Generic Name

Mebendazole

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Classification

FDA Approved Indications

• Treatment of helminthic infections caused by roundworms, hookworms, whipworms, and pinworms

Mechanism of Action

Mebendazole works by inhibiting microtubule synthesis in helminths, disrupting their glucose uptake and depleting their energy sources, which leads to immobilization and eventual death of the parasites.

Dosage and Administration

Adult: Varying based on infection type: typically 100 mg twice daily for 1-3 days; Emverm dosage varies as per specific instructions.

Pediatric: Doses are weight-based, commonly 100 mg twice daily for 1-3 days.

Geriatric: Adjust dosage based on renal and hepatic function, generally similar to adult doses.

Renal Impairment: No specific adjustment recommended, but caution advised.

Hepatic Impairment: Use with caution; no specific dosage adjustment established.

Pharmacokinetics

Absorption: Poorly absorbed from gastrointestinal tract; enhanced when taken with fatty meals.

Distribution: Widely distributed, largely confined to gastrointestinal tract.

Metabolism: Primarily hepatic metabolism with formation of inactive metabolites.

Excretion: Hepatic metabolism with excretion mainly via feces; minimal renal excretion.

Half Life: Approximately 2-4 hours.

Contraindications

• Hypersensitivity to mebendazole or benzimidazoles
• Pregnancy (especially during the first trimester) unless benefits justify risks.

Precautions

• Use with caution in hepatic impairment, monitor liver function during prolonged therapy.

Adverse Reactions - Common

• Abdominal pain (Common)
• Diarrhea (Common)
• Nausea (Common)
• Vomiting (Common)

Adverse Reactions - Serious

• Hepatotoxicity (Rare)
• Leukopenia (Rare)
• Allergic reactions (rash, urticaria) (Rare)

Drug-Drug Interactions

• Albendazole (may increase toxicity)

Drug-Food Interactions

• High-fat meals enhance absorption, which can increase effects and side effects.

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication with fatty meals to improve absorption.
• Complete the full course of therapy.
• Report any signs of liver problems or allergic reactions.
• Practice good hygiene to prevent reinfection.

Special Considerations

Black Box Warnings:

• Carcinogenic and teratogenic potential seen in animal studies, contraindicated during pregnancy unless absolutely necessary.

Genetic Factors: None well established.

Lab Test Interference: May cause transient elevations in liver enzymes.

Overdose Management

Signs/Symptoms: Nausea, vomiting, abdominal pain, dizziness, diarrhea.

Treatment: Supportive care, activated charcoal if ingestion was recent, and symptomatic management.

Storage and Handling

Storage: Store at room temperature, protected from moisture and heat.

Stability: Stable under recommended conditions for shelf life.