Dosing & Uses
Dosage Forms & Strengths
tablet, chewable
- 100mg (Emverm)
- 500mg (Vermox)
Pinworm (Enterobius vermicularis)
100 mg PO as a single dose
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Roundworm (Ascaris lumbricoides)
Emverm: 100 mg PO q12hr for 3 days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox: 500 mg PO as a single dose
Whipworm (Trichuris trichiura)
Emverm: 100 mg PO q12hr for 3 consecutive days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox: 500 mg PO as a single dose
Hookworm (Ancylostoma duodenale, Necator americanus)
Emverm: 100 mg PO q12hr for 3 consecutive days; if cure is not achieved 3 wk after treatment, a second course of treatment is advised
Giardia Duodenalis (Giardiasis; Off-label)
200 mg PO q8hr for 5 days
Mansonella Perstans (Filariasis; Off-label))
100 mg PO q12hr
Visceral Larva Migrans (Toxocariasis; Off-label)
100-200 mg PO q12hr for 5 days
Dosing Considerations
Chewable tablet, see Administration for complete instructions
Dosage Forms & Strengths
tablet, chewable
- 100mg (Emverm)
- 500mg (Vermox)
Pinworm (Enterobius vermicularis)
<2 years: Safety and efficacy not established
Emverm, ≥2 years: 100 mg PO as a single dose
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Roundworm (Ascaris lumbricoides)
Emverm
- <2 years: Safety and efficacy not established
- ≥2 years: 100 mg PO q12hr for 3 days
- If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox
- <1 year: Safety and efficacy not established
- ≥1 year: 500 mg PO as a single dose
Whipworm (Trichuris trichiura)
Emverm
- <2 years: Safety and efficacy not established
- ≥2 years: 100 mg PO q12hr for 3 consecutive days
- If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Vermox
- <1 year: Safety and efficacy not established
- ≥1 year: 500 mg PO as a single dose
Hookworm (Ancylostoma duodenale, Necator americanus)
<2 years: Safety and efficacy not established
Emverm, ≥2 years: 100 mg PO q12hr for 3 consecutive days
If cure is not achieved 3 wk after treatment, a second course of treatment is advised
Dosing Considerations
Chewable tablet, see Administration for complete instructions
Interactions
Interaction Checker
No Results
Contraindicated
Serious
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious (6)
- deferiprone
deferiprone, mebendazole. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.
- ethotoin
ethotoin decreases levels of mebendazole by increasing metabolism. Contraindicated.
- fosphenytoin
fosphenytoin decreases levels of mebendazole by increasing metabolism. Contraindicated.
- metronidazole
mebendazole increases toxicity of metronidazole by Other (see comment). Avoid or Use Alternate Drug. Comment: May increase the risk for toxic epidermal necrolysis or Stevens-Johnson syndrome.
- phenytoin
phenytoin decreases levels of mebendazole by increasing metabolism. Contraindicated.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b, mebendazole. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.
Monitor Closely (2)
- acalabrutinib
acalabrutinib, mebendazole. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.
- cimetidine
cimetidine increases levels of mebendazole by decreasing metabolism. Use Caution/Monitor.
Minor (1)
- carbamazepine
carbamazepine decreases levels of mebendazole by increasing metabolism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Defined
Angioedema
Fever
Dizziness
Headache
Hematuria
Leukopenia
Seizures
Drowsiness
Decreased hemoglobin
Rash
Itching
Agranulocytosis
Alopecia (with high doses)
Abdominal pain
Diarrhea
Nausea
Toxic epidermal necrolysis
May increase AST, ALT, and GGT (hepatitis)
Stevens-Johnson syndrome
Vomiting
Neutropenia (sore throat, unusual fatigue)
Toxic epidermal necrolysis
Unusual weakness
Glomerulonephritis
Warnings
Contraindications
Hypersensitivity
Cautions
Neutropenia and agranulocytosis reported with high doses
Not effective for hydatid disease
Systemic exposure may increase with hepatic impairment
Pregnancy & Lactation
Pregnancy category: C
Lactation: Excretion in breast milk unknown; use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Blocks glucose uptake; inhibits the formation of helminth microtubules in susceptible adult intestine-dwelling helminths
Absorption
Absorption: 2-10%
Peak serum time: 2-4 hr
Distribution
Distribution: To serum, cyst fluid, liver, omental fat, and pelvic, pulmonary, and hepatic cysts; highest concentrations found in liver; relatively high concentrations found in muscle-encysted Trichinella spiralis larvae; crosses placenta
Protein bound: 90-95%
Vd: 1-2 L/kg
Metabolism
Metabolism: Extensively hepatic
Elimination
Half-life elimination: 3-6 hr
Excretion: Feces (primarily); urine (~2%)
Administration
Oral Administration
Emverm
- May take with or without food
- May be swallowed whole, chewed, or crushed and mixed with food
Vermox
- May take with or without food
- Chew tablet completely before swallowing, do not swallow tablet whole
-
Difficulty chewing tablet
- Place ~2-3 mL of drinking water in a suitably sized spoon and place 500-mg tablet into the water
- Within 2 minutes, the tablet absorbs the water and turns into a soft mass with semisolid consistency, which can then be swallowed
Storage
Emverm
- Store at 20-25ºC (68-77ºF)
Vermox
- Store <30ºC
- Keep container tightly closed
- Discard unused tablets 1 month after bottle is first opened
- When the bottle is first opened this Discard After date should be written on the bottle label in the place provided
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
