Almex 400 mg

Description

Indications

Almex is used for the treatment of single and mixed infestations caused by various parasitic worms, including:

• Hookworms (Ancylostoma, Necator)
• Roundworms (Ascaris lumbricoides)
• Threadworms (Enterobius vermicularis)
• Whipworms (Trichuris trichiura)
• Strongyloides
• Tapeworms
• Opisthorchi
• Hydatid disease (Echinococcosis)

Use only as directed by a registered physician.

Description

Almex belongs to the benzimidazole class of anthelmintics, effective against a wide range of nematodes and some cestodes. It is commonly used to treat intestinal nematode infections and, at higher doses, for hydatid disease. Almex has vermicidal, ovicidal, and larvicidal properties. Its primary mechanism of action involves inhibiting tubulin polymerization, leading to the destruction of cytoplasmic microtubules, which ultimately causes the death of the parasite.

Pharmacology

Albendazole, the active ingredient in Almex, is a broad-spectrum anthelmintic that works by disrupting glucose uptake in parasites, depleting their energy stores and leading to immobilization and death. This effect is largely attributed to the inhibition of tubulin polymerization in the parasite, although Albendazole also interacts with human tubulin.

Albendazole undergoes extensive metabolism, primarily in the liver, and has limited gastrointestinal absorption. The primary active metabolite, albendazole sulphoxide, retains anthelmintic activity and has a plasma half-life of approximately 8.5 hours. It is primarily excreted through urine, along with other metabolites.

Dosage & Administration

Adults & Children Over 2 Years:

• For common parasitic infections (Enterobius vermicularis, Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale, and Necator americanus): 400 mg (1 tablet or 10 ml suspension) as a single dose.
• For strongyloidiasis or tapeworm infections: 400 mg (1 tablet or 10 ml suspension) daily for three consecutive days. If symptoms persist after three weeks, a second treatment course may be necessary.

Children (1-2 years):

• A single dose of 200 mg (5 ml suspension).

Children Under 1 Year:

• Not recommended.

For Hydatid Disease (Echinococcosis):

• Patients over 60 kg: 400 mg twice daily for 28 days, taken with meals.
• Patients under 60 kg: 15 mg/kg daily, divided into two doses, with a maximum total daily dose of 800 mg.
• For cystic echinococcosis: The 28-day treatment cycle may be repeated after a 14-day break, up to a total of three cycles.
• For alveolar echinococcosis: Treatment cycles (28 days on, 14 days off) may need to continue for months or even years.
• For giardiasis: 400 mg (1 tablet or 10 ml suspension) once daily for five days.

Use only as directed by a registered physician.

Drug Interactions

No significant pharmacodynamic or pharmacokinetic interactions with Almex have been reported.

Contraindications

• Neonates: Albendazole is not typically used in neonates.
• Children: In children weighing less than 10 kg, a reduced dose of 200 mg may be considered.
• Pregnancy: Albendazole should not be used during pregnancy or in women suspected of being pregnant. There is no data on its placental transfer.
• Concurrent Diseases: No evidence suggests the need for dosage adjustments in patients with renal, hepatic, or cardiac impairment.

Side Effects

Potential side effects include:

• Gastrointestinal issues (nausea, vomiting, abdominal pain)
• Headache and dizziness
• Temporary changes in liver enzymes
• Rare cases of reversible hair loss (alopecia)
• Skin rash and fever
• Blood disorders, including leukopenia and pancytopenia
• Allergic reactions, including anaphylaxis
• Neurological effects (seizures, meningitis-like symptoms) in patients with cerebral parasitic infections

Pregnancy & Lactation

Albendazole is classified as a Category C drug by the U.S. FDA, meaning it should be avoided during pregnancy and lactation unless the benefits to the mother outweigh potential risks to the fetus.

Precautions & Warnings

• Regular blood count and liver function tests should be conducted before treatment and during each treatment cycle.
• Pregnancy should be ruled out before starting therapy.
• Almex should be administered for echinococcosis only under strict medical supervision with regular monitoring of liver enzymes, white blood cell counts, and platelet levels.

Therapeutic Class

Anthelmintic

Storage Conditions

Store in a cool, dry place, away from direct sunlight and heat. Keep out of reach of children.