Albendazole 400mg tablets are a broad-spectrum antiparasitic medication used to treat various worm infections. This benzimidazole carbamate derivative works by inhibiting microtubule synthesis in parasites, effectively killing adult worms and larvae. The 400mg strength is particularly effective against intestinal parasites like giardia, roundworms, and hookworms, as well as tissue-dwelling parasites including hydatid cysts and neurocysticercosis. These tablets offer convenient single-dose therapy for many common helminth infections, with high cure rates ranging from 75-100% depending on the parasite species.
Albendazole 400mg is WHO-recommended first-line treatment for soil-transmitted helminths (ascariasis, trichuriasis, hookworm). It shows 95% efficacy against giardiasis when given for 3-5 days. The tablets are also used for systemic parasitic infections like hydatid disease (tapeworm cysts) and neurocysticercosis (brain tapeworm larvae), typically requiring prolonged courses. Recent guidelines approve its use for strongyloidiasis and cutaneous larva migrans. The 400mg dose provides optimal tissue penetration while maintaining safety, making it suitable for both adult and pediatric patients (>2 years).
For intestinal worms: single 400mg dose (repeated after 2-4 weeks for heavy hookworm infections). Tissue infections require 400mg twice daily for 8-30 days (weight-based for children <60kg). Take with fatty meals to enhance absorption by 5-fold. Tablets may be crushed for children or patients with swallowing difficulties. Renal/hepatic impairment requires no dose adjustment. For neurocysticercosis, combine with steroids to minimize inflammatory reactions. Always follow local parasite prevalence patterns and retreatment guidelines.
Albendazole selectively binds to parasite beta-tubulin, inhibiting microtubule assembly and glucose uptake. This vermicidal action affects intestinal parasites within 24 hours. The drug's sulfoxide metabolite provides systemic activity against tissue-dwelling larvae. Coverage includes nematodes (roundworms, hookworms), cestodes (tapeworms), and some protozoa (Giardia). Unlike older anthelmintics, albendazole acts on both adult worms and developing cysts. Resistance remains rare but emerging in some hookworm endemic areas.
Generally well-tolerated; mild effects include abdominal pain (8%), headache (4%), and dizziness (2%). Systemic treatment may cause elevated liver enzymes (15%) - monitor with prolonged use. Rare severe reactions: leukopenia, pancytopenia (risk increases with long courses). Contraindications include pregnancy (Category C) and known hypersensitivity. Drug-induced cyst rupture in hydatid disease may cause anaphylaxis - supervise initial doses in high-risk cases. Always screen for co-infections before mass deworming programs.
Children 2-12 years: 200mg single dose or 15mg/kg/day for tissue infections. Pregnancy: avoid (teratogenic in animals). Lactation: suspend breastfeeding during treatment. Elderly: no adjustment needed. Hepatic impairment: monitor enzymes with prolonged therapy. HIV patients: may require longer/repeated courses due to reduced efficacy. Always combine with iron supplements in endemic anemia areas.
Albendazole 400mg offers broader spectrum and higher cure rates than mebendazole (especially for hookworms and Strongyloides). Unlike ivermectin, it's effective against tapeworms and giardia. The 400mg single dose improves compliance over 3-day mebendazole regimens. Compared to praziquantel, albendazole is superior for cysticercosis and hydatid disease. However, it requires fatty meals for optimal absorption unlike other antiparasitics. Cost is comparable to alternatives but with better efficacy-per-dose in mass treatment programs.
Store below 30°C in original packaging (light-sensitive). Tablets remain stable for 3 years until expiration. Protect from moisture - do not remove from blister until use. In tropical climates, use desiccant packets in storage containers. Never use tablets that show discoloration or powdering. Travelers should carry tablets in moisture-proof containers when visiting endemic areas.
Generic albendazole 400mg costs $0.10-$0.50 per tablet globally. Included in WHO Essential Medicines List, available in most public health systems. Donated extensively for mass deworming programs (1 billion+ doses distributed). Insurance typically covers with minimal copay. Cost-effective at $0.30 per DALY (disability-adjusted life year) averted in endemic regions.
Take with fatty food (peanut butter, whole milk). Complete full course even if symptoms resolve. For tissue infections, report any neurological changes immediately. Women of childbearing age should use contraception during and 1 month after treatment. May cause drowsiness - avoid driving if affected. Family members often need concurrent treatment. Provide written instructions in low-literacy areas.
Current studies explore: nanoformulations for enhanced bioavailability, combination therapy with ivermectin, and new indications (Chagas disease, microsporidiosis). Resistance monitoring increasing in STH endemic areas. Research continues on optimal dosing intervals for mass drug administration programs. Genetic studies identifying parasite strains with reduced susceptibility.
Dexamethasone/praziquantel increase albendazole sulfoxide levels. Cimetidine may prolong therapeutic levels. Antiepileptics (carbamazepine, phenytoin) reduce efficacy. Avoid with grapefruit juice. No significant interactions with vaccines or antimalarials. Safe with most antibiotics except possibly rifampin.
Albendazole 400mg tablets are used for: intestinal worm infections (roundworms, pinworms, hookworms), systemic parasitic infections (hydatid disease, neurocysticercosis), and off-label for giardiasis. It's the preferred treatment for tissue-dwelling parasites due to its broad-spectrum anthelmintic activity and ability to penetrate cysts.
• Swallow whole with fatty meal (enhances absorption by 5x)
• Intestinal worms: Single 400mg dose (repeat in 2 weeks if needed)
• Hydatid disease: 400mg twice daily for 28-day cycles
• Neurocysticercosis: 15mg/kg/day divided twice daily (max 800mg/day)
• Take with plenty of water
• Crush for children who can't swallow tablets
Albendazole is lipophilic - dietary fats stimulate bile production which increases drug absorption from 5% (fasting) to 30%. A minimum 40g fat intake (equivalent to 1.5 tablespoons of peanut butter) with each dose is recommended for optimal efficacy.
This high-dose formulation:
• Achieves therapeutic levels in tissue cysts
• Allows single-dose eradication of intestinal worms
• Reduces treatment duration for systemic infections
• Maintains effective concentrations between doses
• Cost-effective for mass deworming programs
Category D: Contraindicated in pregnancy due to fetal harm in animal studies. Women of childbearing age should have negative pregnancy test before treatment and use contraception during and for 1 month after therapy.
1. Risk of bone marrow suppression (monitor CBC)
2. May increase liver enzymes (check LFTs)
3. Potential for neurotoxicity in cyst infections
4. Risk of retinal damage with high doses
5. Can cause Stevens-Johnson syndrome
• Intestinal worms: Passed in stool within 24-72 hours
• Hydatid cysts: Size reduction visible on imaging at 3 months
• Neurocysticercosis: Seizure reduction in 4-6 weeks
• Skin infections: Itching subsides in 5-7 days
• Full parasite clearance may require repeated cycles
• Store below 30°C in original packaging
• Protect from moisture and light
• Keep blister strips sealed until use
• Do not refrigerate
• Discard if tablets become discolored
• Dexamethasone: Increases albendazole levels
• Praziquantel: Synergistic effect for tapeworms
• Cimetidine: Boosts drug exposure
• Theophylline: Reduced metabolism
• Antiepileptics: May decrease albendazole efficacy
Albendazole sulfoxide (active metabolite) is hepatically metabolized. Patients with pre-existing liver disease or those taking hepatotoxic drugs require close monitoring. Therapy should be stopped if ALT/AST exceed 2x upper limit.