Disruption of cytoplasmic microtubules leads to blocking the uptake of glucose and other nutrients, resulting in the gradual immobilization and eventual death of the helminths.Poor absorption in the digestive tract makes mebendazole an efficient drug for treating intestinal parasitic infections with limited adverse effects. However mebendazole has an impact on mammalian cells, mostly by inhibiting polymeration of tubulin dimers, thereby disrupting essential microtubule structures such as mitotic spindle. Disassembly of the mitotic spindle then leads to apoptosis mediated via dephosphorylation of Bcl-2 which allows pro-apoptotic protein Bax to dimerize and initiate programmed cell death. Society and culture
Availability
Mebendazole is available as a generic medication. Mebendazole is distributed in international markets by Johnson and Johnson and a number of generic manufacturers. Research
Several studies show mebendazole exhibits potent antitumor properties. mebendazole significantly inhibited cancer cell growth, migration, and metastatic formation of adrenocortical carcinoma, both in vitro and in vivo. Treatment of lung cancer cell lines with mebendazole caused mitotic arrest, followed by apoptotic cell death with the feature of caspase activation and cytochrome c release. Mebendazole induced a dose- and time-dependent apoptotic response in human lung cancer cell lines, and apoptosis via Bcl-2 inactivation in chemoresistant melanoma cells. The anti-cancer effect of mebendazole comes from preclinical studies and case reports. References
External links
"Mebendazole". Drug Information Portal. U.S. National Library of Medicine.
This side effect is due to entacapone metabolism and excretion in the urine and shown to not be harmful. Sudden sleep onset
People have reported sudden sleep onset while engaging in daily activities without prior warning of drowsiness. In controlled studies, patients on entacapone had a 2% increased risk of somnolence compared to placebo. Low blood pressure
Episodes of orthostatic hypotension have been shown to be more common at the start of entacapone use due to increased levels of levodopa. Behavior problems
Post-marketing data shows that entacapone may change or worsen mental status, leading to behaviors such as delusions, agitation, confusion, and delirium.People taking entacapone may experience increased urges to participate in gambling, sexual activities, money spending, and other stimulating reward behaviors. Interactions
In studies, entacapone has shown a low potential for interaction with other drugs. In theory, it could interact with MAO inhibitors, tricyclic antidepressants and noradrenaline reuptake inhibitors because they also increase catecholamine levels in the body, with drugs being metabolized by COMT (for example  methyldopa, dobutamine, apomorphine, adrenaline, and isoprenaline), with iron because it could form chelates, with substances binding to the same albumin site in the blood plasma (for example diazepam and ibuprofen), and with drugs being metabolized by the liver enzyme CYP2C9 (for example warfarin). None of the medications tested in studies have shown clinically relevant interactions, except perhaps warfarin for which a 13% (CI90: 6–19%) increase in INR was seen when combined with entacapone. Pharmacology
Mechanism of action
Entacapone is a selective and reversible inhibitor of catechol-O-methyltransferase (COMT).