Thiabendazole

A to Z Drug Facts

 Action Inhibits helminth-specific enzyme fumarate reductase; suppresses egg or larval production and may inhibit subsequent development of eggs or larvae that are passed in the stool.

 Indications Treatment of strongyloidiasis (threadworm infection), cutaneous larva migrans (creeping eruption) and visceral larva migrans alone or in conjunction with enterobiasis (pinworm). Secondary therapy for uncinariasis (hookworm: Necator americanus and Ancylostoma duodenale), trichuriasis (whipworm) and ascariasis (large roundworm); alleviation of symptoms of trichinosis during invasive phase.

 Contraindications Standard considerations.

 Route/Dosage

ADULTS ³ 150 LB (68 kg): PO 1.5 g/dose bid (maximum 3 g/day). ADULTS & CHILDREN 30–150 LB (13.6–68 kg): PO 10 mg/lb/dose (22 mg/kg/dose) (maximum 3 g/day).

Strongyloidiasis, Ascariasis, Uncinariasis, Trichuriasis, Cutaneous Larva Migrans

2 doses daily for 2 successive days (may repeat for some indications).

Trichinosis

2 doses daily for 2–4 successive days.

Visceral Larva Migrans

2 doses daily for 7 successive days.

 Interactions

Xanthines: Thiabendazole may increase serum concentrations of theophylline to potentially toxic levels.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Hypotension. CNS: Dizziness; fatigue; drowsiness; giddiness; headache; numbness; hyperirritability; eizures; collapse. EENT: Tinnitus; abnormal sensation in eyes; xanthopsia; blurring of vision; rying of mucous membranes; appearance of live ascaris in mouth and nose. GI: Anorexia; nausea; vomiting; diarrhea; epigastric distress. GU: Hematuria; enuresis; malodor of urine; crystalluria. HEMA: Transient leukopenia. HEPA: Jaundice; cholestasis; parenchymal liver damage, transient rise in cephalin flocculation and AST. OTHER: Hypersensitivity reaction (pruritus, fever, facial flush, chills, conjunctival injection (red eye), angioedema, anaphylaxis, skin rashes, erythema multiforme, lymphadenopathy).

 Precautions

Pregnancy: Category C. Lactation: Unknown. Children: Safety and efficacy in children weighing < 13.6 kg (30 lb) not established. Mixed infections with Ascaris lumbricoides: Thiabendazole may cause these worms to migrate. Drug should not be used prophylactically. Supportive therapy: Anemic, dehydrated or malnourished patients may need concomitant therapy to reverse these conditions.

 Administration/Storage

• Shake suspension before administering.
• Administer with food to reduce stomach upset.
• Instruct patient to chew tablets thoroughly before swallowing.
• Store at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Monitor patient closely for signs of hypersensitivity reactions: Stevens-Johnson syndrome and erythema multiforme.
• If anemic, dehydrated or malnourished, provide supportive measures.
• If patient is taking theophylline or aminophylline, monitor theophylline serum levels; dosage adjustment may be necessary.
• Assess patient for possible hypotension after administration.
• Obtain baseline LFTs.

 Patient/Family Education

• Instruct patient to take medicine with food. No special diets are needed.
• Advise patient that all family members should be treated and that treatment may need to be repeated in 7 days to prevent reinfection.
• Instruct patient to bathe daily and to launder bedlinens, clothes and towels daily. Instruct patient on proper technique for hygiene and hand-washing.
• Advise patient to avoid consuming excessive amounts of caffeine-containing beverages, such as coffee.
• Instruct patient to inform physician immediately of any symptoms of hypersensitivity or overdosage.
• Advise patient that drug can cause drowsiness and dizziness and to use caution while driving or performing other tasks requiring mental alertness.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts