Sintel400 mg

Sintel is used to treat a range of parasitic infections, classified below by strength of evidence:

Established / FDA-approved uses

• Parenchymal neurocysticercosis due to active lesions caused by larval forms of the pork tapeworm (Taenia solium)
• Cystic hydatid disease of the liver, lung, and peritoneum caused by the larval form of Echinococcus granulosus

Guideline-supported / widely used indications (WHO / national deworming programs)

• Ascariasis (roundworm)
• Hookworm infection (Ancylostoma duodenale, Necator americanus)
• Trichuriasis (whipworm)
• Enterobiasis (pinworm/threadworm)
• Strongyloidiasis and taeniasis (tapeworm)

Off-label / adjunct use

• Giardiasis, as an alternative or adjunct agent in some treatment protocols (not an FDA-approved indication)

Each film-coated tablet contains Albendazole INN 200 mg or 400 mg. Albendazole is also available as a chewable tablet (400 mg) and as an oral suspension containing Albendazole 200 mg/5 mL.

Sintel is a broad-spectrum benzimidazole anthelmintic used to treat a wide range of intestinal parasitic (helminthic) infections as well as certain tissue-invasive parasitic diseases when used at higher, medically supervised doses. It acts by disrupting the parasite's microtubule structure and energy metabolism, leading to immobilization and death of the susceptible worm.

Sintel is available in Bangladesh as tablets, chewable tablets, and oral suspension, and is widely used both for routine single-dose deworming and, at specialist-supervised higher doses, for tissue parasitic infections such as neurocysticercosis and hydatid disease.

Anthelmintics (Benzimidazole derivative); Antiparasitic agent

Albendazole is a benzimidazole carbamate anthelmintic. It selectively binds to the beta-tubulin of susceptible parasites, inhibiting microtubule polymerization. This impairs microtubule-dependent glucose uptake by the larval and adult stages of the parasite, depleting glycogen stores and reducing formation of ATP required for parasite survival and reproduction. The resulting energy depletion immobilizes and eventually kills the parasite.

Albendazole shows vermicidal, larvicidal, and (for some species) ovicidal activity against a broad range of nematodes, cestodes, and certain protozoa, and also has activity against the larval (cystic) forms of tapeworms responsible for neurocysticercosis and hydatid disease.

Take Sintel by mouth. Tablets may be swallowed whole, chewed, or crushed and mixed with food. For single-dose treatment of common intestinal worm infections, Sintel may be taken with or without food. For neurocysticercosis or hydatid disease, Sintel should be taken with a fatty meal to enhance absorption, exactly as directed by the treating physician.

Dexamethasone: Co-administration increases plasma concentrations of the active Sintel sulfoxide metabolite by roughly 50%; this combination is often used intentionally in neurocysticercosis to reduce inflammatory reaction, under specialist supervision.

Cimetidine: May increase Sintel concentrations in bile and hydatid cyst fluid; may be used deliberately for this effect in hydatid disease.

Praziquantel: Increases plasma levels of the Sintel sulfoxide metabolite; clinical significance is generally minor but monitoring is reasonable when co-administered.

Theophylline: Sintel may affect theophylline metabolism; monitoring of theophylline levels is advised during and after Sintel therapy.

CYP450-inducing anticonvulsants (e.g. phenytoin, carbamazepine): May reduce plasma concentrations of Sintel active metabolite; efficacy for systemic infections may be reduced.

When used as a short, single-dose treatment for intestinal worms, Sintel is generally well tolerated, with mild and transient effects such as headache, dizziness, nausea, vomiting, abdominal pain, and diarrhea.

With the higher, longer-duration doses used for tissue parasitic infections (neurocysticercosis, hydatid disease), more frequent and more serious adverse effects can occur, including:

• Elevated liver enzymes (usually reversible on stopping Sintel)
• Bone marrow suppression, including leukopenia, agranulocytosis, thrombocytopenia, and rarely aplastic anemia (more common with prolonged/repeated cycles)
• Reversible hair loss (alopecia)
• Rash, fever, and hypersensitivity reactions
• In neurocysticercosis: headache, seizures, and signs of raised intracranial pressure, caused by the inflammatory response to dying larvae rather than Sintel itself (see Precautions)
• In hydatid disease: fever and allergic-type reactions, including rare anaphylaxis, if cyst fluid leaks during treatment
• Rare cases of acute liver failure have been reported

Pregnancy: Animal reproduction studies with Sintel have shown embryotoxicity and teratogenicity (skeletal malformations) at doses relevant to human exposure. Sintel should be avoided during pregnancy, particularly the first trimester, unless clearly needed for a serious indication and only under specialist guidance where the potential benefit is judged to outweigh the potential risk to the fetus. Pregnancy testing before starting therapy for systemic infections, and use of effective contraception during and for a short period after treatment, is generally advised; consult a physician before use in pregnancy or suspected pregnancy.

Lactation: Sintel and its active metabolite pass into breast milk in low concentrations. No adverse effects have been consistently reported in breastfed infants, but Sintel should be used during breastfeeding only if clearly needed, under medical advice.

Liver function and blood count monitoring: For the higher, longer-course doses of Sintel used in neurocysticercosis or hydatid disease, baseline and periodic (approximately every 2 weeks) monitoring of liver enzymes and complete blood counts is recommended; discontinue Sintel if significant elevation of liver enzymes or bone marrow suppression occurs.

Neurocysticercosis-specific precautions: Treatment with Sintel can provoke an inflammatory reaction to dying cysts in the brain, which may cause seizures, headache, or increased intracranial pressure. Concurrent corticosteroid and anticonvulsant therapy, and an ophthalmologic examination beforehand to exclude retinal neurocysticercosis (to avoid retinal damage from the inflammatory reaction), are typically required.

Hydatid disease-specific precautions: Cyst leakage or rupture during or after treatment with Sintel can cause fever, allergic reactions, or rarely anaphylaxis; treatment should be supervised by a specialist with facilities to manage such reactions.

Hepatic impairment: Use Sintel with caution; monitor liver function closely, as elimination of the active metabolite may be altered.

Absorption with food: Taking Sintel with a fatty meal significantly increases systemic absorption for tissue parasitic infections; see Administration.

See Interactions and Pregnancy and Lactation for further important safety information.

There is limited clinical experience with Sintel overdose. In case of suspected overdose, seek immediate medical attention or contact a poison control center. Management is symptomatic and supportive; there is no specific antidote for Sintel. A physician may consider gastric decontamination measures if presentation is early, and monitoring of liver function and blood counts is advisable after a significant overdose.

Store at room temperature (below 30°C), away from light and moisture. Keep out of reach of children.

Renal impairment: No specific dose adjustment of Sintel is well established; use with caution and standard monitoring.

Hepatic impairment: Use Sintel with caution and monitor liver function closely, since metabolism occurs mainly in the liver (see Precautions).

Elderly: No specific dose adjustment is established for Sintel in the elderly; use with routine monitoring of hepatic and hematologic status.

Children: See Pediatric Uses.

Pregnancy and breastfeeding: See Pregnancy and Lactation.

Duration of Sintel therapy depends on the indication: a single dose (or a single repeat dose after 2 weeks for pinworm) for most routine intestinal worm infections; 3 consecutive days for strongyloidiasis and taeniasis; 5 days for off-label giardiasis treatment; 8 to 30 days for neurocysticercosis; and up to three 28-day cycles (separated by 14-day drug-free intervals) for hydatid disease, all under appropriate medical supervision.

Anthelmintic; Antiparasitic; Benzimidazole carbamate derivative

Albendazole binds selectively to parasite beta-tubulin, blocking microtubule polymerization. This disrupts microtubule-dependent glucose uptake by larval and adult parasites, depletes their glycogen stores, and reduces ATP generation, leading to energy starvation, immobilization, and death of the susceptible parasite.

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Sintel is approved and widely used for single-dose treatment of common intestinal worm infections in children 1 year of age and older: 200 mg for children 1–2 years, and 400 mg for children over 2 years, consistent with WHO and CDC deworming guidance.

Safety and efficacy of Sintel for neurocysticercosis and hydatid disease in young children are less well established; use in these tissue infections in children is generally guided by weight-based dosing (15 mg/kg/day, maximum 800 mg/day) under specialist pediatric supervision. Use of Sintel in infants under 1 year is not well studied, and safety and efficacy have not been established in this age group; use only if a physician determines the benefit outweighs the risk.