MINTEZOL
Clinical safety rating: caution
Comprehensive clinical and safety monograph for MINTEZOL (MINTEZOL).
Thiabendazole inhibits the mitochondrial fumarate reductase system in susceptible helminths, disrupting energy metabolism.
| Metabolism | Extensively metabolized in the liver via hydroxylation, primarily by cytochrome P450 enzymes, with subsequent glucuronidation. |
| Excretion | Renal: 90% within 24 hours (5% unchanged, 85% as metabolites). Fecal: <10%. |
| Half-life | Terminal elimination half-life: 2-8 hours (mean 4 hours). Hepatic impairment prolongs; dose adjustment recommended. |
| Protein binding | 93% bound to plasma proteins (mainly albumin). |
| Volume of Distribution | 2-4 L/kg; extensively distributed into tissues including brain, liver, and muscles. |
| Bioavailability | Oral: >90% (well absorbed from GI tract). |
| Onset of Action | Oral: 1-2 hours for anthelmintic effect. |
| Duration of Action | Single dose maintains therapeutic levels for 12-24 hours. Repeat dosing often required for complete cure. |
| Molecular Weight | 275.35 |
50 mg/kg/day orally in 2-3 divided doses, maximum 3 g/day, for 2-3 days.
| Dosage form | SUSPENSION |
| Renal impairment | No specific guidelines; use caution in severe renal impairment (CrCl <10 mL/min) with potential for increased toxicity; consider dose reduction or extended interval. |
| Liver impairment | Contraindicated in Child-Pugh class C; for Child-Pugh A and B, use with caution and monitor for adverse effects, no specific dose reduction guidelines. |
| Pediatric use | 50 mg/kg/day orally in 2 divided doses, maximum 3 g/day, for 2-3 days (age >1 year); not recommended for children <1 year. |
| Geriatric use | No specific dose adjustment; use lowest effective dose due to increased risk of CNS and gastrointestinal side effects; monitor renal function. |
| 1st trimester | Avoid due to teratogenicity in animal studies and limited human data; use only if benefit outweighs risk. |
| 2nd trimester | Avoid; potential fetal harm based on animal data. |
| 3rd trimester | Avoid near term due to risk of kernicterus and hemolysis in G6PD-deficient infants. |
Clinical note
Comprehensive clinical and safety monograph for MINTEZOL (MINTEZOL).
| Placental transfer | Crosses the placenta; detected in fetal tissues at concentrations up to 50% of maternal levels. |
| Breastfeeding | Excreted into breast milk in low amounts; however, due to potential for hemolysis in G6PD-deficient infants, caution is advised. Monitor infant for jaundice and diarrhea. |
| Lactation Rating |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to thiabendazoleHistory of cholestasis or liver dysfunctionPregnancy (unless strongly indicated)Concomitant use with drugs causing hepatotoxicityG6PD deficiency (relative, but caution)
| Precautions | May cause serious hepatic injury including cholestatic jaundice and hepatic necrosis; monitor liver function tests. Associated with severe skin reactions (Stevens-Johnson syndrome, erythema multiforme). Avoid in patients with hepatic disease. May cause CNS effects such as dizziness and seizures. Use with caution in renal impairment. |
| Food/Dietary | Take with food or after meals to minimize gastrointestinal side effects. Avoid alcohol consumption during therapy as it may increase risk of hepatotoxicity. |
Loading safety data…
| L3 (Moderately Safe) |
| Teratogenic Risk | FDA Pregnancy Category C. First trimester: avoid use; associated with increased risk of congenital anomalies (cranial, skeletal) in animal studies. Second and third trimesters: use only if clearly needed; potential risk of fetal bradycardia and CNS depression. Limited human data, but risk-benefit assessment required. |
| Fetal Monitoring | Monitor maternal hepatic function (LFTs) and renal function. Fetal monitoring: assess heart rate for bradycardia during prolonged therapy. Consider ultrasound for fetal growth and anatomy if first-trimester exposure. |
| Fertility Effects | No specific human data on fertility impairment. Animal studies have shown no adverse effects on fertility at clinically relevant doses. Theoretical risk of hormonal disruption due to SHBG binding, but clinical significance unknown. |
| Clinical Pearls | MINTEZOL (thiabendazole) is primarily used for strongyloidiasis and cutaneous larva migrans. Monitor for hypersensitivity reactions, including Stevens-Johnson syndrome. Dose adjustment is necessary in hepatic impairment. Avoid in patients with known hypersensitivity to benzimidazoles. Administer after meals to reduce GI upset. |
| Patient Advice | Take this medication exactly as prescribed, usually twice daily for 2 days. · May cause dizziness or drowsiness; avoid driving or operating machinery until you know how you react. · Complete the full course even if symptoms improve. · Report any signs of allergic reaction: rash, itching, swelling, or difficulty breathing. · Do not crush or chew tablets; swallow whole with water. |