Vermox 500mg Tablet
Clinical Summary
Quick overview from the medicine insert
Indication
Treatment of single and mixed helminth gastrointestinal infestations.
Dosage (summary)
One tablet (500 mg) as a single dose for adults and children over 1 year.
Special Populations
- Children under 1 year
- Patients with hepatic impairment
Pregnancy & Breastfeeding
Contraindicated in pregnancy; not recommended during lactation.
Key Drug Interactions
- Avoid with metronidazole
- Cimetidine may increase plasma concentrations
Contraindications
- Hypersensitivity to mebendazole
- Pregnancy
- Children under 1 year
Common side effects
- Abdominal pain
- Diarrhea
- Dizziness
Counselling Points
- Take with liquid if crushed
- Monitor for side effects
- Report any adverse reactions
Serious warnings
- Convulsions reported in children
- Risk of liver function disturbances with high doses
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Clinical Particulars
Section 4 of the official insert — extracted exactly as issued, no alterations
4.1 Therapeutic indications
VERMOX u00ae 500 mg is indicated for the treatment of single and mixed helminth gastrointestinal infestations caused by:
- Nematodes such as:
- Trichuris trichiura (whipworm)
- Ancylostoma duodenale (hookworm)
- Necator americanus (hookworm)
- Ascaris lumbricoides (large roundworm)
- Enterobius vermicularis (pinworm)
4.2 Posology and method of administration
Whipworm; Hookworm; Large Roundworm; Pinworm:
Adults and children older than 1 year: One tablet (500 mg) given as a single dose. The tablets may be crushed and given with some liquid for children. A single dose of VERMOX u00ae 500 mg may not be sufficient to cure infestations with hookworm and whipworm (Trichuris) although a substantial reduction in egg count can be expected. A second course of treatment should be given to those patients who are still infected three to four weeks after the first course. In worm-eradication campaigns the standard course should be administered every quarter during the first year. The efficacy of VERMOX u00ae is dependent upon the duration of physical contact between drug and parasite. For infants under 1 year of age, see section 4.3 and 4.4.
4.3 Contraindications
VERMOX u00ae 500 mg should not be used in children below the age of 1 years. VERMOX u00ae 500 mg is contraindicated in persons with a known hypersensitivity to mebendazole or to any of the other ingredients in VERMOX u00ae 500 mg (see section 6.1). VERMOX u00ae 500 mg should not be given during pregnancy, as it is teratogenic in animals (see section 4.6). Concomitant use of VERMOX u00ae 500 mg and metronidazole should be avoided (see section 4.4 and 4.5).
4.4 Special warnings and precautions for use
Convulsions in children, including in infants below one year of age, have been reported during post-marketing experience with VERMOX u00ae 500 mg (see section 4.8). VERMOX u00ae 500 mg should not be given to children below 1 year of age. VERMOX u00ae 500 mg or VERMOX u00ae SD should not be used and VERMOX u00ae 100 mg Tablets or VERMOX u00ae 20 mg/mL should only be given to very young children if their worm infections interfere significantly with the nutritional status and the physical development. To reduce the risk of choking, mebendazole oral suspension should be considered for patients such as young children who are unable to swallow the tablet. There have been reports of reversible liver function disturbances, hepatitis, neutropenia, agranulocytosis and glomerulonephritis described in patients who were treated with dosages substantially above those recommended for prolonged periods of time (see section 4.9). Results from a case control study investigating an outbreak of Stevens Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) indicated a possible relationship between SJS/TEN and the concomitant use of VERMOX u00ae 500 mg and metronidazole. Further data on interactions are not available. Therefore, concomitant use of VERMOX u00ae 500 mg and metronidazole should be avoided (see section 4.3 and 4.5). Patients with high parasitic burdens when treated with VERMOX u00ae 500 mg have manifested diarrhoea and abdominal pain. Lactose monohydrate VERMOX u00ae 500 mg contains lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, the total lactase deficiency, or glucose-galactose malabsorption should not take VERMOX u00ae 500 mg.
4.5 Interaction with other medicines and other forms of interaction
Concomitant treatment with cimetidine may inhibit the metabolism of the mebendazole in the liver, resulting in increased plasma concentrations of VERMOX u00ae 500 mg especially during prolonged treatment. Concomitant use of VERMOX u00ae 500 mg and metronidazole should be avoided (see section 4.3 and 4.4).
4.6 Fertility, pregnancy and lactation
Pregnancy VERMOX u00ae 500 mg is contraindicated during pregnancy (see section 4.3). Mebendazole has shown embryotoxic and teratogenic activity in rats and in mice at single oral doses. Lactation Limited data from case reports demonstrate that a small amount of mebendazole is present in human milk following oral administration. VERMOX u00ae 500 mg is not recommended during lactation. Fertility The effect on human fertility has not been evaluated.
4.7 Effects on ability to drive and use machines
VERMOX u00ae 500 mg can cause side effects such as dizziness. Caution is advised before driving a vehicle or operating machinery until the effects of VERMOX u00ae 500 mg are known.
4.8 Undesirable effects
Patients with high parasitic burdens when treated with VERMOX u00ae 500 mg have manifested diarrhea and abdominal pain. Clinical trial data The safety of VERMOX u00ae 500 mg was evaluated in 6276 subjects who participated in 39 clinical trials for the treatment of single or mixed parasitic infestations of the gastrointestinal tract. In these 39 clinical trials, no adverse drug reactions (ADRs) occurred in u2265 1% of VERMOX u00ae 500 mg-treated subjects. ADRs occurring in u2264 1% of VERMOX u00ae -treated subjects are shown below.
Blood and the lymphatic system disorders Less frequent: agranulocytosis (higher and prolonged doses) Nervous system disorders Less frequent: dizziness Gastrointestinal disorders Frequent: abdominal pain Less frequent: abdominal discomfort, diarrhoea, flatulence Skin and subcutaneous tissue disorders Less frequent: rash Renal and urinary disorders Less frequent: glomerulonephritis (higher and prolonged doses) Post-marketing Blood and the lymphatic system disorders Less frequent: neutropenia Immune system disorders Less frequent: hypersensitivity including anaphylactic reaction and anaphylactoid reaction Nervous system disorders Less frequent: convulsions Gastrointestinal disorders Less frequent: nausea, vomiting Hepato-biliary disorders Less frequent: hepatitis, abnormal liver function tests Skin and subcutaneous tissue disorders Less frequent: toxic epidermal necrolysis, Stevens Johnson syndrome, exanthema, angioedema, urticaria, alopecia Reporting of suspected adverse reactions: Reporting suspected adverse reactions after authorisation of VERMOX u00ae 500 mg tablets is important. It allows continued monitoring of the benefit/risk balance of VERMOX u00ae 500 mg tablets. Health care providers are asked to report any suspected adverse reactions to SAHPRA via the u201c6.04 Adverse Drug Reactions Reporting Formu201d, found online under SAHPRAu2019s publications: https://www.sahpra.org.za/Publications/Index/8.
4.9 Overdose
In patients treated at dosages substantially higher than recommended or for prolonged periods of time, the following adverse reactions have been reported: alopecia, reversible liver function disturbances, hepatitis, agranulocytosis, neutropenia and glomerulonephritis. With the exception of agranulocytosis and glomerulonephritis, these also have been reported in patients who were treated with VERMOX u00ae 500 mg tablets at standard dosages.
Symptoms In the event of accidental overdose, abdominal cramps, nausea, vomiting and diarrhoea may occur.
Treatment There is no specific antidote. If poisoning or excessive overdosage is suspected it is recommended, on general principles, that vomiting be induced and such symptomatic supportive therapy be administered as appears indicated. Activated charcoal may be given.