Section 15 · Monograph
Albendazole
Reviewed Nov 2026FDA label
AlbenzaAnthelmintic (benzimidazole)
- Forms
- Tab: 200, 400mg
- Dose
- Neurocysticercosis: 15mg/kg/day divided twice daily with food (max 1,200mg/day) x10-14 days, with corticosteroids and antiseizure therapy
- MOA
- Binds parasite tubulin, impairing glucose uptake
Indications
- Neurocysticercosis (parenchymal) caused by Taenia solium larval formsFDA-labeled
- Hydatid disease of the liver, lung and peritoneumFDA-labeled
Mechanism of Action
- Benzimidazole that binds parasite beta-tubulin, impairing microtubule formation and glucose uptake; albendazole sulfoxide is the active metabolite
Full Dosing
Adult / usual
- Neurocysticercosis (guideline dosing): 15mg/kg/day divided twice daily with a fatty meal (max 1,200mg/day) for 10-14 days for viable parenchymal cysts; the label regimen is 400mg twice daily (60kg or more) or 15mg/kg/day (under 60kg, max 800mg/day) for 8-30 days
- Combine with praziquantel for multiple (more than 2) viable cysts
- Give corticosteroids (dexamethasone 0.1mg/kg/day or prednisone 1mg/kg/day) beginning before or with treatment, and antiseizure medication, to limit inflammation from dying cysts
Contraindications
- Hypersensitivity to albendazole or other benzimidazoles
Drug Interactions
- Dexamethasone and cimetidine raise albendazole sulfoxide levels
- Carbamazepine, phenytoin and phenobarbital lower levels
- Praziquantel increases albendazole sulfoxide exposure
Adverse Effects
- Elevated transaminases and hepatotoxicity
- Headache, nausea, abdominal pain
- Neutropenia and pancytopenia (rare)
- Transient intracranial hypertension and seizures from inflammation around dying cysts
Monitoring Parameters
- Liver enzymes and CBC at baseline and every 2 weeks
- Neuroimaging response; intracranial pressure symptoms
- Seizure control and ophthalmologic exam before therapy to exclude retinal cysts
Pregnancy & Lactation
- Avoid in pregnancy (teratogenic in animals); effective contraception required during and for 1 month after treatment
- Present in milk in small amounts