Albendazole !

Broad-spectrum benzimidazole: used for deworming against soil-transmitted helminths and, absorbed with fatty food, for neurocysticercosis and hydatid cysts.

Updated 2026-11-01

Class: Anthelmintics
Target: Helminth β-tubulin (colchicine site)
ATC code: P02CA03
WHO Model List of Essential Medicines

Helminth β-tubulin (colchicine site)Albendazole

The figure shows mebendazole, a sister benzimidazole, bound to bovine tubulin at the colchicine site; albendazole occupies that same site in worm β-tubulin, for which it has higher affinity.

Target in 3D: Helminth β-tubulin (colchicine site). PDB structure 7ODN (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

It binds the colchicine-sensitive site of worm β-tubulin and blocks microtubule formation. Without microtubules the parasite cannot take up glucose, runs out of ATP and dies. It is selective because it binds helminth tubulin more tightly than human tubulin; changes in parasite β-tubulin cause resistance. Its sulfoxide metabolite is the form that acts in tissues.

Albendazole sulfoxide reaches the worm
It binds β-tubulin at the colchicine site
No microtubules form and glucose cannot enter
The parasite runs out of ATP and dies

Pharmacokinetics

Absorption: Low and variable because of poor solubility; a fatty meal raises it several-fold
Distribution: The sulfoxide reaches cyst fluid, CSF, bile and liver
Metabolism: Rapid first pass to albendazole sulfoxide (active), then to the inactive sulfone; induces its own metabolism
Elimination: Mainly in bile; almost none in urine
Half-life: Of the sulfoxide: about 8 to 12 hours

Indications

Parenchymal neurocysticercosis due to Taenia solium, with a corticosteroid Neurocysticercosis →
Cystic hydatid disease (Echinococcus granulosus) of liver, lung and peritoneum Echinococcosis (hydatid disease) →
Soil-transmitted helminthiasis (Ascaris, Trichuris, hookworms) and mass deworming Soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis) →
Strongyloidiasis, as an alternative to ivermectin Strongyloidiasis →

Adverse effects

Common

Headache (mainly in neurocysticercosis)
Nausea, vomiting and abdominal pain
Raised transaminases (mainly in long courses for hydatid disease)
Reversible hair loss
Dizziness and fever

Contraindications

Hypersensitivity to benzimidazoles
First trimester of pregnancy
Retinal cysticerci without prior assessment
Intraventricular cysts: relative (risk of obstructive hydrocephalus), usually treated surgically

Key interactions

Dexamethasone: Raises albendazole sulfoxide levels
Praziquantel: Raises albendazole sulfoxide levels
Cimetidine: Raises the sulfoxide in bile and cyst fluid
Theophylline: Albendazole induces CYP1A: theophylline levels are monitored

What is monitored

Blood count at the start of each cycle and every two weeks
Transaminases at the start of each cycle and every two weeks
Retinal examination before treating neurocysticercosis
Neurological status, seizures and signs of raised intracranial pressure
Pregnancy test before long courses

Administration and safety

Oral with meals: fat increases absorption, which matters for tissue infections.
In neurocysticercosis it is given with a corticosteroid and an antiseizure drug; calcified cysts do not benefit from the antiparasitic.
In hydatid disease it is given in cycles with breaks between them.
Name looks like mebendazole: confirm the drug, because mebendazole does not work for hydatid disease.

Nursing care

Before: blood count, transaminases, pregnancy test and, in neurocysticercosis, fundus examination.
In neurocysticercosis: seizure precautions and watch for severe headache, vomiting or reduced consciousness.
Ask about fever, sore throat or bruising (bone marrow) and jaundice (liver).
Teaching: contraception during treatment and for a few days after; take with food; keep lab appointments.

Pregnancy and breastfeeding

Teratogenic in animals and avoided in the first trimester; WHO does include pregnant women in the second and third trimesters in deworming.

Test yourself

Think of the answer, then tap the question to see it.

Why is albendazole given with a fatty meal in neurocysticercosis?

Because fat raises its absorption several-fold, so more active sulfoxide reaches the cysts and the CSF.

Which examination is done before treating neurocysticercosis with albendazole?

A retinal examination, because inflammation as an ocular cysticercus dies can damage it.

Which serious toxicity requires blood counts during albendazole treatment?

Bone marrow depression, including aplastic anaemia, with fatal cases.

What is the active tissue metabolite of albendazole?

Albendazole sulfoxide.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: DailyMed - ALBENDAZOLE tablet (DailyMed (U.S. National Library of Medicine), 2026); Clinical Care of Cysticercosis (Centers for Disease Control and Prevention (CDC), 2024); Soil-transmitted helminth infections (World Health Organization, 2023); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 68 (McGraw Hill, 2023).

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Representative model, for educational purposes only.