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Mebendazole – Uses, Dosage & Side Effects

Mebendazole is an anthelmintic used to treat worm infections such as roundworm, pinworm, and hookworm. It works by blocking glucose uptake in parasites.

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Things worth knowing about "Mebendazole"

Mebendazole is an anthelmintic used to treat worm infections such as roundworm, pinworm, and hookworm. It works by blocking glucose uptake in parasites.

What is Mebendazole?

Mebendazole is an anthelmintic (antiparasitic) drug belonging to the benzimidazole class. It is used to treat a wide range of intestinal worm infections (helminthiasis) in humans. The drug has been clinically established for decades and is included on the World Health Organization (WHO) List of Essential Medicines.

Indications

Mebendazole is indicated for the treatment of the following parasitic infections:

Enterobiasis (pinworm infection / oxyuriasis)
Ascariasis (roundworm infection)
Trichuriasis (whipworm infection)
Hookworm infection (ancylostomiasis, necatoriasis)
Mixed infections involving multiple worm species simultaneously

Mechanism of Action

Mebendazole works by selectively binding to beta-tubulin in worm cells, preventing the formation of microtubules. These structures are essential for cell division and glucose transport in the intestinal cells of parasites. As a result, the worms are unable to absorb glucose, starve, and die. Because human beta-tubulin has a different binding affinity, toxicity to human tissue is very low.

Dosage and Administration

Dosage depends on the type of worm infection:

Pinworm (Enterobius vermicularis): Single dose of 100 mg; repeat after 2–3 weeks is recommended, as eggs are not killed by the medication.
Roundworm, whipworm, hookworm: 100 mg twice daily for 3 days, or a single dose of 500 mg.

Mebendazole is available as tablets and chewable tablets. They may be swallowed or chewed. In cases of pinworm infection, it is recommended to treat all household members simultaneously to prevent reinfection.

Side Effects

Mebendazole is generally well tolerated. Possible side effects include:

Abdominal pain or cramps
Nausea and vomiting
Diarrhea
Headache
Skin reactions (rare)
Elevated liver enzymes with prolonged use (rare)

In cases of heavy worm burden, symptoms may temporarily worsen at the start of treatment as dying worms release irritants.

Contraindications and Precautions

Known hypersensitivity to mebendazole or other benzimidazoles
Pregnancy (especially the first trimester): use only after careful benefit-risk assessment
Children under 1 year of age: not recommended due to limited data
Caution in patients with chronic liver disease

Drug Interactions

Mebendazole may interact with the following substances:

Cimetidine: May increase mebendazole plasma levels by inhibiting hepatic metabolism
Metronidazole: Combination may increase the risk of Stevens-Johnson syndrome (rare)
Phenytoin / Carbamazepine: May reduce mebendazole levels through CYP enzyme induction

References

World Health Organization (WHO): WHO Model Formulary 2023 – Anthelmintics. Geneva: WHO Press.
Brunton, L.L. et al.: Goodman & Gilman's The Pharmacological Basis of Therapeutics, 13th edition. McGraw-Hill Education, 2018.
European Medicines Agency (EMA): Mebendazole – Summary of Product Characteristics. Amsterdam: EMA, 2022.

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