Description:
Round, flat-cylindrical tablets from white to light yellow in color with a chamfer and a score.
Pharmacotherapeutic group:
anthelmintic agent.
ATX code:
P02CA01
Pharmacological properties
Pharmacodynamics:
Broad-spectrum anthelmintic drug; most effective against Enterobius
vermicularis , Trichuris trichura , Ascaris lumbricoides , Ancylostoma duodenale , Necator americanus , Strongyloides stercoralis , Taenia solium , Echinococcus granulosus , Echinococcus multilocularis , Trichinella spiralis , Trichinella nativa , Trichinella nelsoni
. Causing an irreversible disruption of glucose utilization, it depletes glycogen reserves in the tissues of helminths, prevents the synthesis of cellular tubulin, and also inhibits the synthesis of adenosine triphosphate (ATP).
Pharmacokinetics:
Practically not absorbed in the intestines. After taking the drug at a dose of 100 mg twice a day for three consecutive days, the plasma concentration of mebendazole and its metabolite (2-amino derivative) does not exceed 0.03 mcg/ml and 0.09 mcg/ml, respectively. Communication with plasma proteins – 90%. It is unevenly distributed throughout the organs, accumulates in adipose tissue, liver, and helminth larvae. In the liver it is metabolized to a 2-amino derivative, which does not have anthelmintic activity. The half-life is 2.5-5.5 hours. More than 90% of the dose is eliminated unchanged through the intestines. The absorbed part (5-10%) is excreted by the kidneys.
Preparations of other chemical groups
Pyrantela pamoate
Pyrimidine derivative. Active only against round helminths.
Mechanism of action
Pyrantel pamoate acts against helminths as a depolarizing muscle relaxant, causing the development of neuromuscular blockade.
Activity spectrum
Roundworms, pinworms, hookworms and some other nematodes.
Pharmacokinetics
Poorly absorbed from the gastrointestinal tract. Excreted primarily in feces (less than 15% in urine).
Adverse reactions
Gastrointestinal tract:
abdominal pain, anorexia, nausea, vomiting, diarrhea.
CNS:
headache, dizziness, drowsiness.
Leather:
rash.
Indications
Ascariasis.
Enterobiasis.
Ankylostomiasis.
Contraindications
Hypersensitivity to pyrantel.
Pregnancy.
Lactation.
Warnings
Pregnancy.
There have been no adequate safety studies in humans. Use during pregnancy is not recommended.
Lactation.
There have been no adequate safety studies in humans. Use during breastfeeding is not recommended.
Liver dysfunction.
In case of liver pathology, it should be used with caution.
Drug interactions. Cannot be combined with piperazine due to antagonism.
Patient Information
Pyrantel can be taken orally at any time of the day, during meals or on an empty stomach.
Strictly follow the treatment regimen and regimen throughout the course of therapy.
Do not take laxatives.
Consult your doctor if improvement does not occur within a few days or if new symptoms appear.
In case of enterobiasis, all people living together should be treated.
Diethylcarbamazine
Piperazine derivative. Used for the treatment of filariasis - systemic infestations by filamentous roundworms that parasitize primarily in the lymphatic system.
Mechanism of action
Diethylcarbamazine disrupts the function of the neuromuscular system of helminths, causing their death.
Activity spectrum
Acts on larval stages (microfilariae) and adult forms of Brugia malaya, Wuchereria bancrofti, Loa loa,
Onchocerca volvulus
, etc.
Pharmacokinetics
Well absorbed from the gastrointestinal tract, as well as through the skin and conjunctiva of the eye. Distributed into many tissues. Partially metabolized, excreted by the kidneys. The half-life is 8 hours. As urine acidity increases, excretion accelerates.
Adverse reactions
Leather:
rash, itching, swelling (usually on the face).
Gastrointestinal tract:
more often nausea and vomiting.
Severe toxicoallergic reactions
with involvement of the central nervous system, development of encephalitis, coma; fatal outcomes have been described (in patients with loiasis due to massive death of microfilariae). Prevention and assistance measures: use of glucocorticoids.
Eyes:
visual impairment, up to its complete loss (with onchocerciasis). Preventive measures: strict ophthalmological control.
Other:
cough, eosinophilic infiltrate, lymphadenopathy, enlarged liver, spleen.
Indications
Lymphatic filariasis:
Brugioz; wuchereriosis.
Loiasis.
Onchocerciasis.
Contraindications
Hypersensitivity to diethylcarbamazine.
Pregnancy.
Lactation.
Age up to 6 years.
Cardiovascular diseases in the stage of decompensation.
Warnings
Pregnancy.
There have been no adequate safety studies in humans. Use during pregnancy is not recommended.
Lactation.
There have been no adequate safety studies in humans. Use during breastfeeding is not recommended.
Pediatrics.
Adequate safety studies have not been conducted in children under 6 years of age, so the use of the drug in this age group is not recommended. In other groups it is necessary to use with caution, weighing the possible benefits and risks.
Geriatrics.
It should be used with caution, weighing the possible benefits against the risks.
Renal dysfunction.
In patients with impaired renal function, the excretion of diethylcarbamazine may be impaired and the risk of developing toxic effects may be increased. Must be used with caution.
Drug interactions
Renal excretion of diethylcarbamazine can be enhanced when combined with drugs that lower urine pH (ammonium chloride) and, conversely, weakened when combined with drugs that increase urine pH (sodium bicarbonate, etc.).
Patient Information
Strictly follow the regimen and treatment regimen throughout the course of therapy, do not miss a dose and take it at regular intervals. If you miss a dose, take it as soon as possible; do not take if it is almost time for the next dose; do not double the dose. Maintain the duration of therapy.
Consult your doctor if improvement does not occur within a few days or if new symptoms appear.
Niclosamide
Salicylanilide derivative. Used for infestations of tapeworms, which parasitize the intestines. Ineffective against extraintestinal cestodes, such as cysticercosis and echinococcosis.
Mechanism of action
Niclosamide has a paralytic effect against helminths and reduces their resistance to proteolytic enzymes of the gastrointestinal tract.
Activity spectrum
Active against bovine tapeworm, dwarf tapeworm, broad tapeworm and some other cestodes.
Pharmacokinetics
Practically not absorbed into the gastrointestinal tract. Excreted in feces.
Adverse reactions
Usually well tolerated, adverse reactions occur rarely.
Gastrointestinal tract:
abdominal pain or discomfort, nausea.
Eyes:
photophobia.
Leather:
itching
Indications
Teniarinhoz.
Diphyllobothriasis.
Hymenolepidosis.
Contraindications
Hypersensitivity to niclosamide.
Pregnancy.
Peptic ulcer of the stomach or duodenum.
Anemia.
Cautions
Niclosamide should not be used for taeniasis, as there is a risk of subsequent development of cysticercosis.
Pregnancy.
There have been no adequate safety studies in humans. Use during pregnancy is not recommended.
Lactation.
There have been no adequate safety studies in humans. Use during breastfeeding is not recommended.
Drug interactions
There are no data on drug interactions with niclosamide.
Patient Information
Strictly follow the treatment regimen and regimen.
On the day of taking the drug, liquid, easily digestible food is recommended; After taking the drug, you should take a laxative.
Consult your doctor if improvement does not occur within a few days or if new symptoms appear.
Praziquantel
An isoquinoline derivative with a wide spectrum of anthelmintic activity. It is used for trematodes and cestodes.
Mechanism of action
Causes a generalized contraction of the muscles of helminths, which turns into persistent paralysis, which leads to their death.
Activity spectrum
Trematodes: Clonorchis sinensis
,
Opistorchis felineus
, etc. Schistosomes:
S.haematobium, S.mansoni, S.japonicum
, etc. Cestodes: pork tapeworm, bovine tapeworm, dwarf tapeworm, broad tapeworm, etc.
Pharmacokinetics
Well absorbed from the gastrointestinal tract, bioavailability does not depend on food. The maximum concentration in the blood develops after 1–3 hours. Approximately 80% binds to plasma proteins.
Distributed into many tissues and organs. Passes through the BBB, the concentration in the CSF is 14–20% of the level in the blood plasma. Passes into breast milk. Metabolized in the liver, excreted by the kidneys (99% in inactive form). The half-life is 1–1.5 hours.
Adverse reactions
They are usually mild and temporary.
Gastrointestinal tract:
feeling of discomfort in the abdomen, nausea, vomiting, loose stools.
>CNS (more often with cerebral cysticercosis): headache, dizziness, drowsiness, disorientation, increased intracranial pressure, convulsions.
Symptoms of hypersensitivity:
skin itching, urticaria, fever (may be associated with the antigenic influence of dead helminths).
Indications
Trematodoses:
opisthorchiasis; clonorchiasis; paragonimiasis; schistosomiasis.
Cestodoses:
teniarinhoz; taeniasis; diphyllobothriasis; hymenolepiasis; cysticercosis.
Contraindications
Hypersensitivity to praziquantel.
Pregnancy.
Lactation.
Cysticercosis of the eye.
Age up to 4 years.
Liver lesions not associated with helminthiasis.
Warnings
Pregnancy.
There have been no adequate safety studies in humans. Use during pregnancy is not recommended.
Lactation.
Passes into breast milk. There have been no adequate safety studies in humans. Use during breastfeeding is not recommended.
Pediatrics.
Adequate safety studies have not been conducted in children under 4 years of age, so use in this age group is not recommended.
Liver dysfunction.
Due to the fact that praziquantel is metabolized in the liver, in patients with impaired liver function, accumulation of the drug and an increased risk of developing HP are possible. It is not recommended for use in case of liver pathology not associated with helminthiasis.
Diseases of the central nervous system. The risk of neurotoxic reactions, including the development of seizures, increases. Should be prescribed with caution.
Drug interactions
Inducers of cytochrome P-450 (phenytoin, carbamazepine, etc.) and dexamethasone reduce the concentration of praziquantel in the blood.
Cimetidine may increase the concentration of praziquantel in the blood.
Chloroquine reduces the bioavailability of praziquantel.
Patient Information
Take orally during meals with a small amount of water. Do not take laxatives.
Strictly follow the treatment regimen and regimen.
During the treatment period, refrain from engaging in activities that require increased concentration and reaction speed.
Use caution if you experience dizziness.
Consult your doctor if improvement does not occur within a few days or if new symptoms appear.
Ivermectin
Semi-synthetic macrocyclic lactone obtained from the soil actinomycete Streptomyces avermiсtilis
. As an anthelmintic drug it is used for some filariasis and strongyloidiasis. It is also used to treat scabies. Currently not registered in Russia.
Mechanism of action
Ivermectin enhances inhibitory GABAergic processes in the nervous system of helminths, which leads to their immobilization and death.
Activity spectrum
Effective against microfilariae Onchocerca volvulus, Wuchereria bancrofti,
as well as strongyloides
(Strongilloides stercoralis)
, which has an intestinal localization.
In addition, the scabies mite ( Sarcoptes scabiei
) is sensitive to ivermectin.
Pharmacokinetics
Oral bioavailability varies among individuals. The maximum concentration in the blood develops after approximately 4 hours. It is characterized by a high degree of binding to plasma proteins (93%).
It is distributed into many tissues and passes into breast milk in small quantities. Does not pass through the BBB. Metabolized in the liver, excreted mainly in feces. The half-life is 12–16 hours.
Adverse reactions
They are more often observed and are more pronounced during the treatment of patients with onchocerciasis (caused by the breakdown of microfilariae; they are usually milder than those observed when using diethylcarbamazine).
Allergic reactions:
fever, lymphadenopathy, skin rash, itching, swelling, hypotension.
Eyes:
conjunctivitis, eyelid edema, anterior uveitis, keratitis, chorioretinitis. Prevention and assistance measures: administration of glucocorticoids.
In the treatment of strongyloidiasis, ADRs are relatively rare and have a milder course.
CNS:
general weakness, dizziness, tremor.
Gastrointestinal tract:
abdominal discomfort, nausea.
Leather:
rash, itching.
Indications
Onchocerciasis.
Lymphatic filariasis:
Brugioz;
wuchereriosis.
Strongyloidiasis.
Scabies.
Contraindications
Hypersensitivity to ivermectin.
Children under 5 years old.
Warnings
Pregnancy.
There have been no adequate safety studies in humans. It should be prescribed with caution, weighing the possible benefits and risks.
Lactation.
Passes into breast milk in small quantities. There have been no adequate safety studies in humans. It should be prescribed with caution, weighing the possible benefits and risks.
Pediatrics.
Adequate safety studies have not been conducted in children under 5 years of age, so use in this age group is not recommended.
Geriatrics.
Given age-related changes in liver function and the possible presence of concomitant diseases, it should be prescribed with caution.
Liver dysfunction.
Due to the fact that ivermectin is metabolized in the liver, in patients with impaired liver function, accumulation of the drug and an increased risk of developing HP are possible.
Diseases of the central nervous system.
The risk of neurotoxic reactions increases, especially in patients with epilepsy and meningitis. Should be prescribed with caution.
Drug interactions
There are no data on drug interactions with ivermectin.
Patient Information
Strictly follow the treatment regimen and regimen.
Use caution if you experience dizziness.
Consult your doctor if improvement does not occur within a few days or if new symptoms appear.
Table. Antihelminthic drugs. Main characteristics and application features
| Levamisole | Table 0.05 g and 0.15 g | ND | 3–4 | Orally Adults: for ascariasis - 0.15 g once; for enterobiasis - two doses of 0.15 g with an interval of 7-10 days. Children: for ascariasis 2.5 mg/kg once; for enterobiasis - two doses of 2.5 mg/kg with an interval of 7–10 days | Has a narrow spectrum of activity. Used for ascariasis (one dose) and enterobiasis. Well absorbed from the gastrointestinal tract. Generally well tolerated. Contraindicated during pregnancy and breastfeeding |
| Mebendazole | Table 0.1 g | 5–10 | 2,5–5,5 | Orally Adults: for ascariasis – 0.1 g/day for 3 days; for enterobiasis - 0.1 g once; for hookworm - 0.1 g every 12 hours for 3 days; for trichocephalosis - 0.1 g every 12 hours for 3–6 days; for trichinosis - 0.1–0.2 g every 8 hours for 1–2 weeks; for echinococcosis - in the first 3 days 0.5 g every 12 hours, in the next 3 days 0.5 g every 8 hours, then 25-30 mg/kg/day in 3-4 doses for 15-24 months (taking into account portability). Children: 2–3 years old - single dose 0.025 g; 3–7 years - 0.05 g; over 7 years - 0.1 g; Application regimens are the same as for adults | Has a wide spectrum of antinematode activity. Acts on some cestodes. It is absorbed worse from the gastrointestinal tract than levamisole. Contraindicated in children under 2 years of age, during pregnancy, breastfeeding and severe intestinal damage. |
| Albendazole | Table 0.2 g | ND | 10-15 | Orally Adults and children over 2 years of age: for ascariasis and enterobiasis - 0.2-0.4 g once; for hookworm - 0.4 g/day for 3 days; for strongyloidiasis - 0.4–0.8 g every 12–24 hours for 3–5 days; for trichocephalosis - 0.4 g/day for 1–3 days; for trichinosis - 10 mg/kg/day in 3 divided doses for 7–10 days; for toxocariasis - 10 mg/kg/day in 3 divided doses for 10–20 days; for echinococcosis - 10–20 mg/kg/day in 2–3 doses for several months (2–3 cycles) | Compared to mebendazole, it has a wider spectrum of activity and a longer half-life. Poorly absorbed from the gastrointestinal tract. Contraindicated in children under 2 years of age, during pregnancy, breastfeeding, and retinopathy. |
| Preparations of other chemical groups | |||||
| Pyrantela pamoate | Table 0.125 g; 0.25 g Susp. for oral administration 0.125 g / 2.5 ml in a bottle. 15 ml each | ND | ND | Orally Adults: for ascariasis - 10 mg/kg once; for hookworm - 10 mg/kg/day for 3 days; for enterobiasis - 2 doses of 10 mg/kg with an interval of 1 week. Children: up to 2 years - single dose 62.5 mg; 2–6 years - 0.125 g; 6–12 years - 0.25 g; 12–15 years - 0.375 g; Application regimens are the same as for adults | Active only against nematodes. Poorly absorbed from the gastrointestinal tract. Contraindicated during pregnancy and breastfeeding |
| Diethylcarbamazine | Table 0.05 g; 0.1 g | ND | 8 | Orally Adults and children over 6 years of age: 6 mg/kg/day in 3 divided doses for 10–28 days | Well absorbed from the gastrointestinal tract. Used for filariasis. In patients with loiasis it can cause severe toxic-allergic reactions caused by massive death of microfilariae. With onchocerciasis, visual disturbances, including complete blindness, are possible. Contraindicated in children under 6 years of age, during pregnancy and breastfeeding |
| Niclosamide | Table 0.25 g | ND | ND | Orally Adults: 2.0-3.0 g once Children: over 2 years - 0.5 g, 2-5 years - 1.0 g; 6–12 years – 1.5 g, once | Used for cestodiasis. Practically not absorbed into the gastrointestinal tract. Well tolerated. Contraindicated in pregnancy, anemia, gastric and duodenal ulcers |
| Praziquantel | Table 0.6 g | 80 | 1–1,5 | Orally Adults and children over 4 years of age: for opisthorchiasis, clonorchiasis and paragonimiasis - 75 mg/kg/day in 3 divided doses for 1 day; for schistosomiasis - 40–75 mg/kg/day in 2–3 doses for 1 day; for hymenolepidosis - 2 doses of 20–25 mg/kg with an interval of 10 days; for other cestodes - 20–25 mg/kg once | It is used for trematodes and cestodes. Well absorbed from the gastrointestinal tract. Generally well tolerated. Contraindicated in children under 4 years of age, during pregnancy, breastfeeding and ocular cysticercosis. |
| Ivermectin* | Table 0.006 g | ND | 12 | Orally Adults and children over 5 years of age: for helminthiasis - 0.15–0.2 mg/kg once; for scabies - 0.2 mg/kg once | It is used for filariasis, strongyloidiasis and scabies. Patients with onchocerciasis often experience allergic reactions caused by massive decay of microfilariae (less severe than when using diethylcarbamazine). Contraindicated in children under 5 years of age |
*Not registered in Russia
Directions for use and doses
Inside with a small amount of water.
Adults and children over 3 years old.
For enterobiasis - once 100 mg/day (1 tablet); course of treatment is 1 day. Since reinfection with enterobiasis occurs quite often, treatment should be repeated after 2 and 4 weeks.
It is recommended to treat all family members simultaneously.
For ascariasis, trichuriasis, hookworm and mixed helminthiasis: 200 mg/day (1 tablet in the morning, 1 tablet in the evening); course of treatment is 3 days.
For taeniasis, strongyloidiasis. Adults: 400 mg/day (2 tablets in the morning, 2 tablets in the evening); course of treatment is 3 days. Children over 3 years old: 200 mg/day (1 tablet in the morning, 1 tablet in the evening); course of treatment is 3 days.
For echinococcosis. Adults and children over 14 years of age: in the first three days, 500 mg 2 times a day, in the next 3 days the dose is increased to 500 mg 3 times a day; subsequently the dose is increased to 1000-1500 mg 3 times a day. The average duration of treatment for echinococcosis caused by Echinococcus granulosis is 4-6 weeks, and up to two years for those caused by Echinococcus multilocularis.
For trichinosis, on the 1st day 3 times a day, 200-300 mg, on the 2nd day, 4 times a day, 200-300 mg, and from days 3 to 14 – 3 times a day, 500 mg.
Side effect
Allergic reactions: skin rash, urticaria, angioedema, Steven-Johnson syndrome, toxic epidermal necrolysis, exanthema, anaphylactic and anaphylactoid reactions.
From the hematopoietic organs: neutropenia.
From the digestive system: nausea, vomiting, abdominal pain, diarrhea, increased activity of liver transaminases, alkaline phosphatase, hepatitis (when used in high doses for a long time).
From the nervous system: dizziness, headache, drowsiness, convulsions.
From the urinary system: hypercreatininemia, glomerulonephritis (when used in high doses for a long time).
Other: hair loss (when used in high doses for a long time).
Special instructions for the use of the drug Mebendazole
When using mebendazole, no diet or laxatives are required. During pregnancy, especially in the first trimester, mebendazole should be used only if the expected therapeutic effect outweighs the possible risk. If it is necessary to prescribe mebendazole during lactation, breastfeeding should be interrupted. Children under the age of 1 year are prescribed only if, against the background of helminthic infestation, the digestion process significantly worsens and physical development slows down.
special instructions
The drug contains lactose, therefore this drug is contraindicated in patients with rare hereditary lactose intolerance, lactase deficiency or impaired glucose/galactose absorption.
In patients with diabetes mellitus, it is necessary to monitor the concentration of glucose in the blood plasma.
With long-term use, it is necessary to monitor the peripheral blood picture, liver and kidney function.
During the day after administration, it is prohibited to consume ethanol, fatty foods, or take laxatives.
Periodic examination of smears of the anal area and feces after completion of treatment is mandatory: therapy is considered effective if there are no helminths or their eggs within the next 7 days.
The results of a study on the development of Steven-Johnson syndrome and toxic epidermal necrolysis indicate a possible connection between their occurrence and the simultaneous use of mebendazole and metronidazole. There are no other data documenting cases of such drug interactions. That is why the simultaneous use of mebendazole and metronidazole should be avoided.
Mebendazole Grindeks tablets 100 mg No. 6x1
Name
Mebendazole Grindeks tablet 100 mg in blister pack No. 6x1
Description
6 tablets in a blister made of aluminum foil and polyvinyl chloride film. 1 blister along with instructions for medical use of the drug in a cardboard pack. text
Main active ingredient
Mebendazole
Release form
Pills.
Dosage
100 mg in blister pack No. 6x1
Pharmacodynamics
Mebendazole is an anthelmintic agent of the benzimidazole group with a broad spectrum of action. It is most active against intestinal nematodes; it is also effective against other helminths, their larvae and eggs. The greatest anthelmintic activity of mebendazole is observed in cases of infestation of the following helminths: Ascaris lumbricoides (98%), Ancylostoma duodenale (96%), Necator americanus (96%), Enterobius vermicularis (95%), Trichuris trichiura (68%). Mebendazole is also effective against Mansonella, Trichinella and the primary animal parasites Angiostrongylus cantonensis and Grathostoma spinigerum. Mebendazole is ineffective in cases of Echinococcus infestation. The ability of mebendazole to inhibit the activity of helminths depends on many factors, including the duration of treatment, the degree of helminth infestation, etc. The mechanism of the antihelminthic action of mebendazole is based on its ability to influence the energy processes of helminths, reducing the glucose reserve, depleting glycogen reserves in the tissues of helminths, preventing the synthesis of cellular tubulin, as well as inhibiting ATP synthesis.
Pharmacokinetics
Absorption After oral administration, about 20% of the administered dose reaches the systemic circulation due to incomplete absorption and extensive first-pass metabolism (the “first pass” effect). Maximum plasma concentrations are usually observed 2-4 hours after taking mebendazole. The simultaneous use of mebendazole with food containing fats leads to a slight increase in its bioavailability. Distribution Plasma protein binding is 90-95%. The volume of distribution is 1-2 l/kg, which indicates the distribution of mebendazole outside the blood vessels. This is supported by data obtained from patients who used mebendazole long-term (eg, 40 mg/kg/day for 3-21 months) and in whom tissue levels of mebendazole were determined. Metabolism After oral administration, mebendazole is metabolized primarily in the liver. Plasma concentrations of its main metabolites (in the form of amines and hydroxylated amino derivatives of mebendazole) are significantly higher than those of mebendazole. Impaired liver function, metabolic disorders or impaired biliary excretion may lead to increased concentrations of mebendazole in the blood plasma. Excretion Mebendazole, its conjugated forms and metabolites are partially subject to enterohepatic recirculation and are excreted in urine and bile. The half-life after oral administration in most patients is 3-6 hours. Impaired renal function does not have a significant effect on the excretion of mebendazole from the body. Pharmacokinetics at steady state With long-term use (for example, 40 mg/kg/day for 3-21 months), the plasma concentration of mebendazole and its main metabolites increases, which leads to an approximately 3-fold increase in the total systemic effect compared with a single dose. Pharmacokinetics in children under 2 years of age has not been studied; in children over 2 years of age, they are similar to pharmacokinetics in adults. Pharmacokinetics in elderly patients does not have any peculiarities.
Indications for use
Mebendazole-Grindeks tablets are used for the treatment of single or mixed gastrointestinal infestation of cestodes and nematodes, such as Enterobius vermicularis (pinworms), Trichuris trichiura (whipworm), Ascaris lumbricoides (roundworms), Ancylostoma duodenale and Necator americanus (nematodes).
Directions for use and doses
For oral use with a small amount of water. The tablet can be swallowed whole, chewed or crushed and added to food. During treatment with mebendazole there is no need to follow a diet or use laxatives. For adults and children over 2 years of age, the doses are the same. For pinworm infestation, 100 mg (1 tablet) is prescribed once. Due to the short life cycle of pinworms and the high risk of re-infection, especially in closed groups, the course of treatment should be repeated after 2 weeks. For infection with other helminths and mixed helminth infections - 100 mg in the morning and evening for 3 DAYS in a row. Treatment is repeated if, after 3 weeks, signs of helminthiasis are again detected. The drug should not be prescribed to children under 2 years of age, since its safety for young children has not been confirmed by clinical data. If you forget to take the next dose of medicine on time, wait and do it at the usual time. Do not use a double dose to replace a forgotten dose. If you have any questions about using this medicine, ask your doctor or pharmacist.
Use during pregnancy and lactation
In animal experiments, mebendazole revealed embryotoxic and teratogenic effects. The potential risk to humans is unknown and use during pregnancy is not recommended. Use during breastfeeding is not recommended as it is not known whether mebendazole is excreted into mother's milk.
Precautionary measures
To avoid repeated invasions and relapses of the disease, patients should strictly observe the rules of personal hygiene. With long-term use, it is necessary to monitor the peripheral blood picture, liver and kidney function. Within 24 hours after administration, the consumption of ethanol, fatty foods, and laxatives is prohibited. Periodic examination of smears of the anal area and feces after completion of treatment is mandatory: therapy is considered effective if there are no helminths or their eggs within the next 7 days. In rare cases, mebendazole may cause seizures in children under 2 years of age, so the use of mebendazole in children in this age group is not recommended. The use of mebendazole in very young children is only possible if pinworm infection has an obvious impact on the nutritional status and physical development of the child. The results of clinical studies indicate a possible association between the simultaneous use of mebendazole and metronidazole and the development of Stevens-Johnson syndrome/toxic epidermal necrolysis. Therefore, the simultaneous use of mebendazole and metronidazole should be avoided. The tablets contain lactose, so the use of the drug is contraindicated in patients with rare congenital galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Sunset yellow dye (E110) contained in the tablets may cause allergic reactions.
Interaction with other drugs
In therapeutic doses without exceeding the duration of treatment, mebendazole practically does not interact with other drugs. With long-term simultaneous use with cimetidine, the inactivation of mebendazole in the liver may be slowed down, as a result of which mebendazole accumulates in the body. In this case, it is recommended to determine the concentration of mebendazole in the blood plasma in order to correctly adjust the dose. The simultaneous use of mebendazole and metronidazole should be avoided (see section "Precautions").
Contraindications
Hypersensitivity to mebendazole and/or to any excipient of the drug.
Compound
One tablet contains: active substance - mebendazole 100 mg; excipients: lactose monohydrate, corn starch, povidone, sodium starch glycolate (type A), magnesium stearate, sunset yellow (E 110).
Overdose
Symptoms: in case of acute overdose, disorders of the gastrointestinal tract were observed - abdominal pain, nausea, vomiting, diarrhea, accompanied by a feeling of dizziness and headaches. When using doses significantly higher than recommended or long-term use, the following side effects have been reported in rare cases: alopecia, reversible liver dysfunction, hepatitis, agranulocytosis, neutropenia and glomerulonephritis. Treatment is symptomatic; there is no specific antidote. It is necessary to remove the drug from the stomach by inducing vomiting or performing gastric lavage, as well as taking activated charcoal.
Side effect
Due to the fact that at recommended doses mebendazole acts mainly locally on the gastrointestinal tract, side effects are rare and are usually associated with disturbances in the functioning of the gastrointestinal tract. The side effects mentioned below are in accordance with the MedDRA classification of organ systems and the frequency of occurrence: very often: (? 1/10), often: (? 1/100 to
Storage conditions
Store at a temperature not exceeding 25 °C. Keep out of the reach of children! Do not use after the expiration date stated on the package. Shelf life - 5 years.
