Dosage of Albendazole for Neurocysticercosis and Hydatid Disease.

Dosage of Albendazole for Neurocysticercosis and Hydatid Disease.

Cestode (Tapeworm) Infections
Neurocysticercosis. Because of its activity against the pork tapeworm (T. solium), albendazole therapy for the treatment of neurocysticercosis resulting from active lesions caused by Cysticercus cellulosae (the larval form of T. solium) has been associated with adverse CNS effects (e.g., seizures and/or hydrocephalus) resulting from inflammatory reactions to damaged intracerebral cysts. Therefore, patients receiving albendazole for the treatment of neurocysticercosis should receive appropriate corticosteroid and anticonvulsant therapy as required. Oral or IV corticosteroid therapy should be considered during the first week of albendazole treatment to prevent cerebral hypertension.

Although retinal cysticercosis is rare, patients with neurocysticercosis may have retinal lesions, and destruction of cysticercal lesions by albendazole may cause retinal damage. Therefore, patients should be examined for retinal lesions, and, if any are present, the need for treatment of patients with neurocysticercosis should be weighed against the possibility of retinal damage resulting from albendazole use.

For the treatment of neurocysticercosis in adults and children 6 years of age and older and weighing 60 kg or more, the usual dosage of albendazole is 400 mg given twice daily with meals for 8-30 days. For the treatment of neurocysticercosis in patients weighing less than 60 kg, the usual daily dosage of albendazole is 15 mg/kg daily (not to exceed 800 mg daily), administered as 2 equally divided doses with meals, for 8-30 days. Courses of therapy may be repeated as necessary.

Hydatid Disease. Surgery is considered the treatment of choice for hydatid disease, when medically feasible, and albendazole is administered either before or after surgery. When albendazole is used for the adjunctive perioperative treatment of hydatid disease, optimal killing of cyst contents is achieved by administering the drug in three 28-day courses of therapy, separated by two 14-day albendazole-free intervals.

For the treatment of cystic hydatid disease of the liver, lung, or peritoneum caused by the larval form of the dog tapeworm (Echinococcus granulosus) in adults or children 6 years of age and older and weighing 60 kg or more, the usual dosage of albendazole is 400 mg twice daily given with meals for 28 days, followed by a 14-day albendazole-free interval for a total of 3 dosage cycles. For patients weighing less than 60 kg, the usual dosage is 15 mg/kg daily (not to exceed 800 mg daily), administered in 2 equally divided doses with meals for 28 days, followed by a 14-day albendazole-free interval for a total of 3 dosage cycles. Some clinicians recommend that adults receive 400 mg of albendazole twice daily and that pediatric patients receive 15 mg/kg daily (not to exceed 800 mg daily) for 1-6 months for the treatment of hydatid cyst disease.