Albendazole

*antiparasitic (benzimidazole)

Brands/Synonyms : Albenil, Albex, Ovispec, Valbazen

Therapeutics

Soundalike Alert : 

Fomepizole – ethylene glycol antidote

Fenbendazole – other benzimidazole antiparasitic

Available Formulations

Oral solution 113.6 mg/mL

Indications

*Giardiasis 

Dosage (Dog) 25 mg/kg PO q 12h, Duration 2 days (4 doses total)

Expected Effects Complete elimination of Giardia cysts from feces

*Filaroides hirthi

Dosage (Dog) 50 mg/kg PO q 12h,  Duration 5 days (10 doses total)

Expected Effects  Full elimination of F. hirthi from pups of treated dams (0% infected), vs. 84% infected pups of nontreated dams

*Trichinosis

Pretreatment with milbemycin oxime for 10 days provided minimal if any increase in efficacy

Dosage (DogCat) 50 mg/kg PO q 12h.  Duration 7 days

Expected Effects  Marked reduction in muscle larva burden

*Oslerus (formerly Filaroides) osleri

Dosage (Dog) 9.5 mg/kg PO q 24h  Duration 55 days

Expected Effects

Resolution of clinical signs after 30 days of treatment

Bronchial nodules may persist

*Paragonimiasis

Dosage (Cat) 50-100 mg/kg PO q 24h ,Duration 14-21 days

Expected Effects

Elimination of Paragonimus ova in feces 9 days after start of treatment

Elimination of live flukes from lungs 4-5 weeks after start of treatment

Precautions

Contraindications:  Hypersensitivity to the drug, Neutropenia, Thrombocytopenia, Nonregenerative anemia

Adverse Side Effects : Myelotoxicosis/bone marrow toxicosis described as dose-related (dog) or idiosyncratic (cat) in single case reports - appears to be rare

Teratogenicity/Pregnancy/Lactation : Has teratogenic potential

Pearls

Giardiasis: fenbendazole appears safer and equally effective compared to albendazole

Trichinosis: albendazole treatment seems more effective in dogs than cats

Oslerus (Filaroides) osleri treatment protocol (55 days) is expected to cause bone marrow toxicosis

References PubMed – 9187723

Aluminum hydroxide

*phosphate binder; antacid

Brands/Synonyms : AlternaGEL, Alu-Cap, Aludrox, Amphojel, Dialume, Gaviscon, Nephrox, 

Therapeutics 

Interactions  In dogs, has interfered with absorption of other medications such as beta-blockers, tetracyclines, and fluoroquinolones

Antidote/Reversal Agent : Deferoxamine

Indications

*Chronic kidney disease 

Dosage (Cat) 27.5-40.5 mg/kg PO q 12h , Duration : As needed based on duration of hyperphosphatemia, 

Expected Effects Reduction of serum phosphate level.

* Chronic kidney disease due to renal dysplasia

Dosage (Dog) 50 mg/kg PO q 12h, Duration : 4 months in reported case; usually as needed

Expected Effects Reduction of serum phosphate level

* Primary hypoparathyroidism

Dosage (Cat) 20-130 mg/kg PO q 8-12h,  Duration : Indefinite, according to persistence of hyperphosphatemia (17 months in this case)

Expected Effects Reduction of serum phosphate level

Available Formulations 

Oral solution 60 mg/mL

Tab 300 mg

Precautions

Contraindications : Hypophosphatemia,  Hypersensitivity to the drug

Adverse Side Effects : In dogs, has caused aluminum toxicosis when given in doses of 145-200 mg/kg/day during chronic kidney disease.

Pearls

Generally begun low and titrated up according to response (serum phosphates level), while avoiding aluminum toxicosis

May decrease appetite

Aluminum toxicosis in dogs manifests as central neurologic signs progressing to obtundation and microcytosis, and is confirmed with a serum aluminum level (normal: 0.008-0.012 ppm)

References 

PubMed – 19000253

PubMed – 6681962