[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Anthelmintics](https://durgical.com/en/pharmacology/classes/anthelmintics/) › Albendazole

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# 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](https://durgical.com/en/pharmacology/classes/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](https://www.rcsb.org/structure/7ODN) · Drag to rotate · pinch to zoom

## 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 →](https://durgical.com/en/conditions/neurocysticercosis/)
- Cystic hydatid disease (Echinococcus granulosus) of liver, lung and peritoneum [Echinococcosis (hydatid disease) →](https://durgical.com/en/conditions/echinococcosis/)
- Soil-transmitted helminthiasis (Ascaris, Trichuris, hookworms) and mass deworming [Soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis) →](https://durgical.com/en/conditions/soil-transmitted-helminthiasis/)
- Strongyloidiasis, as an alternative to ivermectin [Strongyloidiasis →](https://durgical.com/en/conditions/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

### Serious (rare, important)

- Bone marrow depression, including aplastic anaemia, with fatal cases
- Hepatitis and acute liver failure
- In neurocysticercosis: seizures and raised intracranial pressure from inflammation as cysts die
- Retinal damage if there are cysticerci in the eye
- Stevens-Johnson syndrome (rare)

## 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.

## Memory aid

ALBENdazole «ALBum of fat»: with a fatty meal it is absorbed and reaches cysts and brain; check marrow and liver every two weeks.

## 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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## Related drugs

- [Mebendazole](https://durgical.com/en/pharmacology/mebendazole/)
- [Praziquantel](https://durgical.com/en/pharmacology/praziquantel/)
- [Ivermectin](https://durgical.com/en/pharmacology/ivermectin/)

## Related conditions

- [Neurocysticercosis](https://durgical.com/en/conditions/neurocysticercosis/)
- [Echinococcosis (hydatid disease)](https://durgical.com/en/conditions/echinococcosis/)
- [Soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis)](https://durgical.com/en/conditions/soil-transmitted-helminthiasis/)
- [Strongyloidiasis](https://durgical.com/en/conditions/strongyloidiasis/)

[← Back to the class: Anthelmintics](https://durgical.com/en/pharmacology/classes/anthelmintics/)

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](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6c48fd89-cb40-477c-8a78-15cbe0df6faa) (DailyMed (U.S. National Library of Medicine), 2026); [Clinical Care of Cysticercosis](https://www.cdc.gov/cysticercosis/hcp/clinical-care/index.html) (Centers for Disease Control and Prevention (CDC), 2024); [Soil-transmitted helminth infections](https://www.who.int/news-room/fact-sheets/detail/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.

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