Mebendazole

 Action Kills parasitic worms by blocking glucose uptake, thus depleting stored glycogen. Without glycogen, parasite cannot reproduce or survive.

 Indications Treatment of pinworm (Enterobius vermicularis), round worm (Ascaris lumbricoides), common hookworm (Ancylostoma duodenale), American hookworm (Necator americanus) and whipworm (Trichuris trichiura) in single or mixed parasitic infections.

 Contraindications Standard considerations.

 Route/Dosage

Trichuriasis, Ascariasis and Hookworm Infection

ADULTS & CHILDREN: PO 100 mg tablet AM and PM on 3 consecutive days.

Ascaris Infection

ADULTS & CHILDREN: Alternative dose: PO 500 mg as single dose.

Enterobiasis

ADULTS & CHILDREN: PO 100 mg as single dose.

 Interactions

Carbamazepine; hydantoins (eg, phenytoin): Pharmacological effects of mebendazole may be decreased.

 Lab Test Interferences None well documented.

 Adverse Reactions

GI: Transient abdominal pain and diarrhea. OTHER: Fever.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children < 2 yr not established.

 Administration/Storage

• Give with food; crush or allow patient to chew tablets if patient has difficulty tolerating ingestion.
• Store in tightly closed container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• Monitor results of stool testing prior to and 3 wk after treatment is initiated.
• Obtain baseline vital signs and monitor throughout therapy.
• Notify physician of new-onset fever after initiation of therapy and diarrhea during expulsion of worms.
• Report to physician any signs of abdominal pain with diarrhea.
• Disinfect toilet facilities, towels, bed linens, and clothing daily.
• Avoid self-contamination. Practice thorough hand washing.
• Check for infection in other family members.

 Patient/Family Education

• Advise patient to chew tablet or to crush tablet and mix with food.
• Instruct patient to wash clothing, bed linens and towels daily and to disinfect bathroom facilities daily.
• Advise that infected person sleep alone.
• Caution patient not to put fingers in mouth.
• Emphasize importance of thorough hand washing, especially after toileting, to avoid reinfecting self.
• Explain that all family members should be treated to eradicate infestation.
• Tell patient that second treatment is sometimes necessary.
• Instruct family/patient to call physician if fever, abdominal pain or diarrhea develops.