Drug profile compiled from the FDA prescribing information, CDC, and WHO guidance. Current as of October 2026. Written for general education; your prescriber and pharmacist are the right people to answer questions about your own treatment.
Albendazole is a prescription anti-worm medicine that kills parasites by cutting off their fuel supply. If you’ve been handed a prescription, or you heard about it from a school deworming program, you’re probably asking: what is albendazole, what does it treat, how the dose is chosen, and what to check before taking it. This profile answers each of those in order, starting with a quick summary table.
What is albendazole? The drug at a glance
| Feature | Details |
|---|---|
| Generic name | Albendazole |
| Drug class | Benzimidazole anthelmintic (anti-worm medicine) |
| Brand names | Albenza (United States); Zentel (sold internationally, including India); many generics |
| Forms | 200 mg film-coated tablets in the US; 400 mg tablets, chewable tablets, and oral suspension in many other countries |
| Prescription status | Prescription-only in the US |
| FDA-approved uses | Parenchymal neurocysticercosis (pork tapeworm larvae in the brain) and cystic hydatid disease of the liver, lung, and peritoneum (Echinococcus granulosus) |
| Other common uses (off-label in the US; standard in WHO programs) | Roundworm, hookworm, whipworm, pinworm, and some other intestinal parasites; mass deworming of children in endemic areas |
| Active form in the body | Albendazole sulfoxide (made in the liver) |
| Half-life | About 8 to 12 hours for the active metabolite |
| Key safety concerns | Bone marrow suppression, liver enzyme elevation, harm to an unborn baby, neurologic reactions when brain cysts die |
Sources for the table: the FDA-approved Albenza prescribing information on DailyMed and the NIH’s StatPearls albendazole review.
How albendazole kills worms
Albendazole starves parasites from the inside. Here is how it works, step by step.
It jams the worm’s internal scaffolding
Every cell is held together and fed by a network of tiny tubes called microtubules, built from a protein called tubulin. Albendazole binds to a specific spot on the worm’s beta-tubulin and stops those tubes from forming. It binds the parasite’s version of tubulin much more strongly than ours, which is why it can harm worms at doses people usually tolerate.
The worm runs out of energy
Without working microtubules, the cells lining the worm’s gut can’t absorb glucose, its main fuel. Its glycogen reserves run down and it can’t make enough ATP, the molecule cells use for energy. The parasite gradually becomes immobile and dies. Because this takes time, dead worms don’t usually show up in the stool right away, and long-lived larval cysts in tissue need weeks of treatment.
The liver turns it into the active drug
Albendazole dissolves poorly in water, so only a small amount is absorbed. What does get absorbed is quickly converted in the liver to albendazole sulfoxide, the metabolite that does most of the work against parasites in tissue. Albendazole sulfoxide spreads widely, reaching cyst fluid and the fluid around the brain and spinal cord. That’s why it can reach hydatid cysts and brain cysts.
Why food timing depends on the infection
According to the FDA label, a fatty meal (around 40 grams of fat) can raise blood levels of albendazole sulfoxide up to about fivefold on average compared with fasting. So the timing of meals depends on where the parasite lives:
- Tissue infections (neurocysticercosis, hydatid cysts): take it with meals, ideally ones with some fat, so more drug reaches the bloodstream and the cysts.
- Intestinal worms (such as pinworm): the parasites live in the gut, so the goal is to keep the drug there. CDC guidance for pinworm says to take albendazole on an empty stomach.
Follow the instructions on your prescription label. They’re based on what you’re being treated for.
Can worms become resistant?
Yes. The FDA label explains that resistance comes from small changes in the worm’s beta-tubulin protein that make it harder for the drug to latch on. This is a well-known problem in livestock parasites, and researchers track it in human deworming programs, where the same drug is given to millions of people year after year. For an individual patient, the practical points are simple: take the full prescribed course, return for follow-up testing if your doctor asks, and report symptoms that don’t go away instead of re-treating yourself. If a parasite doesn’t respond, there are other drug classes your doctor can use.
What albendazole does not do
Albendazole has no effect on bacteria or viruses, and it isn’t a general “detox” or cleanse. WHO also notes that standard deworming with albendazole doesn’t control Strongyloides stercoralis, a different soil worm that is treated with ivermectin instead. And it can’t undo damage that’s already happened. Scar tissue from an old cyst or calcified dead cysts in the brain won’t go away with more medicine. CDC notes that calcified cysts don’t benefit from anti-parasitic treatment at all.
What albendazole treats
Albendazole works against an unusually wide range of worms. The table separates the two FDA-approved uses from uses supported by CDC, WHO, or standard medical references.
| Infection | Parasite | Status | Notes |
|---|---|---|---|
| Neurocysticercosis | Taenia solium (pork tapeworm) larvae in the brain | FDA-approved | Given with steroids and seizure medicine as needed; see albendazole for neurocysticercosis |
| Cystic hydatid disease | Echinococcus granulosus (dog tapeworm) larvae in the liver, lung, or peritoneum | FDA-approved | Often combined with surgery or drainage |
| Roundworm (ascariasis) | Ascaris lumbricoides | Off-label (US); WHO-recommended | Short course, often a single dose |
| Hookworm | Necator americanus, Ancylostoma duodenale | Off-label (US); WHO-recommended | Chronic hookworm causes blood loss and anemia |
| Whipworm (trichuriasis) | Trichuris trichiura | Off-label (US); WHO-recommended | Single doses work less well against whipworm than other worms |
| Pinworm (enterobiasis) | Enterobius vermicularis | Off-label (US); CDC-listed option | Single dose repeated after two weeks |
| Intestinal tapeworm (taeniasis) | Adult Taenia species | Off-label | Praziquantel is often preferred; see albendazole for tapeworm |
| Strongyloidiasis, trichinosis, filariasis | Various | Off-label | Listed in StatPearls; for Strongyloides, WHO says ivermectin is the drug of choice |
| Giardiasis (resistant cases) | Giardia (a protozoan, not a worm) | Off-label | StatPearls lists it for metronidazole-resistant cases only |
The CDC’s page on soil-transmitted helminths notes that treatment for roundworm, whipworm, and hookworm usually takes one to three days and works well regardless of species. Hookworm in particular feeds on blood, so long-term infection can lead to iron-deficiency anemia. After treatment, rebuilding iron stores matters; our guide on how to increase hemoglobin covers diet and supplement basics to discuss with your doctor.
Albendazole has a close relative, mebendazole, that is also used for intestinal worms. Our comparison of albendazole vs mebendazole explains when doctors choose one or the other.
Albendazole dosage overview
Your doctor determines your dose. The figures below summarize official guidance so you can understand a prescription. They are not instructions for treating yourself. Dose depends on the parasite, your weight, where the infection is, your liver function, and other medicines you take.
FDA-labeled dosing (Albenza)
| Condition | Patient weight | Dose | Duration |
|---|---|---|---|
| Hydatid disease | 60 kg (132 lb) or more | 400 mg twice daily with meals | 28-day cycle, then a 14-day break with no albendazole, repeated for a total of 3 cycles |
| Hydatid disease | Under 60 kg | 15 mg/kg/day split into two doses with meals (maximum 800 mg/day) | Same 28-on / 14-off pattern, 3 cycles |
| Neurocysticercosis | 60 kg or more | 400 mg twice daily with meals | 8 to 30 days |
| Neurocysticercosis | Under 60 kg | 15 mg/kg/day split into two doses with meals (maximum 800 mg/day) | 8 to 30 days |
For neurocysticercosis, the label advises that patients get corticosteroids and anti-seizure medicine as needed, and that steroids be considered during the first week to prevent dangerous swelling as cysts die. The CDC’s clinical guidance describes a typical course of 15 mg/kg/day for 15 days. Per IDSA/ASTMH guidelines, praziquantel is added when there are more than two viable cysts in the brain tissue. Longer or repeated courses may be needed for cysts outside the brain tissue itself.
Short-course dosing for intestinal worms
- Mass deworming (WHO): The World Health Organization recommends a single 400 mg dose of albendazole for soil-transmitted worms (roundworm, whipworm, hookworm) in community programs. It’s given periodically to at-risk groups in endemic areas without testing each person first.
- Pinworm (CDC): 400 mg by mouth once, repeated after two weeks. The second dose catches worms that hatch from eggs the first dose didn’t kill.
- Young children: Programs such as India’s National Deworming Day give children aged 1 to 2 half a 400 mg tablet (200 mg). For children under 2, CDC advises weighing risks and benefits first.
How to take the tablets
The FDA label allows tablets to be crushed or chewed and swallowed with water, which helps children and anyone who has trouble swallowing pills. Take the doses at about the same times each day, and finish the full course even if you feel better. For cyst infections in particular, stopping early can leave parasites alive.
Before you take albendazole
For a one-time deworming dose, the checklist is short. For multi-week treatment of cysts, it’s more involved. Tell your prescriber about each item below that applies to you.
Pregnancy and contraception
Animal studies found birth defects at doses below the human dose, so the FDA label warns of possible harm to an unborn baby. It recommends:
- A pregnancy test before starting treatment for anyone who could become pregnant.
- Avoiding albendazole during pregnancy unless there is no suitable alternative.
- Using effective birth control during treatment and for one month after the last dose, according to the current label. (MedlinePlus patient guidance gives a shorter window, so ask your prescriber which applies to you.)
- Stopping the drug and calling your doctor right away if you become pregnant during treatment.
In public health deworming, WHO includes pregnant women in their second and third trimesters, because untreated hookworm anemia also carries risks. That is a population-level decision made where these worms are common. In the US, any treatment during pregnancy should be decided with your obstetric provider.
Liver health and blood counts
Albendazole can raise liver enzymes and, rarely, suppress the bone marrow. For longer courses, the label calls for a complete blood count and liver tests at the start of each 28-day cycle and at least every two weeks during treatment. People with existing liver disease, including hydatid cysts in the liver, need closer monitoring. Our full guide to albendazole side effects explains what those tests look for.
Eye exam for neurocysticercosis
Before treating neurocysticercosis, doctors check the retina for cysts. If a cyst in the eye dies during treatment, the resulting inflammation can damage the retina.
Allergy and hidden infections
Don’t take albendazole if you’ve had an allergic reaction to it or to another benzimidazole, such as mebendazole. People treated for hydatid disease who come from areas where pork tapeworm is common may have undiagnosed brain cysts, and the label recommends checking for these first, because treatment can bring on neurologic symptoms.
Children, older adults, and kidney problems
- Children: The label says albendazole appears to work about as well in children with neurocysticercosis as in adults. Hydatid disease is uncommon in young children. Dosing is weight-based, and crushing or chewing tablets is allowed.
- Adults 65 and older: The label says there isn’t enough data to tell whether older adults respond differently. Since older adults are more likely to have liver problems or take interacting drugs, prescribers often watch them more closely.
- Kidney disease: Very little of the active drug leaves the body in urine (under 1% according to the label), and it hasn’t been formally studied in kidney impairment. Tell your doctor about any kidney condition anyway.
- Blocked bile flow: In a small group of patients with bile-duct obstruction, exposure to the active metabolite rose about sevenfold and its half-life stretched to roughly 32 hours. That’s one reason liver and gallbladder history matters.
- Breastfeeding: There is no human data on whether albendazole passes into breast milk. It does pass into animal milk. Your doctor will weigh the benefits of breastfeeding against your need for treatment.
Albendazole interactions
Several common medicines change how much active albendazole reaches your tissues. Some of these interactions are used on purpose. Others mean your doctor needs to monitor you more closely.
| Medicine | Effect (per FDA label or StatPearls) | What it means |
|---|---|---|
| Dexamethasone | Raised trough levels of albendazole sulfoxide by about 56% | Often given together on purpose in neurocysticercosis |
| Praziquantel | Raised albendazole sulfoxide peak and exposure by about 50% | Combined on purpose for patients with several brain cysts |
| Cimetidine | About doubled albendazole sulfoxide levels in bile and cyst fluid | Sometimes considered for hydatid cysts; increases exposure |
| Theophylline | Albendazole may affect theophylline breakdown | Theophylline levels should be checked during and after treatment |
| Enzyme inducers (phenytoin, carbamazepine, phenobarbital, rifampin) | Can substantially lower albendazole levels | Important in neurocysticercosis, where seizure medicines are common; the regimen may need adjusting |
| Grapefruit juice | May raise albendazole levels | Ask your pharmacist whether to avoid it during treatment |
Give your prescriber and pharmacist a full list of everything you take, including prescriptions, over-the-counter drugs, and herbal products.
If you miss a dose
Patient guidance from MedlinePlus says to take a missed dose as soon as you remember. If it’s almost time for the next one, skip the missed dose and continue on your usual schedule. Never double up to catch up. If you’re on a long course and miss several doses, call your prescriber, since that can affect whether the cysts respond.
What to expect during and after treatment
What treatment looks like depends almost entirely on the infection.
Short courses for intestinal worms
Most people take one to three days of tablets and notice little beyond mild stomach upset, a headache, or nausea, if anything. With pinworm, itching may last a few days while the remaining eggs die off, which is why the second dose two weeks later matters. If symptoms come back, see your doctor rather than starting another round yourself. Reinfection is common, and the worm might not be the one you assumed.
Long courses for cysts
Treatment for hydatid disease or neurocysticercosis runs from a week or two to several months. Expect regular blood draws, and possibly steroids, seizure medicine, surgery, or drainage alongside albendazole. Headaches or a seizure can happen early in neurocysticercosis treatment as the cysts die and the brain reacts with inflammation. That’s the reason steroids are often started at the same time. Doctors judge whether treatment worked with follow-up CT or MRI scans, usually months later, not by how you feel during the course.
Signs that need a prompt call
Call your prescriber right away if you develop a fever, sore throat, or chills (possible signs of low white blood cells); unusual bruising or bleeding; yellowing skin or eyes; a rash or hives; or shortness of breath. Severe headache, confusion, vision changes, or a seizure during treatment for brain cysts needs emergency care.
Storage and handling
Store albendazole tablets at room temperature, 68°F to 77°F (20°C to 25°C), in their original container and out of reach of children. Don’t keep leftover tablets “just in case.” Old medicine may not be right for a future infection, and using it can delay a proper diagnosis. Ask your pharmacy about take-back options for disposal.
Preventing reinfection
Albendazole kills the worms you have now. It doesn’t protect you from catching them again. Prevention depends on how each parasite spreads:
- Soil-transmitted worms: Wear shoes outdoors where sanitation is poor (hookworm larvae enter through bare skin), wash produce well, and wash hands after using the toilet and before eating.
- Pinworm: Keep fingernails short, discourage nail-biting, shower in the morning, and wash bedding and underwear in hot water.
- Pork tapeworm and neurocysticercosis: Cook pork thoroughly, and practice careful hand hygiene. Neurocysticercosis comes from swallowing tapeworm eggs passed by a human carrier, not from eating cysts in meat, so hygiene matters in every household.
- Hydatid disease: Wash hands after handling dogs, keep dogs from eating raw livestock organs, and talk to your vet about deworming working dogs in sheep-farming areas.
Cost and availability: United States vs India
Few medicines show as big a price gap between countries as albendazole.
In the United States
Albendazole is prescription-only, and the US market mostly carries 200 mg tablets. Prices have been notoriously high. GoodRx listed an average retail price of more than $850 for the most common version, though discount cards and certain pharmacies have offered it far lower, in some cases around $15 to $25 at the time of checking. Prices change often, so compare pharmacies, ask about generics, and check with your insurer. For a single pinworm dose, your doctor may suggest mebendazole or over-the-counter pyrantel pamoate instead.
In India
Albendazole is cheap and easy to find in India. Brands such as Zentel and many generics come as 400 mg tablets, chewables, and suspensions, and a single 400 mg tablet costs only a few rupees at retail pharmacies. Although it is technically a prescription medicine, pharmacies commonly dispense it for routine deworming.
India also runs one of the largest deworming programs in the world. Launched in 2015 by the Ministry of Health and Family Welfare, National Deworming Day is held on February 10 and August 10 each year. Children and adolescents aged 1 to 19 receive a free 400 mg albendazole tablet (half a tablet for ages 1 to 2) through schools and anganwadi centres, followed by mop-up days for anyone who missed it. Easy access is not a reason to skip medical advice, though. Long courses for cysts, pregnancy, and liver disease all need a doctor’s supervision in any country.
Albendazole FAQ
How quickly does albendazole work?
Intestinal worms begin dying within days of a short course, though symptoms can take a little longer to clear. Tissue cysts work very differently: treatment lasts weeks, and doctors confirm the response with follow-up imaging months later.
Will I see worms in my stool after taking it?
Sometimes, but not always. Worms are often partly digested by the time they pass. Not seeing worms doesn’t mean the treatment failed, and seeing them doesn’t mean something is wrong.
Should the whole family take albendazole?
With pinworm, it often spreads through a household, and doctors may treat close contacts. CDC stresses that strict handwashing is the best way to prevent it. Ask your doctor before giving anyone medicine prescribed for someone else, especially a child, a pregnant person, or someone with liver disease.
Can I drink alcohol while taking albendazole?
The label doesn’t list a specific alcohol interaction. But albendazole can stress the liver, and so can alcohol. During a long course with liver monitoring, most clinicians advise avoiding or strictly limiting alcohol. Ask your prescriber.
Is albendazole the same as mebendazole?
No. They are in the same drug family and work in a similar way, but albendazole is absorbed better into the body, which is why it’s used for tissue cysts. Mebendazole stays mostly in the gut.
Can I take albendazole for “routine deworming” in the US without symptoms?
Routine deworming of healthy people isn’t standard practice in the US, where these infections are much less common. If you think you have worms, see a clinician, who may order a stool test or a pinworm tape test and choose the right drug.
