Indications of Almex 400 mg

Almex 400 mg is indicated in single and mixed infestations of- Hookworm (Ancylostoma, Necator) Roundworm (Ascaris) Threadworm (Enterobius) Whipworm (Trichuris) Strongyloides Tapeworm Opisthorchi Hydatid.

Theropeutic Class

Anthelmintic

Pharmacology

Almex 400 mg is a broad spectrum benzimidazole anthelminthic drug. In addition to its vermicidal properties, it has both ovicidal and larvicidal activities.

Dosage and Administration of Almex 400 mg

Adults and children over 2 years: 400 mg (1 tablet or 10 ml suspension) as a single dose in cases of Enterobius vermicularis, Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus. In cases of strongyloidiasis or taeniasis, 400 mg (1 tablet or 10 ml suspension) daily should be given for 3 consecutive days. If the patient is not cured on follow-up after three weeks, a second course of treatment is indicated. Children of 1-2 years: Recommended dose is a single dose of 200 mg (5 ml suspension).Children under 1 year: Not recommended.In Hydatid disease (Echinococcosis): Almex 400 mg is given by mouth with meals in a dose of 400 mg twice daily for 28 days for patients weighing over 60 kg. A dose of 15 mg/kg body weight daily in two divided doses (to a maximum total daily dose of 800 mg) is used for patients weighing less than 60 kg. For cystic echinococcosis, the 28 days course may be repeated after 14 days without treatment, to a total of 3 treatment cycles. For alveolar echinococcosis, cycles of 28 days of treatment followed by 14 days without treatment, may need to continue for months or years. In giardiasis, 400 mg (1 tablet or 10 ml suspension) once daily for five days is used.

Dosage of Almex 400 mg

Adults and children over 2 years: 400 mg (1 tablet or 10 ml suspension) as a single dose in cases of Enterobius vermicularis, Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus. In cases of strongyloidiasis or taeniasis, 400 mg (1 tablet or 10 ml suspension) daily should be given for 3 consecutive days. If the patient is not cured on follow-up after three weeks, a second course of treatment is indicated. Children of 1-2 years: Recommended dose is a single dose of 200 mg (5 ml suspension).Children under 1 year: Not recommended.In Hydatid disease (Echinococcosis): Almex 400 mg is given by mouth with meals in a dose of 400 mg twice daily for 28 days for patients weighing over 60 kg. A dose of 15 mg/kg body weight daily in two divided doses (to a maximum total daily dose of 800 mg) is used for patients weighing less than 60 kg. For cystic echinococcosis, the 28 days course may be repeated after 14 days without treatment, to a total of 3 treatment cycles. For alveolar echinococcosis, cycles of 28 days of treatment followed by 14 days without treatment, may need to continue for months or years. In giardiasis, 400 mg (1 tablet or 10 ml suspension) once daily for five days is used.

Interaction of Almex 400 mg

No interaction involving Almex 400 mg, either pharmacodynamic or pharmacokinetic, has been reported.

Contraindications

Neonates: Almex 400 mg is not normally used in neonates.Children: Reduction of the dose from 400 mg to 200 mg may be indicated in children weighing less than 10 kg but there are no grounds for a general reduction in dosage to children.Pregnant woman: Almex 400 mg should not be given during pregnancy or women thought to be pregnant. No information is available on placental transfer.Concurrent disease: There is no evidence to suggest that dose should be altered in renal, hepatic or cardiac failure.

Side Effects of Almex 400 mg

Gastrointestinal disturbances, headache, dizziness, changes in liver enzymes, rarely reversible alopecia; rash, fever, blood disorders including leucopenia and pancytopenia reported; allergic shock if cyst leakage; convulsion and meningism in cerebral disease.

Pregnancy and Lactation

US FDA Pregnancy category of Almex 400 mg is C. So, Almex 400 mg should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.

Precautions and Warnings

Blood counts and liver function tests before treatment and twice during each cycle; breastfeeding; exclude pregnancy before starting treatment. Almex 400 mg should only be used in the treatment of Echinococcosis if there is constant medical supervision with regular monitoring of serum-transaminase concentrations and of leucocyte and platelet counts

Storage Conditions

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

Drug Classes

Anthelmintic

Mode Of Action

Almex 400 mg is a broad spectrum anthelmintic. Almex 400 mg exhibits vermicidal, ovicidal and larvicidal activities. The drug is thought to exert its anthelmintic effect by blocking glucose uptake in the susceptible helminths, thereby depleting the energy level until it becomes inadequate for survival. Immobilization is followed by the parasite. These events may be a consequence of the binding and subsequent inhibition of parasite tubulin polymerization by Almex 400 mg and its metabolites, although the drug also binds to human tubulin. Almex 400 mg is extensively metabolized, probably in the liver. Almex 400 mg is poorly absorbed from the gastrointestinal tract but rapidly undergoes extensive first-pass metabolism. The principal metabolite Almex 400 mg sulphoxide has anthelmintic activity and a plasma half-life of about 8.5 hrs. It is excreted in the urine together with other metabolites.

Pregnancy

US FDA Pregnancy category of Almex 400 mg is C. So, Almex 400 mg should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.