|Biological half-life||3–6 hours|
|Excretion||Faeces, urine (5–10%)|
|Chemical and physical data|
|Molar mass||295.293 g/mol|
|3D model (JSmol)|
|Melting point||288.5 °C (551.3 °F)|
Mebendazole (MBZ) is a medication used to treat a number of parasitic worm infestations. This includes ascariasis, pinworm disease, hookworm infections, guinea worm infections, hydatid disease, and giardia, among others. It is taken by mouth.
Mebendazole is usually well tolerated. Common side effects include headache, vomiting, and ringing in the ears. If used at large doses it may cause bone marrow suppression. It is unclear if it is safe in pregnancy. Mebendazole is a broad-spectrum antihelminthic agent of the benzimidazole type.
Mebendazole came into use in 1971, after it was developed in Belgium. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Mebendazole is available as a generic medication. The wholesale cost in the developing world is between 0.004 and 0.04 USD per dose. In the United States a single dose is about 884.00 USD as of 2016, while in Australia and the UK it costs about 5 USD.
Mebendazole is a highly effective, broad-spectrum antihelmintic indicated for the treatment of nematode infestations, including roundworm, hookworm, whipworm, threadworm, pinworm, and the intestinal form of trichinosis prior to its spread into the tissues beyond the digestive tract. Other drugs are used to treat worm infections outside the digestive tract, as mebendazole is poorly absorbed into the bloodstream. Mebendazole is used alone in those with mild to moderate infestations. It kills parasites relatively slowly, and in those with very heavy infestations, it can cause some parasites to migrate out of the digestive system, leading to appendicitis, bile duct problems, or intestinal perforation. To avoid this, heavily infested patients may be treated with piperazine, either before or instead of mebendazole. Piperazine paralyses the parasites, causing them to pass in the feces. It is also used rarely in the treatment of hydatid disease. Evidence for effectiveness for this disease, however, is poor.
Mebendazole and other benzimidazole antithelmetics are active against both larval and adult stages of nematodes, and in the cases of roundworm and whipworm, kill the eggs, as well. Paralysis and death of the parasites occurs slowly, and elimination in the feces may require several days.
Mebendazole is pregnancy category C, which means it has been shown to cause ill effects in pregnancy in animal models, and no adequate studies of its effects in human pregnancy have been conducted. Whether it can be passed by breastfeeding is unknown.
Mebendazole sometimes causes diarrhea, abdominal pain, and elevated liver enzymes. In rare cases, it has been associated with a dangerously low white blood cell count, low platelet count, and hair loss, with a risk of agranulocytosis in rare cases
Carbamazepine and phenytoin lower serum levels of mebendazole. Cimetidine does not appreciably raise serum mebendazole (in contrast to the similar drug albendazole), consistent with its poor systemic absorption.
Mebendazole is thought to work by selectively inhibiting the synthesis of microtubules in parasitic worms, and by destroying extant cytoplasmic microtubules in their intestinal cells, thereby blocking the uptake of glucose and other nutrients, resulting in the gradual immobilization and eventual death of the helminths.
Society and culture
As of 2016, pricing has dramatically increased in the U.S. as Amedra Pharmaceuticals acquired the rights to this drug from Teva in 2013. It should also be noted that in 2010, Amedra also bought the U.S. Marketing rights to the only other interchangeable anti-parasitic medication, albendazole, from GSK. The result of these acquisitions created a monopoly for this 40+ year old medication and its alternative medication. The retail price was approximately 380 USD per 100 mg tablet in Florida in September, 2016, and marketed under the brand name, Emverm, by Amedra Pharmaceuticals. In Taiwan, a package of 10 capsules (100 mg) sells for $3 US dollars.
Several studies show mebendazole exhibits potent antitumor properties. MBZ 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 MBZ caused mitotic arrest, followed by apoptotic cell death with the feature of caspase activation and cytochrome c release. MBZ induced a dose- and time-dependent apoptotic response in human lung cancer cell lines, and apoptosis via Bcl-2 inactivation in chemoresistant melanoma cells.
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