Mebendazole ( MBZ), sold under the brand name Vermox among others, is a medication used to treat a number of parasitic worm infestations.[ It has been used for treatment of giardiasis but is not a preferred agent.][
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Mebendazole is usually well tolerated.[ Common side effects include headache, vomiting, and tinnitus.][ If used at large doses it may cause bone marrow suppression.][ It is unclear if it is safe in pregnancy.][
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Mebendazole came into use in 1971, after it was developed by Janssen Pharmaceutica in Belgium.
Medical use
Mebendazole is a highly effective, broad-spectrum antihelmintic indicated for the treatment of nematode infestations, including roundworm, hookworm, whipworm, threadworm (pinworm), and the intestinal form of trichinosis prior to its spread into the tissues beyond the digestive tract. Other drugs are used to treat worm infections outside the digestive tract, as mebendazole is poorly absorbed into the bloodstream.[Martin AR in Wilson and Gisvold's Textbook of Organic Medicinal and Pharmaceutical Chemistry, 8th edition, Doerge RF, ed. J.B. Lippincott, 1982, Chapter 4] It is also used rarely in the treatment of echinococcosis. Evidence for effectiveness for this disease, however, is poor.
Mebendazole and other benzimidazole antithelmetics are active against both larval and adult stages of nematodes, and in the cases of roundworm and whipworm, kill the eggs, as well. Paralysis and death of the parasites occurs slowly, and elimination in the feces may require several days.
Special populations
Mebendazole has been shown to cause ill effects in pregnancy in animal models, and no adequate studies of its effects in human pregnancy have been conducted.[Finberg R, Fingeroth J in Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo, Ed. Harrison's Principles of Internal Medicine, 18th ed., McGraw-Hill, 2012, Chapter 217.]
Adverse effects
Mebendazole sometimes causes diarrhea, abdominal pain, and elevated liver enzymes. In rare cases, it has been associated with a dangerously low white blood cell count, thrombocytopenia, and hair loss,
Drug interactions
Carbamazepine and phenytoin lower serum levels of mebendazole. Cimetidine does not appreciably raise serum mebendazole (in contrast to the similar drug albendazole), consistent with its poor systemic absorption.
Stevens–Johnson syndrome and the more severe toxic epidermal necrolysis can occur when mebendazole is combined with high doses of metronidazole.
Mechanism
Mebendazole works by effectively inhibiting the formation of [
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Poor absorption in the digestive tract makes mebendazole an efficient drug for treating intestinal parasitic infections with limited adverse effects. However, mebendazole has an impact on mammalian cells, mostly by inhibiting polymeration of tubulin dimers, thereby disrupting essential microtubule structures such as mitotic spindle.
Society and culture
Availability
Mebendazole is available as a generic medication.[ Mebendazole is distributed in international markets by Johnson and Johnson and a number of generic manufacturers.]
Economics
In the United States, mebendazole is sometimes sold at about 200 times the price of the same medication in other countries.
