Albendazole

How it works

It binds parasite beta-tubulin, inhibiting microtubule polymerisation and impairing glucose uptake, which depletes the parasite's energy stores.

Prescribing in practice

• Can cause bone marrow suppression and hepatotoxicity, particularly with prolonged courses, so monitor blood counts and liver function.
• It is teratogenic in animals and should be avoided in pregnancy, with pregnancy excluded before treatment where appropriate.
• In neurocysticercosis, corticosteroid cover and anticonvulsant use may be needed to manage inflammatory responses, as directed by specialist guidance.

Monitoring

Monitor full blood count and liver function during prolonged or repeated treatment courses.

Counselling the patient

• Take with a fatty meal to improve absorption when treating tissue infections.
• Use effective contraception during and for a period after treatment.
• Report any fever, sore throat, jaundice or unusual tiredness.

Evidence & guidelines

Albendazole is recommended by the World Health Organization for soil-transmitted helminth control and is standard therapy for echinococcosis and neurocysticercosis.