Vormin

Vormin (mebendazole) is an anthelmintic drug that is used to treat various types of helminths, or parasitic worms, in humans. Mebendazole works by killing worms 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 (Ascaris lumbricoides)
• Trichinella spiralis
• Trichuris trichiura
• Some types of tapeworms (Taenia spp., Hymenolepis nana)

Vormin is usually taken orally in the form of tablets or suspensions. It prevents helminths from absorbing glucose, which leads to their death.

Mebendazole usually comes with dosage instructions that should be strictly followed. Treatment can last from several days to several weeks, depending on the type of helminths and the severity of the infection.

Indikasjoner Vormina

1. Pinworms (Enterobius vermicularis): An infection caused by parasitic worms that live in the intestines, often resulting in itching in the anus.
2. 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 spiralis: These worms are common in the meat of infected animals such as pigs and bears. The infection can lead to muscle pain, headaches, fever and swelling.
4. Trichuris trichiura: These are roundworms that can cause a disease called trichuria. It can lead to 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 animal pain and stomach upset.

Utgivelsesskjema

1. Tablets: This is the most common form of release of Vormin. The tablets are usually taken orally with water. The dosage and frequency of administration are determined by the instructions on the package or the recommendations of the doctor.
2. Suspension: Suspensions may be used to treat children or people with difficulty swallowing. This is a liquid form of the drug, which 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 topical use. It may be useful in treating some skin infections caused by parasites.

Farmakodynamikk

1. Inhibition of tubulin synthesis: Mebendazole acts by binding to the tubulin protein, which plays an important role in the formation of the mitotic fuse and in mitosis. This leads to disruption of the division and migration of helminth cartilaginous cells, 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 re-infection.
4. Action against 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.

Farmakokinetikk

1. Absorption: Mebendazole is poorly absorbed from the gastrointestinal tract after oral administration. Its bioavailability is low due to low solubility in water and high degree of binding to plasma proteins.
2. Metabolism: Mebendazole is metabolized in the liver by hydrolysis to the main metabolite - mebendazole acid. This process is not essential, and most of the mebendazole is excreted unchanged from the body through feces.
3. Elimination: Mebendazole and its metabolites are eliminated primarily through the intestines. About 2-10% of the dose taken is excreted through the urine in the form of metabolites.
4. Sex addiction: Women may metabolize mebendazole more intensively, 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 starting to take mebendazole.

Dosering og administrasjon

1. Tablets:

   • Tablets are usually taken orally with food to improve their absorption.
   • 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 in the drug package.

3. Ointment:

   • If Vormin is provided as a topical ointment, follow the instructions on the package or your healthcare provider's recommendations regarding method of application and frequency of use.

Bruk Vormina under graviditet

1. FDA Risk Category:

   • Mebendazole is classified as FDA Category C. This means that animal studies have shown negative effects on the fetus, but no controlled studies have been conducted in pregnant women. 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 can cause birth defects. Based on data from animal studies, there is a potential risk of congenital abnormalities 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 under strict indications and under medical supervision.

3. Alternative treatments:

   • Doctors may consider alternative deworming agents with lower 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.
• The doctor will assess your condition, conduct the necessary examinations and determine which treatment will be the safest and most effective for you and your child.

Kontra

1. Allergies: People with a known allergy to mebendazole or any other ingredients of the drug should avoid its use.
2. Pregnancy: The safety of mebendazole 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 only be used with strict doctor's prescription if the expected benefits outweigh the potential risks.
3. Breastfeeding: The safety of mebendazole during breastfeeding has not been established. If it is necessary to use the drug while breastfeeding, you must stop breastfeeding 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 must be strictly followed as recommended by the doctor.
5. Liver 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 peptic ulcers of the stomach or intestines, chronic kidney or heart disease, or in patients with ulcers or other damage to the lining of the stomach or intestines.

Bivirkninger Vormina

1. Gastrointestinal disorders: Including nausea, vomiting, abdominal pain, diarrhea, or dyspepsia (digestion).
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. Deterioration of 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, increased anemia, increased levels of eosinophils in the blood 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 increased 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 are possible.
5. Other symptoms: General malaise, weakness and visual disturbances may occur.

Interaksjoner med andre legemidler

1. Anthelmintic drugs: Interactions with other anthelmintic drugs may result in increased therapeutic effect or increased side effects. When mebendazole is co-administered with other anthelmintic drugs, it is recommended to carefully monitor the patient's condition.
2. Drugs metabolized by the liver: Drugs metabolized by the liver may affect the rate of metabolism of mebendazole and its metabolites. This may lead to a change in the concentration of mebendazole in the blood and its therapeutic effect.
3. Cimetidine and other CYP450 inhibitors: Inhibitors of cytochrome P450 enzymes 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.