THERAPY FOR NEUROCYSTICERCOSIS - PHARMACOKINETIC INTERACTION OF ALBENDAZOLE SULFOXIDE WITH DEXAMETHASONE

Albendazole is considered the drug of choice for neurocysticercosis. I t is frequently used in combination with dexamethasone to prevent the acute inflammatory reaction due to cysticercal death. It has been repo rted that dexamethasone increases the plasma level of albendazole sulf oxide, the active metabolite of albendazole. The pharmacokinetic inter action of albendazole sulfoxide with dexamethasone, associated or not with cimetidine, was investigated in 24 patients with active intrapare nchymal brain cysticercosis. Eight of these patients received albendaz ole alone, eight received it in combination with dexamethasone, and ei ght received it in combination with both dexamethasone and cimetidine. The pharmacokinetic parameters maximum plasma concentration, rime to maximum plasma concentration. absorption half-life, and absorption rat e constant did not differ between groups, suggesting that the formatio n of albendazole sulfoxide was not altered by the administration of de xamethasone, combined or not with cimetidine. There were significant d ifferences, however, in the parameters plasma concentration-time curve , oral clearance, elimination half-life, and elimination rate constant , suggesting that dexamethasone, combined or not with cimetidine, decr eases the rate of elimination of albendazole sulfoxide.