Mebendazole

About Mebendazole

Mebendazole is labeled for pinworm (Enterobius vermicularis), whipworm (Trichuris trichiura), common roundworm (Ascaris lumbricoides) and the common and American hookworms (Ancylostoma duodenale and Necator americanus), in single or mixed infections. Children and adults take the same dose: one 100 mg tablet once for pinworm, and one tablet in the morning and one in the evening for three days in a row for the other worms. If the infection is not cured three weeks after treatment, the label advises a second course. The tablet can be chewed, swallowed whole, or crushed and mixed with food, and no fasting or purging is needed. It has not been studied much in children under 2, so for them the prescriber weighs the benefit against the risk.

The only contraindication is allergy to mebendazole. In heavy infections, brief abdominal pain and diarrhea can occur as the worms are passed. Rash, hives and swelling under the skin (angioedema) are rare, and very rare convulsions have been reported. Taken for a long time at doses well above those recommended, it has rarely lowered white blood cell counts (neutropenia and agranulocytosis) and raised liver tests, with rare hepatitis, so blood and liver checks are advised during prolonged treatment. There is no evidence that it works for hydatid disease, even at high doses. The label says it is not recommended in pregnancy, and the patient leaflet says not to take it if you are or may be pregnant; it is used with caution while breastfeeding.

To prevent reinfection and spread, the patient leaflet for pinworm advises washing hands and fingernails with soap often; wearing close-fitting underpants day and night and changing them daily; and washing bed linens and nightclothes without shaking them. The label does not address treating others in the home; patient guides note that household members may also need treatment, which is the prescriber’s decision. Vermox, the original brand, came as a 100 mg chewable tablet and, from 2016, a 500 mg chewable tablet; the Orange Book now lists both as discontinued. Cimetidine may raise mebendazole levels.

Taking Mebendazole

How to take it

Chew the tablet, swallow it whole, or crush it and mix it with food; no fasting is needed. For pinworm, take one tablet once; for whipworm, roundworm or hookworm, one tablet in the morning and one in the evening for three days. Wash hands and fingernails often, especially before eating and after using the toilet.

If you miss a dose

During a three-day course, take a missed tablet as soon as you remember, unless it is almost time for the next one; then skip it. Do not take a double dose.

Storage

In the original package, tightly closed, at room temperature, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Cimetidine may raise mebendazole levels. Tell the prescriber about all other prescription and nonprescription medicines, vitamins and supplements you take, and about pregnancy or breastfeeding.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Mebendazole differs from pharmacy to pharmacy

A course is tiny: one tablet for pinworm, six for the other worms, so the dispensing fee and any minimum charge make up much of a cash quote, and small quantities are priced very unevenly. Emverm is the only mebendazole product, sold under its brand name, so a pharmacy has no other version to substitute; not every pharmacy keeps it in stock, and one that does not may need to order it.

When the prescriber treats more than one person in a household, each person’s tablets are a separate fill with its own fee.

Ways to pay less for Mebendazole without insurance

• Ask the pharmacy to confirm it has Emverm in stock before the prescription is sent.
• Ask for exactly the tablets your course needs: one for pinworm, six for whipworm, roundworm or hookworm.
• If others in your home are being treated, send all the prescriptions to the same pharmacy and ask for one quote covering them.
• Compare quotes from more than one pharmacy, since fees and minimum charges differ.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Mebendazole

1. 1.Should others in my household be treated at the same time?
2. 2.Will I need a second course if I am not cured after three weeks?
3. 3.Can my child chew the tablet, or should I crush it into food?
4. 4.What should I do if I am pregnant or might be?

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