A single dose of albendazole is sufficient to treat intestinal infestations by A. duodenale or Necator americanus
Intestinal capillariasis, as an alternative to mebendazole
Mansonelliasis when caused by Mansonella perstans. Albendazole works against the adult worms but not against the younger microfilariae. Oesophagostomumiasis, when caused by Oesophagostomum bifurcum
Strongyloidiasis, as an alternative to ivermectin or thiabendazole Albendazole can be given with diethylcarbamazine to lower microfilaremia levels. Toxocariasis, also called "visceral larva migrans", when caused by the dog roundworm Toxocara canis or cat roundworm T. catis. Corticosteroids can be added in severe cases, and surgery might be required to repair secondary damage. Trichinosis, when caused by Trichinella spiralis or T. pseudospiralis. Albendazole has a similar efficacy to thiabendazole, but fewer side effects. It works best when given early, acting on the adult worms in the intestine before they generate larva that can penetrate the muscle and cause a more widespread infection. Corticosteroids are sometimes added on to prevent inflammation caused by dying larva. Trichostrongyliasis, as an alternative to pyrantel pamoate. A single dose is sufficient for treatment. Trichuriasis (whipworm infection), sometimes considered as an alternative to mebendazole and sometimes considered to be the drug of choice. Only a single dose of albendazole is needed. It can also be given with ivermectin.
Most of it is oxidized into albendazole sulfoxide (also known as ricobendazole and albendazole oxide) in the liver by cytochrome P450 oxidases (CYPs) and a flavin-containing monooxygenase (FMO), which was discovered later. In humans, the cytochrome P450 oxidases are thought to include CYP3A4 and CYP1A1, while those in the rats are thought to be CYP2C6 and CYP2A1.Oxidation to albendazole sulfoxide by FMO produces R(+) enantiomers, while oxidation the cytochromes and by some enzymes in the gut epithelium produce S(-). Different species produce the R(+) and S(-) enantiomers in different quantities; humans, dogs, and most other species produce the R(+) enantiomer more (with the human AUC ratio being 80:20). Compared to the S(-) enantiomer, the R(+) has greater pharmacological activity, lasts longer in the bloodstream, is found in higher concentrations in the infected host tissues, and is found in higher concentrations within the parasites themselves. Some albendazole is also converted to hydroxyalbendazole, mainly by CYP2J2.For systemic parasites, albendazole acts as a prodrug, while albendazole sulfoxide reaches systemic circulation and acts as the real antihelminthic. Albendazole sulfoxide is able to cross the blood-brain barrier and enter the cerebrospinal fluid at 43% of plasma concentrations; its ability to enter the central nervous system allows it to treat neurocystocercosis.Albendazole sulfoxide is converted to the inactive albendazole sulfone by cytochrome P450 oxidases, thought to include CYP3A4 or CYP2C. Other inactive metabolites include: 2-aminosulfone, ω-hydroxysulfone, and β-hydroxysulfone.