AL-DS Tablet

Indication:

AL-DS Tablet is indicated for the treatment of-

Common Intestinal Nematode Infections: Effective against Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), Enterobius vermicularis (pinworm/threadworm), Ancylostoma duodenale and Necator americanus (hookworms), and Strongyloides stercoralis (threadworm).

Systemic Cestode Infections:

• Neurocysticercosis: Treatment of parenchymal neurocysticercosis caused by larval forms of the pork tapeworm, Taenia solium.
• Hydatid Disease (Cystic Echinococcosis): Treatment of cystic hydatid disease of the liver, lung, and peritoneum, caused by the larval form of the dog tapeworm, Echinococcus granulosus.

Protozoal Infections (Off-Label): Used in the treatment of giardiasis (Giardia lamblia / duodenalis) in pediatric populations when first-line therapies are unfeasible.

”রেজিস্ট্রার চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন”

Dogase & Adminstration:

Common Intestinal Infections (Roundworm, Hookworm, Whipworm, Pinworm):

• Adults & Children (Over 2 years of age): 400 mg (one 400 mg tablet or 10 mL suspension) as a single dose.
  • For Pinworm (Enterobiasis): A second dose of 400 mg is highly recommended after 2 weeks to prevent reinfection.
  • For Strongyloidiasis: 400 mg once daily for 3 consecutive days.
• Children (Aged 1 to 2 years): 200 mg (5 mL suspension) as a single dose.

Systemic Helminthic Infections (High-Dose / Long-Term Therapy):

• Neurocysticercosis (Duration: 8 to 30 days):
  • Patients weighing $ge 60$ kg: 400 mg orally twice daily with meals.
  • Patients weighing $<60$ kg: 15 mg/kg/day orally in two divided doses with meals (Maximum: 800 mg/day).
• Hydatid Disease (Duration: Three 28-day cycles separated by 14-day drug-free intervals):
  • Patients weighing $ge 60$ kg: 400 mg orally twice daily with meals.
  • Patients weighing $<60$ kg: 15 mg/kg/day orally in two divided doses with meals (Maximum: 800 mg/day).

Administration Instructions:

• Intestinal Deworming: May be taken on an empty stomach. The tablet can be chewed, swallowed whole, or crushed and mixed with food.
• Systemic Infections (Hydatid/Neurocysticercosis): Must be taken with food (specifically a fatty meal) to enhance systemic absorption and tissue penetration of the active metabolite.

”রেজিস্ট্রার চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন”

Pharmacology:

• Mechanism of Action: Albendazole is a broad-spectrum benzimidazole carbamate anthelmintic with larvicidal, ovicidal, and vermicidal activity. It exerts its primary therapeutic effect by binding selectively and with high affinity to parasitic beta tubulin
  • Inhibition of Microtubule Polymerization: By binding to beta-tubulin, albendazole blocks its polymerization into microtubules. This disrupts the vital structural and functional microtubular network within the intestinal cells of the parasite.
  • Metabolic Depletion: The loss of intracellular microtubules inhibits glucose uptake and glycogen storage in the susceptible larval and adult stages of the helminth. This leads to a severe depletion of Adenosine Triphosphate (ATP) stores, eventually resulting in the metabolic starvation, immobilization, and death of the parasite.
• Pharmacokinetics:
  • Absorption: Albendazole is poorly absorbed from the gastrointestinal tract ($<5) due to its low aqueous solubility. However, absorption is significantly increased (up to 5-fold) when administered with a high-fat meal.
  • Distribution & First-Pass Metabolism: It undergoes rapid and extensive first-pass metabolism in the liver. The parent drug is virtually undetectable in systemic circulation because it is rapidly converted by hepatic monooxygenases to its active metabolite, albendazole sulfoxide. This metabolite distributes widely into systemic tissues, cerebrospinal fluid (CSF), and hydatid cyst fluids.
  • Elimination: Albendazole sulfoxide is further metabolized into inactive compounds and primarily excreted through bile and feces, with a minor portion excreted in urine. Its elimination half-life ($t_{1/2}$) is approximately 8 to 12 hours.

Side Effects:

• Common (Short-term use): Transient gastrointestinal discomfort (epigastric pain, nausea, diarrhea), headache, and dizziness.
• Serious (Long-term / High-dose systemic therapy): Reversible leukopenia/pancytopenia (bone marrow suppression), severe elevation of hepatic enzymes (ALT/AST), and reversible alopecia (hair loss).

Drug Interaction:

• Dexamethasone, Praziquantel, & Cimetidine: Concomitant use increases the plasma concentration of the active metabolite, albendazole sulfoxide. This interaction is therapeutically beneficial in treating neurocysticercosis but increases the risk of side effects.
• Theophylline: Albendazole may induce hepatic CYP1A2 enzymes, potentially decreasing plasma concentrations of theophylline. Monitor theophylline levels during co-administration.

Pregnancy & Lactation:

• Pregnancy: Category X. Albendazole has demonstrated teratogenic and embryotoxic properties in animal studies. It is strictly contraindicated during pregnancy. Women of childbearing potential should perform a negative pregnancy test before starting treatment and use effective contraception during therapy and for 1 month after discontinuation.
• Lactation: Albendazole is excreted in human breast milk in small amounts. Caution should be exercised, and breastfeeding is generally not recommended during treatment and for at least 48 hours after the last dose.

Over Dosage:

• Symptoms: Nausea, vomiting, diarrhea, tachycardia, and transient elevations in liver transaminases.
• Treatment: In case of overdose, symptomatic (gastric lavage, activated charcoal) and supportive therapy should be instituted. Monitor blood counts and liver function closely.

Therapeutic Class:

Broad-Spectrum Anthelmintic (Anti-worm agent).

Storage Conditions:

Store below at 30°C  temperature in a dry place. Away from light and out of reach of children. Do not use the medication after its expiration date.