Latin name:
Sanoxal
Active substance Sanoxal:
Albendazole
Release form Sanoxal:
chewable tablets
Owner / Registrar Sanoxal:
PROTECH BIOSYSTEMS, PVT. Ltd.
International Classification of Diseases (ICD-10)A07.1
Giardiasis [giardiasis] B60
Other protozoal diseases, not elsewhere classified B66.0
Opisthorchiasis B67
Echinococcosis B69
Cysticercosis B76
Ankylostomiasis B77
Ascariasis B78
Strongyloidosis B79
Trichuroz B80
Enterobiasis
Sanoxal
Pharmacological group Sanoxal:
Anthelmintic drug
pharmachologic effect Sanoxal:
Antihelminthic and antiprotozoal agent Sanoxal. Selectively inhibits beta-tubulin polymerization, which leads to destruction of cytoplasmic microtubules of cells of the intestinal tract of helminths; alters the course of biochemical processes (suppresses glucose utilization), blocks the movement of secretory granules and other organelles in the muscle cells of roundworms, causing their death. The most effective against larval forms of cestodes - Echinococcus granulosus and Taenia solium; nematodes - Strongyloides stercolatis.
Pharmacokinetics Sanoxal:
Suction
After oral administration, it is poorly absorbed from the gastrointestinal tract due to poor water solubility. The drug is rapidly metabolized during the "first pass" through the liver, therefore, the plasma concentrations of unchanged albendazole are negligible and undetectable. Oral bioavailability is low. However, the simultaneous intake of fatty foods significantly increases the absorption and concentration of albendazole in the blood plasma (5 times). Sanoxal C max of albendazole sulfoxide is achieved after 2-5 hours.
Distribution
Plasma protein binding is 70%. Albendazole/Sanoxal is well distributed in the body, reaching high concentrations in urine and bile, liver, wall and fluid of parasitic cysts, cerebrospinal fluid.
Metabolism
Albendazole/Sanoxal is rapidly metabolized in the liver to form the primary metabolite - albendazole/Sanoxal sulfoxide, which also has anthelmintic activity. Albendazole sulfoxide, in turn, is converted to albendazole sulfone (a secondary metabolite) and other oxidized products devoid of pharmacological activity.
Albendazole/Sanoxal is an inducer of CYP1A2 microsomal enzymes in human liver cells.
Withdrawal
T 1/2 of albendazole sulfoxide is 8-12 hours. The drug is excreted in the form of various metabolites in the urine and bile, while the renal excretion is insignificant (less than 1%).
Pharmacokinetics in special clinical situations:
Against the background of liver damage, the bioavailability of albendazole increases. The C max of albendazole sulfoxide is doubled, and T 1/2 is lengthened.
In patients with impaired renal function, the clearance of albendazole and its metabolites does not change.
From the digestive system: abnormal liver function with changes in liver function tests (mild or moderate increase in transaminase activity), abdominal pain, nausea, vomiting.
From the hematopoietic system: oppression of bone marrow hematopoiesis (leukopenia, granulocytopenia, agranulocytosis, thrombocytopenia, pancytopenia).
From the nervous system: headache, dizziness, meningeal symptoms.
Allergic reactions: skin rash, itching.
Others: increased body temperature, increased blood pressure, acute renal failure, reversible alopecia.
Overdose Sanoxal:
Treatment: gastric lavage, intake of activated carbon, symptomatic therapy.
special instructions Sanoxal:
Patients with neurocysticercosis should receive appropriate therapy with GCS and anticonvulsants. GCS for oral administration and intravenous administration are used to prevent a sharp increase in blood pressure in the first week of anticyst therapy.
Monitoring of the cellular composition of the blood is recommended; blood tests should be performed at the beginning of every 28 day cycle and every 2 weeks during albendazole therapy. If leukopenia occurs, treatment is suspended. Continuation of treatment with albendazole is possible if the decrease in the total content of leukocytes and neutrophilic leukocytes is moderate and does not progress.
In case of impaired liver function, before and during treatment, regular laboratory monitoring is required (every 2 weeks). In the event of a significant increase in hepatic transaminase levels, treatment should be discontinued. However, if the level of liver enzymes has returned to the original, then albendazole can be re-prescribed, subject to constant monitoring of laboratory parameters.
In case of neurocysticercosis with eye damage, a retinal examination is necessary before starting treatment due to the risk of aggravating its pathology.
Use in pediatrics
The drug Sanoxal should be prescribed with caution to children aged 3 to 6 years .
With renal failure
In patients with impaired renal function, the clearance of albendazole and its metabolites does not change.
In case of liver dysfunction
With caution: liver failure, liver cirrhosis
Application during pregnancy and lactation
Use during pregnancy is not recommended unless alternative treatment is not possible. Before starting treatment in women of childbearing age, a pregnancy test is performed. During and within a month after the end of treatment, reliable contraception is required.
With extreme caution, the drug is prescribed during breastfeeding.
Drug interactions Sanoxal:
When used together, dexamethasone, cimetidine, praziquantel increase the concentration of albendazole sulfoxide in the blood.
How to take Sanoxal:
The drug is taken orally. The dose is set individually, depending on the type of helminth and the patient's body weight.
With neurocysticercosis and echinococcosis, patients weighing 60 kg or more are prescribed 400 mg 2 times / day, with a body weight less than 60 kg - at a dose of 15 mg / kg / day in 2 divided doses. The maximum daily dose is 800 mg. The course of treatment for neurocysticercosis is 8-30 days, for echinococcosis - 3 cycles of 28 days with a 14-day break between cycles. With surgical treatment, the duration of drug treatment is 3 courses.
For ascariasis, trichocephalosis, enterobiasis, ankylostomiasis for adults and children over 3 years old - 400 mg once, if necessary, repeat the reception after 3 weeks.
With giardiasis, adults and children over 3 years old - 400 mg 1 time / day for 3 days.
With strongyloidosis and cestodosis for adults and children over 3 years old - 400 mg 1 time / day for 3 days, if necessary, repeat after 3 weeks.
The Sanoxal tablets can be chewed or swallowed whole.
Storage conditions and shelf life
The drug should be stored out of the reach of children, in a dry, dark place at a temperature not exceeding 25 ° C. The shelf life is 3 years.
