For the treatment of Trichuris trichuria (whipworm), Enterobius vermicularis (pinworm or threadworm), Ascaris lumbricoides (roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed gastrointestinal infestations.

There is no evidence that BENDAZOLE Tablets are effective in the treatment of cysticercosis.

Route of administration: Oral

Adults and children over 2 years:

For the control of trichuriasis, ascariasis and hookworm infections, one tablet twice a day for three consecutive days.

For the control of enterobiasis a single tablet is administered. It is highly recommended that a second tablet is taken after two weeks, if re-infection is suspected.

Tablets may be chewed or swallowed whole. Crush the tablet before giving it to a young child. Always supervise a child while they are taking this medicine.

Not recommended in the treatment of children under 2 years.

A case-control study of a single outbreak of Stevens-Johnson syndrome /toxic epidermal necrolysis (SJS/TEN) suggested a possible association with the concomitant use of metronidazole with mebendazole. Although there are no additional data on this potential interaction, concomitant use of mebendazole and metronidazole should be avoided.

Concomitant treatment with cimetidine may inhibit the metabolism of mebendazole in the liver, resulting in increased plasma concentrations of the drug.

Concomitant use of mebendazole and metronidazole should be avoided (see section 4.4).

Since BENDAZOLE is contra-indicated in pregnancy, patients who think they are, or may be, pregnant should not take this preparation.

Lactation

      As it is not known whether mebendazole is excreted in human milk, it is not advisable to breast feed following administration of BENDAZOLE .

BENDAZOLE has no influence on the ability to drive and use machines.

Throughout this section adverse reactions are reported. Adverse reactions are adverse events that were considered to be reasonably associated with the use of BENDAZOLE based on the comprehensive assessment of the available adverse event information. A causal relationship with BENDAZOLE cannot be reliably established in individual cases. Further, because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.

The safety of BENDAZOLE was evaluated in 6276 subjects who participated in 39 clinical trials for the treatment of single or mixed parasitic infestations of the gastrointestinal tract. In these 39 clinical trials, no adverse drug reactions (ADRs) occurred in ≥1% of BENDAZOLE -treated subjects.

ADRs identified from clinical trials and post-marketing experience with BENDAZOLE are included in Table 1. The displayed frequency categories use the following convention:

Very common (≥1/10); Common (≥1/100 to <1/10); Uncommon (≥1/1000 to <1/100); Rare (≥1/10,000 to <1/1000); Very rare (<1/10,000), Not known (cannot be estimated from the available data).

Table 1: Adverse Drug Reactions Reported in Clinical Trials and Post-marketing Experience for Mebendazole

^a ADR frequency data derived from Clinical Trials or Epidemiological Studies

^b ADRs not observed in clinical trials and frequency calculated using “Rule of 3”, as detailed in SmPC guideline 2009. 6276 patients exposed in clinical trials and epidemiological studies, divided by 3 (Frequency = 1/2092). Note: frequencies differ from those reported in the August 2009 CCDS, as these were not calculated using the formula detailed in the SmPC guideline 2009.

In patients treated at dosages substantially higher than recommended or for prolonged periods of time, the following adverse reactions have been reported rarely: alopecia, reversible liver function disturbances, hepatitis, agranulocytosis, neutropenia and glomerulonephritis. With the exception of agranulocytosis and glomerulonephritis, these also have been reported in patients who were treated with mebendazole at standard dosages (see section 4.8).

Symptoms

     In the event of accidental overdosage, abdominal cramps, nausea, vomiting and diarrhoea may occur.

Treatment

    There is no specific antidote. Within the first hour after ingestion, gastric lavage may be performed. Activated charcoal may be given if considered appropriate.

Pharmacotherapeutic group: anthelmintic for oral administration, benzimidazole derivatives; ATC code: P02CA01.

In vitro and in vivo work suggests that mebendazole blocks the uptake of glucose by adult and larval forms of helminths, in a selective and irreversible manner. Inhibition of glucose uptake appears to lead to endogenous depletion of glycogen stores within the helminth. Lack of glycogen leads to decreased formation of ATP and ultrastructural changes in the cells.

There is no evidence that BENDAZOLE is effective in the treatment of cysticercosis.

Using a tracer dose of ³H-mebendazole, the pharmacokinetics and bioavailability of a solution and IV drug have been examined. After oral administration, the half life was 0.93 hours. Absorption of this tracer dose was almost complete but low availability indicated a high first pass effect. At normal therapeutic doses, it is very hard to measure levels in the plasma

No relevant information additional to that contained elsewhere in the Summary of Product Characteristics

Maize starch

Colloidal anhydrous silica

Sunset yellow

Povidone (K29-32) (10% solution)

Sodium starch glycollate Type A

Magnesium stearate

Peppermint (20.258 Flashman)

Not applicable

Bendazole  100 Tablets should not be stored at a temperature above 30ºC.

Bendazole  100 Tablets are packed in boxes of  6 Tablets blistered in aluminium foil.

   Bendazole  100 Tablets are packed in boxes of  1 Tablets blistered in aluminium foil.

   Bendazole  100 Tablets are packed in boxes of  10 Tablets blistered in aluminium foil.

Not all pack sizes may be marketed

Any unused product or waste material should be disposed of accordance with local requirements.