Indications

Almex is a medication used to treat single and mixed infestations of various parasites, including:

• Hookworm (Ancylostoma, Necator)
• Roundworm (Ascaris)
• Threadworm (Enterobius)
• Whipworm (Trichuris)
• Strongyloides
• Tapeworm
• Opisthorchis
• Hydatid disease (Echinococcosis)

Description

Almex is a benzimidazole anthelmintic that is effective against most nematodes and some cestodes. It works by exhibiting vermicidal (killing worms), ovicidal (killing eggs), and larvicidal (killing larvae) activity. Its main mode of action is to inhibit tubulin polymerization, which causes the loss of cytoplasmic microtubules in the parasites. This ultimately leads to a loss of energy and the death of the parasite.

Pharmacology

Albendazole, the active ingredient in Almex, is a broad-spectrum anthelmintic. It works by blocking the parasites' ability to absorb glucose, which depletes their energy levels and immobilizes them. This is a result of the drug binding to and inhibiting the polymerization of parasite tubulin. The drug is poorly absorbed from the gastrointestinal tract but is rapidly and extensively metabolized in the liver to its active metabolite, albendazole sulphoxide, which has a half-life of about 8.5 hours. It is then excreted in the urine.

Dosage & Administration

• Adults & Children over 2 years:
  • For most common worms (Enterobius, Trichuris, Ascaris, Ancylostoma, Necator), a single dose of 400 mg (1 tablet or 10 ml suspension) is recommended.
  • For strongyloidiasis or taeniasis, 400 mg should be taken daily for 3 consecutive days. A second course of treatment may be needed after three weeks.
• Children 1-2 years: A single dose of 200 mg (5 ml suspension) is recommended.
• Children under 1 year: Not recommended.
• Hydatid disease (Echinococcosis):
  • Patients over 60 kg: 400 mg twice daily for 28 days, taken with meals.
  • Patients under 60 kg: 15 mg/kg body weight daily in two divided doses (maximum 800 mg total daily dose).
  • Treatment for cystic echinococcosis can be repeated for up to three cycles, with a 14-day break between each 28-day course.
• Giardiasis: 400 mg once daily for five days.

Interaction

No significant drug interactions involving Almex have been reported.

Contraindications

• Neonates: Not typically used.
• Children: A reduced dose of 200 mg may be considered for children weighing less than 10 kg.
• Pregnant women: Should not be used by pregnant women or those who may be pregnant.
• Concurrent disease: The dose does not need to be altered for patients with kidney, liver, or cardiac failure.

Side Effects

Side effects may include gastrointestinal disturbances, headache, dizziness, and changes in liver enzymes. Rarely, reversible hair loss, rash, fever, and blood disorders such as low white blood cell count (leucopenia) and low red blood cell count (pancytopenia) have been reported. In cases of cerebral disease, allergic shock, convulsions, and meningism may occur.

Pregnancy & Lactation

Albendazole is a Pregnancy Category C drug. It should be avoided during pregnancy and lactation unless the potential benefits to the mother clearly outweigh the possible risks to the fetus.

Precautions & Warnings

Before and during treatment, especially for Echinococcosis, blood counts and liver function tests should be monitored regularly. Women should have pregnancy excluded before starting treatment. Almex should only be used for Echinococcosis under constant medical supervision.

Therapeutic Class

Almex is an anthelmintic.

Storage Conditions

Store in a dry place, away from light and heat. Keep out of the reach of children.