Zenmox Special Precautions

General precaution: Confirmation of eradication of many intestinal and tissue parasites is necessary after treatment.
Use in Systemic Helminth Infections (longer duration of treatment at higher doses): Hepatic Effects: Mild to moderate elevations of liver enzymes have been reported with albendazole. Elevations of liver enzymes increase risk of hepatotoxicity and bone marrow suppression. In prolonged higher dose albendazole therapy for hydatid disease, there have been rare reports of severe hepatic abnormalities associated with jaundice and histological hepatocellular damage, which may be irreversible. Case reports of hepatitis have also been received. Enzyme abnormalities usually normalize on discontinuation of treatment.
Myelosuppression: Can cause bone marrow suppression, aplastic anemia, and agranulocytosis in patients with or without underlying hepatic dysfunction. Reversible leukopenia has occurred in <1% of patients receiving the drug; granulocytopenia, pancytopenia, agranulocytosis, or thrombocytopenia reported rarely. Rare fatalities reported due to granulocytopenia or pancytopenia.
Albendazole has been shown to cause bone marrow suppression and therefore blood counts should be monitored at the start of each 28-day cycle and every two weeks during treatment. Closer monitoring of blood counts is recommended in patients with liver disease, including hepatic echinococcosis, since these individuals may be more susceptible to bone marrow suppression leading to pancytopenia, aplastic anemia, agranulocytosis, and leukopenia. Albendazole should be discontinued if clinically significant decreases in blood cell counts occur.
Precautions Related to Treatment of Neurocysticercosis: Destruction of cysticercosis lesions by albendazole may cause irreparable retinal damage, even when corticosteroids are given. Prior to treatment of neurocysticercosis, examine patient for cysticercosis retinal lesions. In those with such lesions, weigh the need for treatment against the possibility of irreparable retinal damage.
Symptoms associated with an inflammatory reaction following death of the parasite within the brain may occur in patients receiving albendazole treatment for neurocysticercosis (e.g. seizures, raised intracranial pressure, hydrocephalus, focal signs). These should be treated with appropriate corticosteroid and anticonvulsant therapy. Oral or intravenous corticosteroids are recommended during the first week of treatment to prevent cerebral hypertension. Pre-existing neurocysticercosis may also be uncovered in patients treated with albendazole for other conditions. Symptoms may occur soon after treatment, appropriate steroid and anticonvulsant therapy should be started immediately.
There is a risk that treatment of Taenia solium infections may be complicated by cysticercosis, and appropriate measures should be taken to minimise this possibility.
Effects on Ability to Drive and Use Machine: When driving vehicles or operating machinery it should be taken into account that dizziness has been reported after using Zenmox Chewable Tablet 200 mg.
Use in Impaired Renal or Hepatic Function: The use in patients with impaired renal or hepatic function has not been studied. However, caution should be used in patients with pre-existing liver disease, since albendazole is metabolised by the liver and has been associated with idiosyncratic hepatotoxicity.
Use in Children: There is limited experience in children under 2 years of age, therefore use in this age group is not recommended.