mebendazole: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
mebendazole: clinical details
Prescribing considerations
- Confirm the likely worm and select a product whose licence covers that infection.
- Selected products are not recommended below age two; use in very young children requires careful individual benefit–risk assessment, and selected product information states they should not be used below age one.
- Reconcile the product-information pregnancy contraindication with independent UK pregnancy evidence through an individual benefit–risk discussion.
- Review metronidazole and cimetidine use and check formulation-specific excipients.
Contraindications and cautions
- Hypersensitivity to mebendazole or a formulation component.
- Pregnancy according to selected product information.
- Sucrose-containing suspensions should not be used in certain hereditary disorders of fructose or carbohydrate absorption.
Monitoring
- Routine laboratory monitoring is not specified for usual licensed intestinal use.
- Investigate symptoms suggesting liver injury, neutropenia or another serious reaction.
- Prolonged or substantially excessive exposure has been associated with agranulocytosis and glomerulonephritis.
Clinical pharmacology
Mebendazole inhibits helminth glucose uptake, depleting glycogen and ATP. Oral absorption is low because of incomplete absorption and extensive first-pass metabolism; hepatic impairment or inhibited metabolism may increase systemic exposure.
Formulation and product differences
- Selected Ovex tablets and suspension are licensed for threadworm only; selected Vermox formulations cover a broader range of gastrointestinal helminths.
- Tablets may be chewed, swallowed or crushed for a young child; suspension may suit people unable to swallow tablets.
- Suspensions contain sucrose and parabens; selected Ovex suspension also contains a small amount of propylene glycol. Tablet excipients differ by product.
mebendazole preparations and strengths
Oral suspension
Route: Oral
Strengths: 100 mg/5 mL
Tablet
Route: Oral
Strengths: 100 mg
mebendazole interactions
Check current medicines before supplying or prescribing mebendazole.
Metronidazole
Avoid concurrent use because a possible association with severe blistering skin reactions has been reported.
Cimetidine
May reduce hepatic metabolism of mebendazole and increase its plasma concentration.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.