Practical information on using benzimidazoles

The benzimidazoles, albendazole and mebendazole, are predominantly used to treat intestinal worm infections, such as roundworm (Ascaris lumbricoides), threadworm (or pinworm) (Enterobius vermicularis), hookworm (Ancylostoma duodenale and Necator americanus), dog hookworm (Ancylostoma caninum), whipworm (Trichuris trichiura) and strongyloidiasis (Strongyloides stercoralis). Albendazole is also used for community deworming programs.

Albendazole has some specific uses; for example, it is used to treat hydatid disease (Echinococcus species of tapeworm) in conjunction with surgery or percutaneous drainage, and neurocysticercosis (in those with active cysts) in conjunction with corticosteroids. It is also used as an alternative to ivermectin to treat cutaneous larva migrans.

For treating systemic infections and intestinal worm infections that can cause invasive disease, albendazole should be taken with a fatty meal to improve absorption. In contrast, for treating other intestinal worm infections, albendazole should be taken on an empty stomach to limit systemic absorption.

The main adverse effects of both albendazole and mebendazole are elevated liver transaminases, gastrointestinal symptoms and haematological abnormalities (eg leucopenia). Avoid albendazole in children 6 months or younger.

Triclabendazole is used to treat liver fluke (Fasciola hepatica).