mebendazole (Rx)

Brand and Other Names:Emverm, Vermox
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and mebendazole

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (5)

              • 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.

              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.

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              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

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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

              Neutropenia and agranulocytosis reported with high doses

              Not effective for hydatid disease

              Systemic exposure may increase with hepatic impairment

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              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.

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              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%)

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              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

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Emverm oral
              -
              100 mg chewable tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              mebendazole oral

              MEBENDAZOLE CHEWABLE TABLET - ORAL

              (meh-BEN-duh-zole)

              COMMON BRAND NAME(S): Emverm, Vermox

              USES: Mebendazole is used to treat intestinal worm infections such as pinworm, roundworm, and hookworm.

              HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking mebendazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor. It may be chewed, swallowed whole, or crushed and mixed with food. The dosage is based on your medical condition and response to treatment.For treatment of pinworm infections, the medication is usually given as a single dose. If necessary, a second treatment may be given in a few weeks. For other types of common worm infections (e.g., roundworm, hookworm), take mebendazole by mouth as directed by your doctor, usually twice a day (in the morning and in the evening) for 3 days. If necessary, a second treatment may be given in a few weeks. For other types of infections, follow your doctor's directions. Your doctor may order you to take this medication more often than twice a day and for longer than 3 days.It is very important to continue taking this medication exactly as prescribed by your doctor. Do not skip any doses. Keep taking this medication until the full prescribed amount is finished, even if symptoms disappear. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

              SIDE EFFECTS: Stomach/abdominal pain, vomiting, diarrhea, headache, dizziness, or drowsiness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: severe abdominal pain, easy bleeding/bruising, signs of serious infection (e.g., fever, persistent sore throat), unusual/extreme tiredness, seizures, weakness, dark or pinkish urine, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking mebendazole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Tell your doctor your medical history, especially of: low blood count (anemia), liver disease, intestinal problems (e.g., Crohn's disease, ulcerative colitis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: metronidazole.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.If you are taking this medication for a long time, laboratory and/or medical tests (e.g., complete blood count, liver/kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Pinworm infections can easily spread to others. All family members in close contact with the patient should be treated to decrease the chance of spreading the infection.Practice strict hygiene to prevent another infection. Wash hands frequently, especially after using the bathroom. Disinfect toilets daily. Change and launder undergarments, towels, and bedclothes daily.

              MISSED DOSE: If you are taking more than one dose and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              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.
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              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.