC); Mebendazol L.CH.® (CL); Mebendazol Northia® (AR); Mebendazol Richet® (AR); Mebendil® (BR); Mebendol® (BD); Mebex® (IN); Mebutar® (AR); Medazole® (TH); Mensole® (CL); Menzol® (DO); Metabasal® (EC); Minix® (BD); Moben® (BR); Multielmin® (BR); Necamin® (BR); Nemasole® (AR); Nemazole® (BD); Noxworm® (TH); Ovex® (GB); Oxitover® (ES); Panamox® (BD); Panfugan® (BR); Pantelmin® (AT, BR, CO, CR, DO, GT, HN, PA, PT, SV); Permax® (RO); Pharaxis® (CO); Pluriverm® (BR); Pripsen Mebendazole® (GB); Revapol® (MX); Rioworm® (ZA); Rolab-Anthex® (ZA); Sirben® (BR); Solas® (BD); Soltrik® (YU); Sufil® (ES); Surfont® (DE); Tesical Mebendazol® (AR); Tetrahelmin® (BR); Thelmox® (CY, JO, RO); Vagaka® (TH); Vermacare® (RO); Vermazol® (TR); Vermicol® (MX); Vermidil® (MX); Vermin® (MX, RO); Vermitox® (BD); Vermizine® (BD); Vermox® (AU, BE, BG, CA, CH, CY, CZ, DE, DK, DO, EG, GB, HK, HR, HU, ID, IE, IL, IT, JO, LB, LU, MT, NL, NO, PL, RO, RU, SE, SI, ZA); Versid® (TR); Warca® (TH); Wormgo® (ZA); Wormin® (BD, CZ, IN, RO, ZA); Wormkuur® (NL); Wormstop® (ZA)

References

de Silva N, Guyatt H, and Bundy D, "Anthelmintics. A Comparative Review of Their Clinical Pharmacology,"Drugs, 1997, 53(5):769-88.

"Drugs for Parasitic Infections,"Med Lett Drugs Ther, 1998, 40(1017):1-12.

Hotez PJ, "Hookworm Disease in Children,"Pediatr Infect Dis J, 1989, 8(8):516-20.

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