In a recent trial involving more than 600 children given treatment for a geohelminth eradication program in Zanzibar, the most common adverse events were limited to abdominal cramps (11%), fatigue (6%), headache (6%), vertigo (4.4%), and nausea (3.7%).45 This is similar to reports from other large clinical trials. Abstract. Although mebendazole does not eradicate echinococcal infection, the drug prevents progression of existing cysts and the development of new cysts when administered in high dose for a prolonged period. If the pharmacy that's willing to deliver medicines to your home doesn't have mebendazole in stock, you can ask for one of the branded alternatives for mebendazole. Mechanism of Action of Mebendazole Mebendazole is a benzimidazole used as a broad spectrum anthelminthic which acts by blocking glucose uptake in the parasite and depletion of its glycogen stores. The data are summarised and discussed in relation to suggested mechanisms of action. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for mebendazole and other medicines and health products. The drug has activity against T. saginata, T. solium and Hymenolepis nana, although praziquantel is more effective. Potentially contaminated vegetables should be thoroughly cooked and water boiled before ingestion. Mebendazole (MBZ), a drug commonly used for helminitic infections, has recently gained substantial attention as a repositioning candidate for cancer treatment. However, despite its use in millions of patients for over 40 years its molecular mechanism of action remains elusive. Mebendazole binds irreversibly to colchicine-sensitive sites on tubulin, blocking microtubule assembly. Mechanism of Action. In veterinary practice, resistance to benzimidazoles is associated with a single amino acid substitution from phenylalanine to tyrosine at position 200 in parasite β-tubulin. Mechanism of action. Thus, systemic bioavailability is low, accounting not only for its poor tissue levels and relative lack of usefulness in extraintestinal infections, but also for its low rate of side effects. We use cookies to help provide and enhance our service and tailor content and ads. Because of its rapid killing effects, an inflammatory response termed the Mazzotti reaction (itching, rash, fever, swollen lymph nodes, and arthralgias) may occur as the worms are eliminated. The in vitro and in vivo results obtained by these authors would indicate that the mode of action of benzimidazole may be, in part, due to a bioenergetic disruption caused by transmembrane proton discharge. The cytoplasmic and mitochondrial MDH obtained from A. suum, F. hepatica and M. expansa was inhibited by mebendazole, while albendazole, parbendazole and thiabendazole inhibited the F. hepatica enzymes more than the enzyme from A. suum[238]. The principal mode of action for Mebendazole is by its inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules. When taken at higher doses for longer periods (50 mg/kg for 3 to 12 months) for the treatment of echinococcosis, side effects occurred in approximately 20% of patients, were minimal and reversible in all patients without discontinuing treatment (transient elevation of transaminases, abdominal pain, headache, vertigo, urticaria, and dyspepsia).46,47 There are also case reports of reversible bone marrow suppression.48. Drugs of choice are listed in Table 4-25. A 52-year old woman with an acute parasitic infection took a first dose of mebendazole 100 mg and 2 hours later developed acute generalized urticaria. Prevention of infection involves sanitary disposal of human excreta and prevention of fecal contamination of the topsoil by infected animals. Mebendazole works by preventing the worms from absorbing sugars which they need to survive. As a result, its glucose uptake and the digestive and reproductive functions are disrupted, leading to immobilization, inhibition of egg production and death of the helminth. Two of these compounds, mebendazole (MBZ) and albendazole (ABZ) are registered for human use. The inhibition of glucose transport in A. suum and T. spiralis larvae at 10− 5 - 10− 6 M concentration of mebendazole has also been demonstrated [233]. Mechanism of Action Albendazole is found to inhibit the polymerization of the parasite tubulin into microtubules. • Mechanism of action: – Mebendazole probably acts by inhibiting microtubule synthesis. In addition, glucose uptake into the parasite is disrupted with mebendazole, causing worms to starve to death. MECHANISM OF ACTION Mebendazole inhibits the formation of the worms' microtubules and causes the worms' glucose depletion. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body. Through microtubular destruction, mebendazole kills helminths by inhibiting glucose uptake into susceptible parasites. single dose of 100 mg and it is supplied in a container or package containing not more than 800 mg. In this study, MZ arrested cells at the G2-M phase before the onset of apoptosis, as detected by using fluorescence-activated cell sorter analysis. However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. Like albendazole, mebendazole is poorly soluble, poorly absorbed, and undergoes extensive first-pass metabolism in the liver. Without glucose, the cells of the worms lose their energy supply and quickly die. In addition mebendazole probably blocks glucose uptake in parasite and depletes its glycogen stores. Data from the NCI 60 cell line panel revealed only modest correlation between MBZ and ABZ, indicating differences in mechanism of action. Mark Kester PhD, ... Kent E. Vrana PhD, in Elsevier's Integrated Review Pharmacology (Second Edition), 2012. Further work on the mode of action of benzimidazoles has shown that drugs of this class interfere with the energy pathway of the helminths by inhibiting both cytoplasmic and mitochondrial malate dehydrogenase (MDH) [237,238]. Praziquantel is effective against a broad spectrum of helminths, including cestodes and many flukes. Based on the evidence presented, it is proposed that … Praziquantel increases cell membrane permeability, causing a loss of intracellular calcium, massive contractions, and paralysis. Mebendazole crosses the blood-brain barrier but reaches levels significantly lower than serum. Mechanism of action Mebendazole causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. It is ovicidal for Ascaris and Trichuris spp. By continuing you agree to the use of cookies. Although mebendazole kills adult worms, it does not kill the eggs. Tick mebendazole mechanism of action: a) Inhibiting oxidative phosphorylation in some species of helminthes b) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes c) Inhibiting microtubule synthesis in … Although thiabendazole 25 mg/kg twice daily (maximal daily dose of 3 g) for 2 days is effective, thiabendazole-resistant Trichostrongylus strains have been identified, and the drug is associated with side effects. A recent review has led the WHO to recommend use of mebendazole, if otherwise indicated, in children as young as 1 year of age.71 There are no data on the agent's excretion in human milk, but little is excreted in animal milk; caution is indicated but breastfeeding women can be treated if necessary. Mebendazole is a benzimidazole carbamate with a broad range of anthelmintic activity.1,2,64,65 It is active against the larvae and adults of E. vermicularis, A. lumbricoides, T. trichiura, N. americanus and A. duodenale. Mebendazole is active against tapeworms, roundworms, hookworms, threadworms, pinworms , pork worms, and whipworms. Test of cure should not be performed for at least 1 week after therapy. Mebendazole, formulated as 100 mg tablets, has low water solubility and is poorly absorbed. High-dose mebendazole often is used as a secondary agent in the treatment of trichinellosis; systemic corticosteroids must be used concomitantly. 42-2) was first introduced in 1977 as a veterinary anthelmintic agent for treatment of Echinococcus multilocularis. Data now suggest no increase in major congenital defects, so mebendazole can be recommended for use in the second and third trimesters if absolutely necessary.72, F. Matthew Kuhlmann, James M. Fleckenstein, in Infectious Diseases (Fourth Edition), 2017. It activate Nicotinic Receptor B. Some of the brands for mebendazole might be better known than mebendazole itself. Several studies have reported that single dose ivermectin (200–400 µg/kg body weight) in combination with albendazole improves cure and egg reduction rates in trichuriasis.33. Nilanthi R. de Silva, Edward S. Cooper, in Tropical Infectious Diseases (Third Edition), 2011, Mebendazole or albendazole by mouth are recommended for treatment of trichuriasis. It also blocks glucose uptake in parasites and depletes its glycogen store. Donald AP Bundy, ... Simon Brooker, in Hunter's Tropical Medicine and Emerging Infectious Disease (Ninth Edition), 2013. Furthermore, concomitant administration of phenytoin and carbamazepine results in lower plasma levels, presumably because of induction of the cytochrome P-450 enzyme CYP3A4. The effects of mebendazole during pregnancy have been investigated in a case–control study in the mothers of babies born with congenital abnormalities and in matched control mothers of babies born without congenital abnormalities in the population-based data set of the Hungarian Case–control Surveillance of Congenital Abnormalities between 1980 and 1996 [17]. Unlike albendazole, these and other metabolites are not believed to have significant anthelmintic activity. The data are summarised and discussed in relation to suggested mechanisms of action. It is useful for giardiasis, trichuriasis, filariasis, neurocysticercosis, hydatid disease, pinworm disease, and ascariasis, among other diseases. These drugs may cause gastrointestinal upset. Of 38 151 women whose neonates had no defects, 14 had taken mebendazole during pregnancy; of 22 843 women whose neonates had congenital abnormalities, 14 had taken mebendazole for intestinal parasites during pregnancy (OR = 1.67; 95% CI = 0.7, 4.2). Numerous types of helminths (flatworms, round worms, flukes, and tapeworms) are particularly problematic in areas of the world where sanitation is poor. Its bind with parasite ‘β-tubulin’ and inhibit its polymerization. James S. McCarthy, Thomas A. Moore, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015. Mechanism of Action of Mebendazole. You can get this information while placing the order for mebendazole with the pharmacy. Mechanism of Action Although the exact mechanism of anthelmintic activity of mebendazole has not been fully elucidated, the drug appears to cause selective and irreversible inhibition of the uptake of glucose and other low molecular weight nutrients in susceptible helminths; inhibition of glucose uptake appears to result in endogenous depletion of glycogen stores in the helminth. Mebendazole (Fig. Indications and Usage for Mebendazole Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American … About half of the absorbed dose is excreted in the urine as metabolites40; however, a significant portion is also excreted in bile as metabolites. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for mebendazole before they complete the sale. This leads to hyperpolarization of invertebrate nerve and muscle cells, which causes paralysis. She was given intramuscular methylprednisolone and dexchlorpheniramine and improved within 1–2 hours. Fortunately, ivermectin does not cross the mammalian blood-brain barrier. ROUTE ONSET PEAK DURATION Oral Unknown 2-4 hr Variable. Because of this it is important to break the cycle of re-infection. Although the exact mechanism of action of albendazole has not been fully elucidated, the principal anthelmintic effect of benzimidazoles, including albendazole, appears to be the specific, high-affinity binding of the drug to free beta-tubulin in parasite cells, resulting in selective inhibition of parasite microtubule polymerization, and inhibition of microtubule-dependent uptake of glucose. However, its pharmacokinetic profile enables a single 500-mg dose to be administered for mass treatment campaigns to control soil-transmitted helminths. In addition, glucose uptake into the parasite is disrupted with mebendazole, causing worms to starve to death. Affected parasites are expelled in the feces. It interferes with protein synthesis. It is notable that skin tests were apparently not useful in making the diagnosis in this case. A recent systematic review of the efficacy of single dose, oral mebendazole, albendazole, levamisole, and pyrantel found that all four showed low cure rates in trichuriasis, whereas higher cure and egg reduction rates were reported when 3-day dosing schedules of mebendazole or albendazole were used.29 A double blind, placebo-controlled study that examined the efficacy of ivermectin for treatment of trichuriasis found it to be at least as effective as single dose albendazole,30 but other studies have reported low efficacy.31 Thus for clinically significant infections, mebendazole 200 mg/day on 3 successive days is recommended, or albendazole 400 mg/day for 3 days. It binds to β-tubulin with high affinity and inhibit microtubule polymerization in parasites. Lack of data in children <2 years of age has precluded specific U.S. labeling for or establishment of dosage in this age group though the label leaves the physician some discretion in electing to treat children <2 years of age. Thus, treatment with mebendazole during pregnancy was not significantly teratogenic or fetotoxic, although the numbers of treated cases and controls in this study were limited, which may have reduced the statistical power of this case–control study. This kills the worm within a few days. The absorbed portion of mebendazole is predominantly metabolized by the liver. The broad-spectrum of activity and safety of mebendazole remain, after 5 years of clinical experience, unique features of this anthelmintic. There is a higher affinity of albendazole to the parasite tubulin and so the activity is mediated mainly against the parasite rather than on the host. Mebendazole inhibits the formation of the worms’ microtubules and causes the worms’ glucose depletion. Although mebendazole has not been fully evaluated in children 2 years or younger, it is well tolerated in community geohelminth control programs.42,43 The maximum recommended dosage in humans, regardless of total body weight, is 500 mg/day. Based on the evidence presented, it is proposed that mebendazole would synergise with a range of other drugs, including existing chemotherapeutics, and that further exploration of the potential of mebendazole as an anti-cancer therapeutic is warranted. Anticancer treatment efficacy is limited by the development of refractory tumor cells characterized by increased expression and activity of mechanisms promoting survival, proliferation, and metastatic spread. It would be best to get this clarified while placing the order. Note that some of these medications are available only outside the United States or through the Centers for Disease Control and Prevention. 6. In a randomized, placebo-controlled trial in Peru, where women in the second and third trimesters were enrolled, no differences in the incidence of adverse effects were observed between the treatment arm compared with those receiving placebo.51 The beneficial effect of decreased incidence of very low birth weight was again noted. ... Mebendazole is a famous antiparasitic drug and it has significant activity in microtubule and fibroblast inhibition and suppresses the tumor cells remarkably. Pediatric dosage is identical to adult dosage. we explored the mechanism behind the anticancer action of Mebendazole, and found out that Mebendazole acts in a similar way as a group of chemotherapies such as Taxol. Although metabolites are excreted in the urine, there are no clinical data on the use of mebendazole in patients with kidney disease, and dose adjustment does not appear to be necessary in this setting. Susceptible helminths become paralyzed and depleted of energy stores, but death and clearance of the worms from the gastrointestinal tract can take days. For the treatment of soil-transmitted helminths, mebendazole is typically administered as 100 mg given twice daily for 3 days. However, 90 minutes after an oral challenge with mebendazole 75 mg, she developed itching and wheals on her forearms. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. xPharm: The Comprehensive Pharmacology Reference, Laboratory Diagnosis and Therapy of Infectious Diseases, Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), Approaches to Design and Synthesis of Antiparasitic Drugs, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), Tropical Infectious Diseases (Third Edition), Elsevier's Integrated Review Pharmacology (Second Edition), Nematodes Limited to the Intestinal Tract (Enterobius vermicularis, Trichuris trichiura, Capillaria philippinensis and Trichostrongylus spp. Indication : Enterobiasis; Trichuriasis; Ascariasis; Ancylostomiasis; Contraindications : Mebendazole is a benzimidazole used as a broad spectrum anthelminthic which acts by blocking glucose uptake in the parasite and depletion of its glycogen stores. The drug's poor absorption does not appear to affect clinical efficacy except, perhaps, in the treatment of systemic helminth infections. Adverse effects generally involve gastrointestinal discomfort and are short lived. Mebendazole, like other benzimidazoles, causes death of parasites by interfering with the function of tubulin, an important protein in parasites, and preventing glucose uptake. Selectively and irreversibly inhibits uptake of glucose and other nutrients by susceptible helminthes. The drug is effective, cheap and has few side-effects. Common side effects include nausea, abdominal pains, and headaches. Mebendazole 100 mg twice daily for 3 days or a single dose of albendazole 400 mg is effective. Mebendazole is used to treat infections caused by worms such as whipworm, pinworm, roundworm, and hookworm. The uptake of exogenous glucose in A. suum and M. expansa is inhibited by mebendazole. In the same article (Ref.) The drug also has been reported to prompt the migration of adult Ascaris spp. The low bioavailability is attributable both to the low solubility of the oral formulation and to the high-level of first-pass metabolism in the liver. Nevertheless, caution seems warranted in these patients; therefore, if a prolonged course of therapy is anticipated, drug levels (if available) should be obtained. Mebendazole has largely been replaced by albendazole for echinococcosis. By preventing or disrupting the production of microtubules, a kind of proteins, these drugs interrupt the growth of cancer cells, prevent the transportation of nutrients to malignant cells, and may also hinder the formation of DNA in these atypical cells. Although it has been approved for the treatment of both intestinal and tissue helminths, it is less effective than albendazole for treatment of extraintestinal helminths, and therefore, it is used almost exclusively for the treatment of common intestinal nematode infections. Mebendazole is also effective in the treatment of certain types of filariasis; it is considered the drug of choice against Mansonella perstans (diethylcarbamazine is ineffective) and has been shown to have efficacy against L. loa, O. volvulus and Dracunculus medinensis infections. It Bind to GABA receptor & Hyperpolarize the worm muscle Due to the poor tissue penetration of mebendazole and the current availability of albendazole in all countries, mebendazole should no longer be used for these indications. Mebendazole- and albendazole-specific IgE was not detected. Mebendazole and thiabendazole block assembly of tubulin polymers. Ivermectin is effective for treating nematodes. It can also be used for infections caused by Angiostrongylus cantonensis, Angiostrongylus costaricensis, Toxocara canis and Trichostrongylus spp. Mebendazole, a well-known anti-helminthic drug in wide clinical use, has anti-cancer properties that have been elucidated in a broad range of pre-clinical studies across a number of different cancer types. In addition, some worm infections may be obtained by eating poorly cooked pork. These drugs are contraindicated in the first trimester of pregnancy and not recommended for infants, but clinical judgment must be used in the event of symptomatic infection. Abdominal pain and diarrhea may occur after mebendazole administration. It works by stopping the worms using sugar (glucose). Worm expulsion will be followed by clinical cure, but if the environment is unchanged reinfection is likely and retreatment every 3 months,21 or at least every year,32 is well justified. What is the mechanism of action of mebendazole? According to McCracken and Stilwell [239], the benzimidazole anthelmintics may act as lipid-soluble proton conductors both in artificial (phospholipid bilayer) and natural (rat-liver mitochondria) membrane systems. Seven hours after taking albendazole 400 mg, she developed identical lesions on her trunk, was treated as before, and recovered within 1 hour. By disrupting microtubule assembly, the formation of mitotic spindles is disrupted. In addition, these agents are embryotoxic and should be avoided during pregnancy. Immediate hypersensitivity to mebendazole and albendazole has been reported [36]. Treatment of capillariasis, infection with a nematode that is rare outside a circumscribed area of the Philippines, requires administration of mebendazole orally for 20 days, but albendazole generally is preferred for this indication. Significantly, there are also two case reports of anti-cancer activity in humans. Mebendazole acts by binding parasite tubulin, thus blocking microtubule assembly and interfering with glucose absorption. Satyavan Sharma, Nitya Anand, in Pharmacochemistry Library, 1997. Yet, in contrast to chemotherapies, due to the way Mebendazole works, its toxicity is incomparably lower. In six groups of different congenital abnormalities there was no higher prevalence of mebendazole use by the mothers. Intracellular microtubules in the cells of the worm are gradually lost. Most well-demonstrated mechanism of action of these drugs (fenbendazole, albendazole, and so on) is their effect on microtubules. Because of poor gastrointestinal tract absorption (<10%), side effects from the usual low-dose regimens are restricted to abdominal pain and diarrhea, mostly in people with heavy worm burdens, in whom an Ascaris worm occasionally migrates to the nose or mouth. ), Hunter's Tropical Medicine and Emerging Infectious Disease (Ninth Edition), Meyler's Side Effects of Drugs (Sixteenth Edition), Following systemic administration, mebendazole is found in liver, kidney, fat, muscle, spleen, and cerebrospinal fluid, There is a great deal of intra- and intersubject variation in plasma concentration levels of mebendazole, The half-life of mebendazole varies among individuals. The principal mode of action is by its inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules. Pyrantel pamoate 11 mg/kg once (maximal dose 1 g) can be used as an alternative. Although teratogenic in rats, the safety of mebendazole in pregnancy has been examined in three large human studies. It is less effective than thiabendazole against S. stercoralis. In ruminants, PO treatment with the benzimidazoles removes most of the major adult GI parasites and many of the larval stages. Mebendazole is an antihelmintic used for the treatment of pinworms, whipworms, hookworms, and roundworms. With high-dose regimens, monitoring for bone marrow suppression (leukopenia, agranulocytosis) and hepatic transaminase elevation is required. It is 95% protein-bound in plasma and undergoes rapid and extensive first-pass metabolism in the liver. Mebendazole reaches its highest tissue concentrations in the liver. Mebendazole is an anthelmintic (an-thel-MIN-tik) or anti-worm medication. The relative rates of oxidation in the liver and reduction in the GI tract vary between cattle and sheep, with the metabolism and excretion of benzimidazole compounds being more extensive in cattle than in sheep. 2 Mechanism of action of Albendazole is A. Mebendazole kills worms that cause gut infections such as threadworm (sometimes known as pinworm) and other less common worm infections (whipworm, roundworm and hookworm). directory of Pharmacies, Chemists and Druggists, Ministry of Health & Family Welfare-Government of India, Department of Health Research (DHR), Government of India, Department of Indian Systems of Medicine and Homoeopathy, Pharmacopoeial Laboratory for Indian Medicine (PLIM). Mebendazole tablets can be chewed, swallowed whole, or crushed with food. Ivermectin causes a tonic paralysis of worms, probably by activating a glutamate-activated chloride channel. Q. Albendazole, also known as albendazolum, is a medication used for the treatment of a variety of parasitic worm infestations. The blocking of glucose utilisation or its transport leads to decreased ATP synthesis causing depletion of the energy source in the worm. Home delivery services for mebendazole may be free or they may cost you depending on the pharmacy and the minimum order requirements. Because neither DEC nor ivermectin is effective against Mansonella perstans infection, mebendazole is thought to be the optimal treatment.70 Mebendazole has been used in the past to treat Angiostrongylus cantonensis, Gnathostoma spinigerum, and echinococcal disease. The drug has activity against adult Trichinella spiralis, with some activity against larval forms, and it is currently recommended in the treatment of trichinosis. Mebendazole has been used at high doses and for long periods in the treatment of C. philippinensis. The following discussion features a few of the medications used to treat worm infections. Mebendazole is excreted primarily (>90%) in feces, with the remainder eliminated in urine. Mean gestational age was longer and mean birth weight higher in neonates born to mothers who had taken mebendazole. A pyrosequence assay has shown this substitution to occur commonly in T. trichiura but not A. lumbricoides.34 This could explain why benzimidazoles are much less effective against trichuriasis than ascariasis. Mebendazole, a synthetic benzimidazole, is the agent used most widely in the U.S. for treatment of intestinal helminthiasis, including ascariasis, hookworm infection, trichuriasis, trichostrongyliasis, and enterobiasis. Mebendazole is a generic medicine name and there are several brands available for it. Potentially serious side effects include bone marrow … No side effects have been reported so far. Intracellular microtubules in the cells of the worm are gradually lost. Mebendazole acts by inhibiting the production of microtubules via binding to colchicine binding-site of β-tubulin and thereby blocking polymerization of tubulin dimers in the intestinal cells of parasites. Its mode of action is similar to other benzimidazoles. Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including mebendazole. Mebendazole tablets can be sold to the public if supplied for oral use in the treatment of enterobiasis in adults and children over 2 years provided its container or package is labelled to show a max. However, it is even less well absorbed than albendazole, with a bioavailability of only 1% to 2% after administration of a single oral dose. The drug binds to beta tubulin of susceptible worms with high affinity and inhibits its polymerization. In a survey of 170 women who took mebendazole in the first trimester of pregnancy, fetal loss or neonatal death was not significantly higher than that observed in the general population.49 In a second series, one congenital hand malformation was observed in 112 first-trimester exposures.49 In a larger retrospective study sponsored by the World Health Organization (WHO), involving more than 7000 Sri Lankan women who had accidentally taken the drug anytime during their pregnancy, there was a significantly lower rate of fetal loss and perinatal death, presumably resulting from reduced levels of maternal anemia.50 Despite this ostensible beneficial effect, there was a trend toward a higher rate of congenital malformations among those who were exposed during the first trimester (2.5% vs. 1.5%). Mebendazole Mechanism of action. These drugs disturb the transmembrane proton gradient severely, leading to a considerable drop in cellular ATP levels. Cross reactivity with other benzimidazole derivatives could not be excluded. Glucose uptake by the organism is thus inhibited without an effect on serum glucose levels in humans. Craig M. Wilson, in Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), 2012. However, the mechanism of action behind its anticancer activity remains unclear.