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Clinical pharmacokinetics of high dose mebendazole in patients treated for cystic hydatid disease

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Summary

The plasma concentrations of mebendazole and its metabolites have been monitored in twelve patients after receiving a 10 mg/kg dose for cystic hydatid disease. The mebendazole plasma concentration-time profiles differed considerably between patients; elimination half-lives ranged from 2.8–9.0 h, time to peak plasma concentration after dosing ranged from 1.5–7.25 h and peak plasma concentrations ranged from 17.5 to 500 ng/ml. The mean peak plasma concentration of mebendazole after an initial dose (69.5 ng/ml) was lower than found in patients during chronic therapy (137.4 ng/ml). The plasma AUCTs for the major metabolites of mebendazole (methyl 5-(α-hydroxybenzyl)-2-benzimidazole carbamate and 2-amino-5 benzoylbenzimidazole) were about five times the plasma AUCT found for mebendazole in patients on chronic therapy. It is suggested that the slower clearance of these polar metabolites relative to mebendazole results from enterohepatic recycling. Since mebendazole is also highly plasma protein bound, caution should be observed in administering mebendazole to patients with liver disease. Concentrations of mebendazole found in the tissue and cyst material collected from two patients during surgery ranged from 59.5 to 206.6 ng/g wet weight.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, University of Tasmania, 43 Collins Street, 7000, Hobart, Tasmania, Australia

    P. A. Braithwaite

  2. School of Pharmacy, Faculty of Medicine, University of Tasmania, Churchill Avenue, 7005, Sandy Bay, Tasmania, Australia

    M. S. Roberts

  3. Department of Pharmacy, University of Sydney, 2006, New South Wales, Australia

    R. J. Allan & T. R. Watson

  4. Department of Surgery, University of Melbourne Royal Melbourne Hospital, 3052, Parkville, Victoria, Australia

    P. A. Braithwaite

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  1. P. A. Braithwaite
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  2. M. S. Roberts
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  3. R. J. Allan
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  4. T. R. Watson
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Braithwaite, P.A., Roberts, M.S., Allan, R.J. et al. Clinical pharmacokinetics of high dose mebendazole in patients treated for cystic hydatid disease. Eur J Clin Pharmacol 22, 161–169 (1982). https://doi.org/10.1007/BF00542462

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