Mebex Plus
Mebex Plus Uses, Dosage, Side Effects, Food Interaction and all others data.
Mebendazole is a synthetic derivative of benzimidazole with a potent anthelmintic activity against the most common nematodes and some cestodes. It is highly effective against ascariasis, enterobiasis, trichuriasis and hookworm infections. It is equally effective in single or in mixed infections. The effect of the drug is due to its ability to inhibit glucose uptake irreversibly but it does not affect blood glucose concentration in the host, even in high doses. Mebendazole does not necessitate any dosage calculation since the same dosage is used for children and adults. It can be taken at any time and no special procedures such as purging, use of laxatives and/or dietary changes are required. Parasite immobilization and death occur slowly and clearance from the gastro-intestinal tract may not be completed up to 3 days after administration.
Mebendazole is a (synthetic) broad-spectrum anthelmintic. The principal mode of action for Mebendazole is by its inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules.
Pyrantel is a pyrimidine-derivative anthelmintic agent for the oral treatment of various parasitic worm infections including ascariasis, hookworm infections, enterobiasis (pinworm infection), trichostrongyliasis, and trichinellosis .
Pyrantel was initially described in 1965 by researchers from Pfizer who sought cyclic amidines with suitable pharmacokinetic properties (specifically, duration of action) for use as an anthelmintic drug. Pyrantel is mainly available in formulations for dogs and cats as the embonate salt, containing a 34.7% pyrantel base .
Pyrantel is on the World Health Organization's List of Essential Medicines, which are the safest and most effective medicines required in a functioning health system , .
| Trade Name | Mebex Plus |
| Generic | Mebendazole + Pyrantel |
| Weight | 150mg |
| Type | Tablet |
| Therapeutic Class | |
| Manufacturer | Cipla Limited |
| Available Country | India |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Mebendazole is used for the treatment of pinworm (Enterobius vermicularis), round worm (Ascaris lumbricoides), hookworm (Ancylostoma duodenale and Necator americanus), whip worm (Trichuris trichiura), tape worm (Taenia solium and taenia saginata) and threadworm (Strongyloides stercoralis) in single or mixed infections
Pyrantel is an anthelmintic used to treat helminth infections.
For the treatment of enterobiasis including roundworm (ascariasis), pinworm (enterobius) and hookworm (strongyloides) and hookworm (ancylostoma) in the pyrantel pamoate form .
Pyrantel is available in various formulations for humans, dogs, and cats as the pamoate (US Pharmacopeia nomenclature) or embonate (European Pharmacopoeia nomenclature) salt, which contains 34.7% pyrantel base combined with pamoic acid . , .
Pyrantel pamoate (embonate) ingested orally is effective for removal and control of ascarid and hookworm infections in puppies and dogs (adult Toxocara canis, Toxascaris leonina, Ancylostoma tubaeforme, An. braziliense, Uncinaria stenocephala), cats (adult Toxocara cati, Toxa. leonina, An. caninum, An. braziliense, U. stenocephala), horses and ponies (adult and immature Parascaris equorum, adult Strongylus vulgaris, S. edentatus, S. equinus, Cyathostomes (Triodontophorus spp., Cyathostomum spp., Cylicodontophorus spp., Cylicocyclus spp., Cylicostephanus spp., Poteriostomum spp.), Oxyuris equi, Anoplocephala perfoliata), swine (adult Ascaris suum, Oesophagostomum dentatum), and humans (adult A. lumbricoides, Enterobius vermicularis, An. duodenale, Necator americanus) .
Mebex Plus is also used to associated treatment for these conditions: Ancylostoma caninum infection, Ancylostoma duodenale infection, Ascaris lumbricoides infection, Capillariasis, Enterobius vermicularis infection, Filariasis, Giardiasis, Necatoriasis due to necator americanus, Strongyloides Stercoralis Infection, Taenia solium infection, Toxocariasis, Whipworm infectionEnterobiasis, Helminthic infection
How Mebex Plus works
Mebendazole causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. The loss of the cytoplasmic microtubules leads to impaired uptake of glucose by the larval and adult stages of the susceptible parasites, and depletes their glycogen stores. Degenerative changes in the endoplasmic reticulum, the mitochondria of the germinal layer, and the subsequent release of lysosomes result in decreased production of adenosine triphosphate (ATP), which is the energy required for the survival of the helminth. Due to diminished energy production, the parasite is immobilized and eventually dies.
By promoting the release of acetylcholine, inhibiting cholinesterase, and stimulating ganglionic neurons, pyrantel serves as a depolarizing neuromuscular blocking agent in helminths. This causes extensive depolarization of the helminth muscle membrane, resulting in tension to the helminth's muscles, leading to paralysis and release of their attachment to the host organism intestinal walls .
This action is unlike piperazine, which is a hyperpolarizing neuromuscular blocking agent that causes relaxation of the helminth muscles, leading to a subsequent detachment from the intestinal wall. Excretion of the parasites in the feces occurs by normal peristalsis .
Dosage
Mebex Plus dosage
Mebendazole 100 mg tablet and suspension: This have the same dosage schedule applies to adults & children.
Enterobiasis: A single tablet or 1 teaspoonful of the suspension.
Ascariasis, Ancylostomiasis, Trichuriasis: 2 tablets, one in the morning, the other in the afternoon for 3 consecutive days or 1 teaspoonful in the morning & 1 teaspoonful in the afternoon for 3 consecutive days
Taeniasis & strongyloidiasis:
- Adults: 2 tablets twice daily for 3 consecutive days.
- Children: 1 tablet twice daily or 1 teaspoonful twice daily for 3 consecutive days.
Mebendazole 500 mg tablet: One Mebendazole 500 mg tablet in a single intake regardless of body weight, for all nematode and some cestode infestations. The same dosage applies to adults and children age two years and above.
May be taken with or without food.
Side Effects
Mebendazole is well tolerated by adults and children. It has virtually no side effects. Transient abdominal pain and diarrhoea have been reported only rarely, in case of massive infestation and expulsion of worms.
Toxicity
Acute oral toxicity (LD50): 620 mg/kg [Mouse]. Symptoms of overdose include elevated liver enzymes, headaches, hair loss, low levels of white blood cells (neutropenia), fever, and itching.
Mild adverse effects include nausea, vomiting, diarrhea, headache, and dizziness .
LD50 in rats is 535 mg/kg .
Reported effects in humans in case of overdose include gastrointestinal disturbance, central nervous system effects, and superficial skin reactions. In one study, serum aspartate aminotransferase (AST) and serum alanine-aminotransferase (ALT) values were increased in approximately 2% of patients .
Pyrantel should be used with caution in patients with severe malnutrition or anemia. Supportive therapy is recommended for anemic, dehydrated, or malnourished patients before administration of the drug .
Pyrantel pamoate has been placed in pregnancy category C. This refers to the fact that animal studies have revealed adverse effects on the fetus (teratogenic/embryocidal, or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus .Data on the use of pyrantel pamoate in pregnant women are quite limited. In mass treatment programs for which the World Health Organization (WHO) has observed that the benefits of treatment outweigh the risks, WHO allows the use of pyrantel pamoate in the 2nd and 3rd trimesters of pregnancy, due to the fact that the effects of pyrantel on birth outcome are uncertain. The risk of treatment in pregnant women already known to have an infection needs to be balanced with the risk of disease progression if treatment were to be omitted . Individuals with liver disease are more susceptible to the toxicity in cases of pyrantel overexposure , .
There are no data regarding the presence of pyrantel in breast milk. Pyrantel is poorly absorbed from the GI tract; therefore, excretion into breast milk may be minimal. Some experts recommend that a single dose of pyrantel therapy may be given to breastfeeding women .
Precaution
Hepatic impairment. Children. Pregnancy and lactation.
Interaction
Concomitant treatment with cimetidine may inhibit the metabolism of mebendazole in the liver, resulting in increased plasma concentrations of the drug especially during prolonged treatment.
Elimination Route
Poorly absorbed (approximately 5 to 10%) from gastrointestinal tract. Fatty food increases absorption.
Pyrantel is poorly absorbed from the GI tract of humans , .
Peak serum concentrations occur 1–3 hours after a single dose .
Half Life
2.5 to 5.5 hours (range 2.5 to 9 hours) in patients with normal hepatic function. Approximately 35 hours in patients with impaired hepatic function (cholestasis).
In pigs, following intravenous administration, pyrantel exhibited a half-life of 1.75 +/- 0.19 h .
Elimination Route
In man, approximately 2% of administered mebendazole is excreted in urine and the remainder in the feces as unchanged drug or a primary metabolite.
Approximately 50% of an oral dose is excreted unchanged in feces; 7% excreted in urine as unchanged drug and metabolites .
Pregnancy & Breastfeeding use
Mebendazole should not be administered during pregnancy and in women thought to be pregnant. It is not known whether mebendazole or its metabolites are secreted in human breast milk. Thus Mebendazole should not be used during lactation unless the potential benefits are considered to outweigh the potential risk associated with treatment.
Contraindication
Mebendazole is contraindicated in pregnancy and in patients who have shown hypersensitivity to the product or any of its components.
Acute Overdose
Symptoms: Alopecia, reversible liver function disturbances, hepatitis, agranulocytosis, neutropenia, glomerulonephritis, abdominal cramps, nausea, vomiting and diarrhoea.
Management: Within the 1st hr after ingestion, gastric lavage may be performed. Activated charcoal may be given if considered appropriate.
Storage Condition
Store between 20-25° C.
Innovators Monograph
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