Albendazole interactions

Food & lifestyle

• grapefruit juice

  Moderate

  Metabolism

  Food enhances the oral bioavailability of albendazole, which is rapidly converted by hepatocytes and intestinal mucosal cells into the active metabolite, albendazole sulfoxide (ABZSX), following absorption. The proposed mechanism is stimulation of gastric acid secretion, as the absorption of albendazole is thought to be pH-dependent. According to the product labeling, plasma concentrations of ABZSX are up to 5-fold higher on average when albendazole is administered with a fatty meal (fat content approximately 40 g) compared to administration in the fasted state.

  What to do: To ensure maximal oral absorption, albendazole should be taken with food. Grapefruit juice may also enhance the oral bioavailability of albendazole.

  3 sources

  1. Awadzi K, Hero M, Opoku NO, Buttner DW, Coventry PA, Prime MA, Orme ML, Edwards G "The chemotherapy of onchocerciasis XVII. A clinical evaluation of albendazole in patients with onchocerciasis; effects of food and pretreatment with ivermectin on drug response and pharmacokinetics." Trop Med Parasitol 45 (1994): 203-8
  2. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):
  3. Nagy J, Schipper HG, Koopmans RP, Butter JJ, van Boxtel CJ, Kager PA "Effect of grapefruit juice or cimetidine coadministration on albendazole bioavailability." Am J Trop Med Hyg 66 (2002): 260-3

• high-fat foods

  Moderate

  Absorption

  Food enhances the oral bioavailability of albendazole, which is rapidly converted by hepatocytes and intestinal mucosal cells into the active metabolite, albendazole sulfoxide (ABZSX), following absorption. The proposed mechanism is stimulation of gastric acid secretion, as the absorption of albendazole is thought to be pH-dependent. According to the product labeling, plasma concentrations of ABZSX are up to 5-fold higher on average when albendazole is administered with a fatty meal (fat content approximately 40 g) compared to administration in the fasted state.

  What to do: To ensure maximal oral absorption, albendazole should be taken with food. Grapefruit juice may also enhance the oral bioavailability of albendazole.

  3 sources

  1. Awadzi K, Hero M, Opoku NO, Buttner DW, Coventry PA, Prime MA, Orme ML, Edwards G "The chemotherapy of onchocerciasis XVII. A clinical evaluation of albendazole in patients with onchocerciasis; effects of food and pretreatment with ivermectin on drug response and pharmacokinetics." Trop Med Parasitol 45 (1994): 203-8
  2. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):
  3. Nagy J, Schipper HG, Koopmans RP, Butter JJ, van Boxtel CJ, Kager PA "Effect of grapefruit juice or cimetidine coadministration on albendazole bioavailability." Am J Trop Med Hyg 66 (2002): 260-3

Conditions

Conditions in which Albendazole needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  Reversible leukopenia has been reported during albendazole therapy. Rarely, granulocytopenia or pancytopenia have resulted in death. Therapy with albendazole should be administered cautiously in patients with predisposition to myelosuppression. Clinical monitoring of hematopoietic function prior to each cycle of albendazole and every two weeks during therapy is recommended. Albendazole can be continued with a modest, non- progressive decrease in leukocyte count and absolute neutrophil count.

  2 sources

  1. Fernandez FJ, Rodriguezvidigal FF, Ledesma V, Cabanillas Y, Vagace JM "Aplastic anemia during treatment with albendazole." Am J Hematol 53 (1996): 53-4
  2. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):

• Kidney Diseases

  Moderate

  The pharmacokinetics of albendazole in patients with impaired renal function have not been studied. Caution is advised if used in these patients.

  1 source

  1. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):

• Liver Diseases

  Moderate

  Albendazole is converted to its biologically active metabolite and further metabolized to an inactive form by the liver. Biliary excretion of albendazole is the primary route of elimination and biliary obstruction results in increased albendazole serum concentration and AUC. Metabolism and therapeutic activity may be altered in patients with hepatic impairment. Elevated liver transaminase levels have been reported in 16% of patients receiving albendazole. Therapy with albendazole should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of hepatic function is recommended prior to initiation of each cycle of albendazole and at least every two weeks during therapy. Patients with elevated liver enzyme test results are at increased risk for hepatotoxicity and bone marrow suppression. Discontinue therapy if liver enzymes are significantly increased or if a clinically significant decrease in blood cell counts occur.

  3 sources

  1. Choudhuri G, Prasad RN "Jaundice due to albendazole." Indian J Gastroenterol 7 (1988): 245-6
  2. Marriner SE, Morris DL, Dickson B, Bogan JA "Pharmacokinetics of albendazole in man." Eur J Clin Pharmacol 30 (1986): 705-8
  3. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):

• Neurologic Manifestations

  Moderate

  Albendazole therapy of neurocysticercosis can induce an inflammatory response within the CNS that precipitates seizures and cerebral hypertension. Therapy with albendazole for neurocysticercosis should be administered cautiously in patients with or predisposition to seizures. The use of corticosteroids during the first week of therapy to prevent cerebral hypertension and anticonvulsant therapy as required is recommended.

  2 sources

  1. Cruz I, Cruz ME, Carrasco F, Horton J "Neurocysticercosis: optimal dose treatment with albendazole." J Neurol Sci 133 (1995): 152-4
  2. "Product Information. Albenza (albendazole)." SmithKline Beecham (2001):