Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease

Background/Aim. Modern treatment of cystic echinococcosis, except for surgical treatment and percutaneous drainage of cyst considers also administration of albendazole as a type of individual therapy. However, clinicians fear of the serious adverse effects of high doses of albendazole, first of all...

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Main Authors: Jevtić Miodrag, Mikić Dragan, Arsić-Komljenović Gordana, Stanković Nebojša, Ristanović Elizabeta, Sjeničić Goran, Janićijević-Hudomal Snežana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2008-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500807539J.pdf
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author Jevtić Miodrag
Mikić Dragan
Arsić-Komljenović Gordana
Stanković Nebojša
Ristanović Elizabeta
Sjeničić Goran
Janićijević-Hudomal Snežana
author_facet Jevtić Miodrag
Mikić Dragan
Arsić-Komljenović Gordana
Stanković Nebojša
Ristanović Elizabeta
Sjeničić Goran
Janićijević-Hudomal Snežana
author_sort Jevtić Miodrag
collection DOAJ
description Background/Aim. Modern treatment of cystic echinococcosis, except for surgical treatment and percutaneous drainage of cyst considers also administration of albendazole as a type of individual therapy. However, clinicians fear of the serious adverse effects of high doses of albendazole, first of all the elevation of serum transaminases activity, very frequently results in subdosing of albendazole and wrong conclusions its efficacy and safety. The aim of this study was to investigate adverse effects of a longterm, continual administration of high doses of albendazole in the treatment of patients with echinococcal disease. Methods. A total of 42 patients (mean age 40.4 ± 18.3 years) with echinococcal disease were included in the study. They were treated with continual administration of high doses of albendazole within the period of 4 to 6 months. The subgroups of 27 and 15 patients were treated with 15-20 mg/kg/day and with 21-25 mg/kg/day albendazole, respectively. The patients in the control group (18 with surgical treatment, 6 with percutaneous drainage of cyst) were treated with 800 mg albendazole per day (< 15 mg/kg body weight) in the cycles of 28 days (1-3 cycles) and a two-week pause between them. Results. In the study group adverse effects of albendazole were registered in 20 (47.6%), whereas in the control group in 6 (30.0%) of the patients. In both subgroups elevated activity of serum transaminases were found more frequently in the study group compared to the control one (35.7% vs 25%, p < 0.05), especially in the patients who were treated with higher doses of albendazole. The patients in the study group, compared to the patients in the control group had significantly higher mean activity of serum alanin aminotransferase in the course of the second and third month of the therapy (p < 0.05). Administration of albendazole due to adverse effects was stopped in 3 (7.1%) of the patients in the study group. Two (4.8%) of them had a very high activity of serum transaminases and one had a muscle pains and high activity of serum creatine kinase. After the interruption of the therapy we documented a normalization of serum enzyme levels in all the patients. Conclusion. Longterm, continual administration of high doses of albendazole in the patients with echinococcal disease results in significant elevation of serum transaminases activity, compared to the patients treated with albendazole in the cycles, but in the majority of the patients serum transaminases activity was normalizated by the end of a 6-month period.
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spelling doaj-art-cc595e7b0b934353afee24d2bac1d5672025-08-20T03:04:42ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502008-01-0165753954410.2298/VSP0807539JAdverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal diseaseJevtić MiodragMikić DraganArsić-Komljenović GordanaStanković NebojšaRistanović ElizabetaSjeničić GoranJanićijević-Hudomal SnežanaBackground/Aim. Modern treatment of cystic echinococcosis, except for surgical treatment and percutaneous drainage of cyst considers also administration of albendazole as a type of individual therapy. However, clinicians fear of the serious adverse effects of high doses of albendazole, first of all the elevation of serum transaminases activity, very frequently results in subdosing of albendazole and wrong conclusions its efficacy and safety. The aim of this study was to investigate adverse effects of a longterm, continual administration of high doses of albendazole in the treatment of patients with echinococcal disease. Methods. A total of 42 patients (mean age 40.4 ± 18.3 years) with echinococcal disease were included in the study. They were treated with continual administration of high doses of albendazole within the period of 4 to 6 months. The subgroups of 27 and 15 patients were treated with 15-20 mg/kg/day and with 21-25 mg/kg/day albendazole, respectively. The patients in the control group (18 with surgical treatment, 6 with percutaneous drainage of cyst) were treated with 800 mg albendazole per day (< 15 mg/kg body weight) in the cycles of 28 days (1-3 cycles) and a two-week pause between them. Results. In the study group adverse effects of albendazole were registered in 20 (47.6%), whereas in the control group in 6 (30.0%) of the patients. In both subgroups elevated activity of serum transaminases were found more frequently in the study group compared to the control one (35.7% vs 25%, p < 0.05), especially in the patients who were treated with higher doses of albendazole. The patients in the study group, compared to the patients in the control group had significantly higher mean activity of serum alanin aminotransferase in the course of the second and third month of the therapy (p < 0.05). Administration of albendazole due to adverse effects was stopped in 3 (7.1%) of the patients in the study group. Two (4.8%) of them had a very high activity of serum transaminases and one had a muscle pains and high activity of serum creatine kinase. After the interruption of the therapy we documented a normalization of serum enzyme levels in all the patients. Conclusion. Longterm, continual administration of high doses of albendazole in the patients with echinococcal disease results in significant elevation of serum transaminases activity, compared to the patients treated with albendazole in the cycles, but in the majority of the patients serum transaminases activity was normalizated by the end of a 6-month period.http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500807539J.pdfechinococcosisalbendazoledose-response relationshipdrugdrug toxicity
spellingShingle Jevtić Miodrag
Mikić Dragan
Arsić-Komljenović Gordana
Stanković Nebojša
Ristanović Elizabeta
Sjeničić Goran
Janićijević-Hudomal Snežana
Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
Vojnosanitetski Pregled
echinococcosis
albendazole
dose-response relationship
drug
drug toxicity
title Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
title_full Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
title_fullStr Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
title_full_unstemmed Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
title_short Adverse effects of long term, continual administration of high doses of albendazole in the treatment of echinococcal disease
title_sort adverse effects of long term continual administration of high doses of albendazole in the treatment of echinococcal disease
topic echinococcosis
albendazole
dose-response relationship
drug
drug toxicity
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500807539J.pdf
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