Vormin

Wormin (mebendazole) is an antihelminthic drug that is used to treat various types of helminths, or parasitic worms, in humans. Mebendazole works by killing the helminths or helping the body get rid of them.

This drug can be used to treat infections caused by various types of helminths, such as:

• Pinworms (Enterobius vermicularis)
• Ascaris lumbricoides
• Trichinella (Trichinella spiralis)
• Trichuris trichiura
• Some species of tapeworms (Taenia spp., Hymenolepis nana)

Wormin is usually taken orally in tablet or suspension form. It prevents helminths from absorbing glucose, which leads to their death.

Mebendazole usually comes with dosage instructions that must be strictly followed. Treatment may last from a few days to a few weeks, depending on the type of worm and the severity of the infection.

Indications Wormina

1. Pinworms (Enterobius vermicularis): An infection caused by parasitic worms that live in the intestines, often resulting in itching in the anal area.
2. Roundworms (Ascaris lumbricoides): This is a type of roundworm that can enter the body through contaminated food or water. Symptoms may include abdominal pain and allergic reactions.
3. Trichinella (Trichinella spiralis): These worms are common in the meat of infected animals such as pigs and bears. The infection can cause muscle pain, headaches, fever and swelling.
4. Trichuris trichiura: These are roundworms that can cause a disease called trichuriasis. It can cause symptoms such as diarrhea, abdominal pain, and fatigue.
5. Tapeworms (Taenia spp., Hymenolepis nana): These types of parasites can also cause infections in humans, characterized by a variety of symptoms, including stomach pain and upset stomach.

Release form

1. Tablets: This is the most common form of Wormin. Tablets are usually taken orally with water. The dosage and frequency of administration are determined by the instructions on the package or by the doctor's recommendations.
2. Suspension: Suspensions can be used to treat children or people with difficulty swallowing. This is a liquid form of the drug that can be measured using a special measuring spoon or syringe included in the package.
3. Ointment: In some cases, mebendazole may be available as an ointment for external use. This may be useful for treating certain skin infections caused by parasites.

Pharmacodynamics

1. Inhibition of tubulin synthesis: Mebendazole acts by binding to the tubulin protein, which plays an important role in the formation of the mitotic fusee and in mitosis. This leads to disruption of the division and migration of the cartilaginous cells of helminths, which leads to their death.
2. Paralyzing effect: After interaction with tubulin, mebendazole leads to paralysis of the muscles of helminths, which makes them incapacitated and prevents their further reproduction and spread in the body.
3. Killing adult worms and their eggs: Mebendazole is effective against both adult worms and their eggs, which helps prevent reinfection.
4. Action on various types of parasites: Mebendazole is active against a wide range of helminths, including roundworms, flatworms and nematodes.
5. Local action in the intestine: Since mebendazole is poorly absorbed from the gastrointestinal tract, its action is usually localized in the intestine, which reduces the risk of systemic side effects.

Pharmacokinetics

1. Absorption: Mebendazole is poorly absorbed from the gastrointestinal tract after oral administration. Its bioavailability is low due to low water solubility and high plasma protein binding.
2. Metabolism: Mebendazole is metabolized in the liver by hydrolysis to the major metabolite, mebendazole acid. This process is not major and most mebendazole is excreted unchanged in the feces.
3. Elimination: Mebendazole and its metabolites are eliminated primarily via the faeces. About 2-10% of the administered dose is excreted in the urine as metabolites.
4. Sexual dependence: In women, the metabolism of mebendazole may be more extensive, which is associated with higher levels of metabolism in the liver.
5. Speed of action: The maximum therapeutic effect is achieved approximately 3-4 days after the start of taking mebendazole.

Dosing and administration

1. Pills:

   • The tablets are usually taken orally with food to improve absorption.
   • The dosage usually depends on the type of infection and the patient's weight. A single application or short-term course of treatment is usually recommended. For repeated treatment, a second course may be required after a certain period of time.

2. Suspension:

   • The suspension can be used to treat children or adults with difficulty swallowing tablets.
   • The dosage is determined by the doctor and can be measured using a special measuring spoon or syringe included with the drug package.

3. Ointment:

   • If Wormin is available as an ointment for topical use, follow the directions on the package or your doctor's recommendations for how to use it and how often to use it.

Use Wormina during pregnancy

1. FDA Risk Category:

   • Mebendazole is in FDA category C. This means that animal studies have shown harmful effects on the fetus, but controlled studies in pregnant women have not been conducted. Therefore, the drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

2. Risks and limitations:

   • Mebendazole may be teratogenic, meaning it may cause birth defects. Based on animal studies, there is a potential risk of birth defects when mebendazole is used during the first trimester of pregnancy.
   • Because of these risks, the use of mebendazole in the first trimester is generally avoided, and in the second and third trimesters the drug is used only if strictly indicated and under the supervision of a physician.

3. Alternative treatments:

   • Doctors may consider alternative anthelmintics with less risk for pregnant women, such as pyrantel pamoate, which is considered safer for use during pregnancy.

Recommendations for pregnant women:

• If you are pregnant and suspect a helminth infestation, it is important to consult your doctor before starting treatment with mebendazole or any other anthelmintic drug.
• Your doctor will assess your condition, conduct any necessary tests, and determine which treatment will be safest and most effective for you and your baby.

Contraindications

1. Allergy: People with a known allergy to mebendazole or any other ingredients of the drug should avoid using it.
2. Pregnancy: The safety of mebendazole use during pregnancy has not been established. Therefore, its use in the first trimester of pregnancy may be contraindicated. In the second and third trimesters of pregnancy, mebendazole can be used only under strict medical supervision, if the expected benefit outweighs the potential risks.
3. Breastfeeding: The safety of mebendazole use during breastfeeding has not been established. If it is necessary to use the drug during breastfeeding, breastfeeding should be discontinued for the duration of treatment.
4. Children: The use of mebendazole in children may be contraindicated depending on the age and weight of the child. The dosage should be strictly followed according to the doctor's recommendations.
5. Hepatic impairment: The use of mebendazole may be limited in patients with severe hepatic impairment due to the risk of toxic effects.
6. Certain conditions: The drug may be contraindicated in patients with certain conditions such as gastric or intestinal ulcers, chronic kidney or heart disease, or in patients with ulcers or other damage to the lining of the stomach or intestines.

Side effects Wormina

1. Gastrointestinal disorders: Including nausea, vomiting, abdominal pain, diarrhea, or dyspepsia (indigestion).
2. Headache: Headache or dizziness may occur in some patients.
3. Allergic reactions: Rarely, allergic reactions such as skin rash, itching or angioedema (swelling of the skin, mucous membranes or subcutaneous tissue) may occur.
4. Decreased liver function: In some cases, changes in liver function tests may occur, so it is important to monitor your liver health while taking mebendazole.
5. Rare: Other possible side effects may include bleeding, worsening anemia, increased blood eosinophil levels, and other hematological abnormalities.

Overdose

1. Gastrointestinal disorders: Severe abdominal pain, nausea, vomiting and diarrhea may occur.
2. Liver disorders: Overdose may cause liver damage and elevated levels of liver enzymes in the blood.
3. Central nervous system: In rare cases, dizziness, drowsiness, headache and even seizures may occur.
4. Allergic reactions: Allergic reactions such as skin rash, itching and angioedema may occur.
5. Other symptoms: General malaise, weakness and visual disturbances may occur.

Interactions with other drugs

1. Anthelmintics: Interactions with other anthelmintics may result in increased therapeutic effect or increased side effects. When mebendazole is administered concomitantly with other anthelmintics, careful monitoring of the patient is recommended.
2. Drugs metabolized in the liver: Drugs metabolized in the liver may affect the rate of metabolism of mebendazole and its metabolites. This may lead to changes in the blood concentration of mebendazole and its therapeutic effect.
3. Cimetidine and other CYP450 inhibitors: Cytochrome P450 enzyme inhibitors may affect the metabolism of mebendazole, which may lead to increased blood concentrations and increased side effects.
4. Alcohol: Although there is no direct data on the interaction of mebendazole with alcohol, it is recommended to avoid drinking alcohol while taking mebendazole due to the possibility of increased side effects on the liver.