III. Mechanism

  1. Synthetic benzimidazole derivative
  2. Inhibits Helminth (worm) reproduction and survival
    1. Blocks microtubule formation (polymerization) in cytoplasm
    2. Blocks Glucose uptake and depletes Helminth glycogen stores
    3. Results in reduced ATP and Helminth death

IV. Medications

  1. Chewable Tablets: 100 mg
    1. In U.S., Vermox was original trade name and discontinued in 2012
    2. Rebranded in 2016 as Enverm (at astronomical prices)

V. Dosing: Adults and Children

  1. Doses for adults and children are the same
  2. Pinworm
    1. Mebendazole 100 mg orally for a single dose, and repeat in 2 weeks
  3. Roundworm, Hookworm or Whipworm
    1. Mebendazole 100 mg orally twice daily for 3 days OR
    2. Mebendazole 500 mg orally twice daily for one dose (off label)

VI. Adverse Effects

  1. Transient gastrointestinal symptoms
    1. Abdominal Pain
    2. Anorexia
    3. Diarrhea
    4. Flatulence
    5. Nausea and Vomiting
  2. Serious (Uncommon to rare)
    1. Bone Marrow suppression (Agranulocytosis, Neutropenia)
    2. Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis (SJS/TEN)

VII. Safety

  1. Unknown safety in first trimester (may be used in later pregnancy)
  2. Considered safe in Lactation

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Cost: Medications

emverm (on 2/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
EMVERM 100 MG TABLET CHEW $538.55 each