Flubendazole Plays an Important Anti-Tumor Role in Different Types of Cancers

Flubendazole, belonging to benzimidazole, is a broad-spectrum insect repellent and has been repurposed as a promising anticancer drug. In recent years, many studies have shown that flubendazole plays an anti-tumor role in different types of cancers, including breast cancer, melanoma, prostate cancer, colorectal cancer, and lung cancer. Although the anti-tumor mechanism of flubendazole has been studied, it has not been fully understood. In this review, we summarized the recent studies regarding the anti-tumor effects of flubendazole in different types of cancers and analyzed the related mechanisms, in order to provide the theoretical reference for further studies in the future.

The efficacy of an alternative mebendazole formulation in mice infected with Echinococcus multilocularis

This study was conducted to investigate the efficacy of a new formulation of MBZ oily suspension (MBZ-OS) in experimentally Echinococcus multilocularis-infected mice. MBZ-OS was prepared and administered to mice infected with E. multilocularis at 12.5 and 25 mg/kg for 14 consecutive days. Then, the cysts were collected, weighed and histologically examined. The results showed that the reduction rate of cyst weight induced by MBZ-OS at two doses was 95.23% and 92.67%, which was significantly higher than that of MBZ-1% tragacanth (positive control) at corresponding concentrations (87.41% and 69.47%), indicating that the treatment of alveolar echinococcosis at lower doses could be achieved by the use of MBZ-OS. This finding shows that MBZ-OS is also a promising formulation for alveolar echinococcosis as well as cystic echinococcosis and deserves to be investigated in clinical applications against echinococcosis.

Phenolic Metabolites of Dalea ornata Affect Both Survival and Motility of the Human Pathogenic Hookworm Ancylostoma ceylanicum

Hookworms are ubiquitous human parasites, infecting nearly one billion people worldwide, and are the leading cause of anemia and malnutrition in resource-limited countries. Current drug treatments rely on the benzimidazole derivatives albendazole and mebendazole, but there is emerging resistance to these drugs. As part of a larger screening effort, using a hamster-based ex vivo assay, anthelmintic activity toward Ancylostoma ceylanicum was observed in the crude extract of aerial parts of Dalea ornata. These studies have led to the isolation and characterization of phenolic metabolites 1-10. The structures were determined by 1D and 2D NMR spectroscopy, and the absolute configuration of 1 was assigned using electronic circular dichroism data. The new compound, (2S)-8-(3-methylbut-2-en-1-yl)-6,7,4'-trihydroxyflavanone (1), was weakly active at 7.3 μM, with 17% reduction in survival of the hookworms after 5 days. The rotenoids deguelin (9) and tephrosin (10), predictably perhaps, were the most active, with complete worm mortality observed by day 4 (or earlier) at 6.3 and 6.0 μM, respectively. The effects of 1-10 on hookworm motility and on toxicity to hamster splenocytes were also explored as important measures of treatment potential.

Exploring the potential of flubendazole in filariasis control: evaluation of the systemic exposure for different pharmaceutical preparations

The goal of elimination of the human filariases would benefit greatly from the use of a macrofilaricidal agent. In vivo trials in humans and many experimental animal models suggest that flubendazole (FLBZ) is a highly efficacious macrofilaricide. However, since serious injection site reactions were reported in humans after parenteral FLBZ administration, the search for alternative pharmaceutical strategies to improve the systemic availability of FLBZ and its metabolites has acquired urgency in both human and veterinary medicine. The goal of the current work was to compare the systemic exposure of FLBZ formulated as either an aqueous hydroxypropyl-β-cyclodextrin (CD) or aqueous carboxymethyl cellulose (CMC) suspension or a Tween 80-based formulation (TWEEN) in rats and jirds (Meriones unguiculatus). Healthy animals of both species were allocated into four experimental groups of 44 animals each: FLBZ-CD_oral and FLBZ-CD_sc, treated with the FLBZ-CD formulation by the oral or subcutaneous routes, respectively; FLBZ-TWEEN_sc, dosed subcutaneously with the FLBZ-TWEEN formulation; and FLBZ-CMC_oral, treated orally with the FLBZ suspension. The FLBZ dose was 5 mg/kg. FLBZ and its hydrolyzed (H-FLBZ) and reduced (R-FLBZ) metabolites were recovered in plasma samples collected from rats and jirds treated with the different FLBZ formulations. In both species, FLBZ parent drug was the main analyte recovered in the bloodstream. In rats, FLBZ systemic exposure (AUC_0-LOQ) was significantly (P<0.05) higher after the FLBZ-CD treatments, both oral (4.8±0.9 µg.h/mL) and subcutaneous (7.3±0.6 µg.h/mL), compared to that observed after oral administration of FLBZ-CMC suspension (0.93±0.2 µg.h/mL). The same differences were observed in jirds. In both species, parenteral administration of FLBZ-TWEEN did not improve the systemic availability of FLBZ compared to FLBZ-CD_oral treatment. In conclusion, formulation approaches that enhance the availability of flubendazole in the rat and jird may have therapeutic implications for a drug with poor or erratic bioavailability.

Lymphatic filariasis and onchocerciasis are tropical parasitic diseases caused by filarial nematodes, which constitute a serious public health issue in tropical regions. Lymphatic filariasis causes debilitating lymphedema and hydrocele, resulting in temporary or permanent disability. Onchocerciasis (also known as river blindness) causes visual impairment and blindness, constituting one of the leading causes of blindness in the world. The control of human filarial infections currently depends on strategies predominantly focused at killing microfilariae (larval stage) by the use of ivermectin or diethylcarbamzine, usually in combination with albendazole. It is now generally recognized that the success of filariasis control programs in a reasonable time-frame requires the addition of a macrofilaricide (adult stage) compound. Although flubendazole has demonstrated macrofilaricidal activity in vivo, the approved formulations provide almost no oral bioavailability. The search for alternative pharmaceutical strategies to improve the systemic availability of flubendazole has acquired urgency in both human and veterinary medicine. Searching for improved flubendazole absorption, different flubendazole pharmaceutical preparations were assessed, both in rats and jirds, in the study described here. The work demonstrated that flubendazole pharmacokinetics could be markedly modified by changes in drug formulation. The resulting improved systemic exposure of flubendazole may have a significant impact on its macrofilaricidal efficacy.

Development of a capillary zone electrophoresis method for determination of mebendazole and levamisole hydrochloride in a combined tablet and a comparison with a LC method

The separation and determination of mebendazole (MEB) and levamisole hydrochloride (LH) from a combination tablet by capillary zone electrophoresis (CZE) was developed and validated. The separation was performed in a 60 cm (50.5 cm to detection window) x 75 microm internal diameter fused silica capillary using a background electrolyte of NaH2PO4 (20 mM/L, pH 3.0 ) at 25 kV. Good separation was obtained in less than 8 min. The LOQ values for LH and MEB were 1.43 and 2.50 microg/mL, respectively; calibration curves were linear from 10 to 500 microg/mL with r2 > 0.999. Mean recoveries of the analytes were greater than 96%. In addition, a comparison with the LC method described in the 2010 Chinese Pharmacopoeia demonstrated that the developed CZE method was equally comparable with regard to linearity, sensitivity, precision, and accuracy, but the analysis time and reagent consumption were decreased. The CZE method is an effective and lower-cost alternative to the LC method.

Development and in vitro characterization of mebendazole delayed release tablet for colonic drug delivery

The main objective behind this study was to formulate delayed release colon targeted tablet of Mebendazole by using different polymers. The precompressional parameters of powder blend were studied. The wet granulation method was used for the preparation of tablets. The tablets of all formulation were subjected for different physicochemical evaluation. The drug-excipient interaction study was carried out by using Fourier transforms Infrared spectroscopy (FTIR). The in vitro evaluation was carried out at different pH ranges (0.1M HCl, 6.8 and 7.4 Phosphate buffer) for the prepared tablets. From the stability, Fourier transform infra-red spectroscopy studies Mebendazole tablet does not show any interaction between drug and polymer. The prepared tablets were complied all the physicochemical test as per official limit. The formulated (M3) batch shows better sustained release 99.89% over a period of 12 hours and the data was fitted into Korsemeyer-Peppas kinetic equation. The result indicates that Mebendazole colon targeted matrix tablet remain stable in the stomach and shows better release into the colon with the help of pH dependent synthetic polymers.

Biotransformation of benzimidazole anthelmintics in reed (Phragmites australis) as a potential tool for their detoxification in environment

Benzimidazole anthelmintics, the drugs against parasitic worms, are widely used in human as well as veterinary medicine. Following excretion, these substances may persist in the environment and impact non-target organisms. In order to test phytoremediation as a possible tool for detoxification of anthelmintics in environment, the biotransformation pathways of albendazole (ABZ) and flubendazole (FLU) were studied in reed (Phragmites australis) in vitro. Reed cells were able to uptake and biotransform both anthelmintics. Ten ABZ metabolites and five FLU metabolites were found. Some atypical biotransformation reactions (formation of glucosylglucosides, acetylglucosides and xylosylglucosides), which have not been described previously, were identified. Based on the obtained results, the schemes of metabolic pathways of ABZ and FLU in reed were proposed. Most of ABZ and FLU metabolites can be considered as anthelmintically less active; therefore uptake and biotransformation of these anthelmintics by reed could be useful for decrease of their toxicity in environment.

Process dominance analysis for fate modeling of flubendazole and fenbendazole in liquid manure and manured soil

Fate monitoring data on anaerobic transformation of the benzimidazole anthelmintics flubendazole (FLU) and fenbendazole (FEN) in liquid pig manure and aerobic transformation and sorption in soil and manured soil under laboratory conditions were used for corresponding fate modeling. Processes considered were reversible and irreversible sequestration, mineralization, and metabolization, from which a set of up to 50 different models, both nested and concurrent, was assembled. Five selection criteria served for model selection after parameter fitting: the coefficient of determination, modeling efficiency, a likelihood ratio test, an information criterion, and a determinability measure. From the set of models selected, processes were classified as essential or sufficient. This strategy to identify process dominance was corroborated through application to data from analogous experiments for sulfadiazine and a comparison with established fate models for this substance. For both, FLU and FEN, model selection performance was fine, including indication of weak data support where observed. For FLU reversible and irreversible sequestration in a nonextractable fraction was determined. In particular, both the extractable and the nonextractable fraction were equally sufficient sources for irreversible sequestration. For FEN generally reversible formation of the extractable sulfoxide metabolite and reversible sequestration of both the parent and the metabolite were dominant. Similar to FLU, irreversible sequestration in the nonextractable fraction was determined for which both the extractable or the nonextractable fraction were equally sufficient sources. Formation of the sulfone metabolite was determined as irreversible, originating from the first metabolite.

Characterization of solid-state forms of mebendazole

This study deals with the generation and characterization of various solid-state forms of mebendazole (MBZ), a benzimidazole antihelmentic. The drug was subjected to polymorphic screen using different solvents to explore the possibility of existence of different solid forms. Different reported polymorphic forms of MBZ, i.e. form A, B and C were found to be recrystallized from acetic acid:methanol mixture (1:1), ethyl acetate and methanol, respectively. N,N-Dimethyl acetamide (DMA) and N,N-dimethyl formamide (DMF) yielded two new solvates of MBZ. These solid-state forms were characterized by thermoanalytical (DSC, TGA, HSM), crystallographic (XRD), microscopic (optical, polarized), and spectroscopic (FTIR) techniques. Solubility studies were carried out for the solvates to identify the solubility advantage. Molecular modeling studies revealed moderately strong hydrogen bonding between the solvent molecules and MBZ.

Mebendazole Selective Membrane Sensor and Its Application to Pharmaceutical Analysis

A PVC membrane sensor for the selective determination of mebendazole (MBZ) was fabricated. The sensor is based on an ion association of MBZ with silicotungstic acid (STA) as ion pair and bis(2-ethylhexyl)phthalate (BEP) as the plasticizing agent in a PVC matrix. The sensor showed a linear response for MBZ for a concentration range 1.0x10(-6)-5.0x10(-2) M with a Nernstian slope of 55.8 mV/decade (limit of detection 6.3x10(-7) M) in the pH range 4-7. It has a fast response time of <30 s. The sensor showed a very good selectivity for MBZ with respect to a large number of ions. The direct determination of MBZ in pharmaceutical formulations gave results that compare well with the data obtained from the standard method.

Variable-temperature X-ray powder diffraction analysis of the crystal transformation of the pharmaceutically preferred polymorph C of mebendazole

Mebendazole is a common benzimidazole anthelmintic that is water insoluble. It is reported to exist in three different polymorphic forms in the solid state, i.e. polymorph A, B and C. Form C is the pharmaceutically preferred form because of its increased aqueous solubility. This paper deals with the use of variable-temperature X-ray powder analysis (VTXRPD) to study the transformation of Form C. Results showed that Form C was stable and transformed to the more stable polymorph A at high temperature (>180 degrees C). This transformation is a first-order process with activation energy of 238 +/- 16 kJ/mole. Further studies showed that compression did not cause any significant changes in the crystal structure of polymorph C.

Rapid determination of the antiparasitic drugs flubendazole and febantel in feeds by HPLC with ultraviolet detection

A rapid and very effective analytical procedure for the simultaneous HPLC determination of two anthelmintics, Flubendazole (FLUB) and Febantel (FEBA), in swine and poultry feeds was developed and tested. The ground feed samples were extracted using dimethylformamide. The extracts were directly analyzed, without any purification, on a reversed-phase ODS column (150 mm x 4.6 mm, 5 microm) with acetonitrile-phosphate buffer (pH 3; 0.017 M) as mobile phase. Ultraviolet detection of FLUB and FEBA was carried out at 300 nm. The method was validated for specificity, linearity, accuracy, repeatability, limit of detection and limit of quantification. The limits of detection (LOD) of FLUB and FEBA in feeds, based on a detector signal-to-noise ratio of 3, were 3 mg kg(-1) and the lowest levels tested in feeds by this procedure (limit of quantification, LOQ) were 10 mg kg(-1). The mean recovery of FLUB and FEBA from spiked samples, in a concentration range of 10-200 mg kg(-1), was 98% with a CV% of 4% and 99% with a CV% of 2%, respectively.

The effect of solubilization on the oral bioavailability of three benzimidazole carbamate drugs

The effect of solubilization by complexation with povidone on the oral bioavailability of three anthelmintic benzimidazole carbamate drugs: mebendazole (MBZ), albendazole (ABZ) and ricobendazole (RBZ), was studied in mice. The following in vitro characteristics of the initial raw materials and the drug-povidone complexes were evaluated: melting point (MP); mean dissolution time (MDT); solubility constants (Cs) in n-octanol, acid (pH 1.2) and neutral (pH 7.4) aqueous media; apparent partition coefficients (P) and capacity factors (k'W) determined by HPLC. The following in vivo parameters were also evaluated: AUC(0-infinity), C(max), T(max) and MRT. The possible relationship between in vitro characteristics and in vivo parameters was explored and it was found that an increase in solubility, especially in acidic medium, leads to an increase in AUC and C(max) and a decrease in T(max). Therefore, dissolution seems to be the absorption limiting step for these drugs. For the in vivo parameters related to the amount of absorbed drug (AUC and C(max)), the best correlation was obtained with the in vitro characteristics related to solubility which are Cs, MP and MDT. On the other hand, there were good linear correlations between T(max) which is an in vivo parameter related to the rate of drug absorption, and the lipophilia/hydrophilia (logP and log k'W) relation-parameters.

Albendazole, mebendazole and praziquantel. Review of non-clinical toxicity and pharmacokinetics

The pharmacokinetics and toxicity of albendazole, mebendazole and praziquantel are extensively reviewed, drawing on original published work and reviews in the open scientific literature and on assessments by international agencies and official regulatory bodies in Europe and the USA. Information about human and veterinary medical uses and adverse reactions is evaluated. The totality of the non-clinical information available about these long-established drugs may not comply with current official guidelines for new medicines but reasons are given why the "deficiencies" are only apparent and the data gaps can be replaced by other results, largely obtained from the target species and the many years of clinical experience of safe use of these drugs in humans and animals.

Quality evaluation of generic drugs by dissolution test: changing the USP dissolution medium to distinguish between active and non-active mebendazole polymorphs

Mebendazole is practically insoluble in water and studies of its polymorphism has led to the identification and characterization of three polymorphic forms (A, B, C) displaying solubility and therapeutic differences that show that polymorph C is therapeutically favored. The objective of this study was to adjust the USP dissolution test for mebendazole so that it was able to distinguish between the dissolution properties of three mebendazole polymorphs. This would provide generic manufacturers with one more test to ensure that the therapeutically active polymorph C is used. The results obtained in this study show that the USP dissolution test conditions were not able to distinguish between the dissolution properties of completely dispersed mebendazole polymorphs with comparable particle sizes. When sodium lauryl sulfate was removed from the dissolution medium, the percentage dissolved versus time profiles changed so that polymorph C dissolved faster (70% within 120 min) compared to polymorph B (37% within 120 min) and polymorph A (20% within 120 min).

Developing a discriminating dissolution test for three mebendazole polymorphs based on solubility differences

Mebendazole, a broad spectrum anthelmintic drug, is practically insoluble in water and exists in three polymorphic forms, A, B, and C, of which C is pharmaceutically favoured. Since the dissolution of drugs from solid oral dosage forms can depend on the crystal form of the drug an attempt should be made while developing dissolution tests to set test parameters that are sensitive to changes in the crystal form. USP 24 describes 0.1 M hydrochloric acid containing 1.0% sodium lauryl sulphate (SLS) as the dissolution medium for mebendazole tablets. Results showed that the high concentration of sodium lauryl sulphate in the USP dissolution medium does not allow the use of this test to distinguish between the solubility differences of the three mebendazole polymorphs. By decreasing the amount of sodium lauryl sulphate in the dissolution medium clear differences in the dissolution rates of the three forms were observed. The most discriminating medium was 0.1 M HCl, containing no sodium lauryl sulphate.

Analysis of mebendazole polymorphs by Fourier transform IR spectrometry using chemometric methods

A diffuse reflectance IR Fourier transform IR spectrometry (DRIFTS) method was developed for the rapid, direct measurement of mebendazole in drugs. Conventional KBr spectra and DRIFTS spectra were compared for the best determination of the active substance in the drug formulations. Two chemometric approaches were used in the data processing: multicomponent partial least squares (PLS2) and principal component regression. The best results were obtained with the PLS2 method.

Development and validation of a liquid chromatography-electrospray tandem mass spectrometry method for mebendazole and its metabolites hydroxymebendazole and aminomebendazole in sheep liver

A quantitative liquid chromatography-electrospray tandem mass spectrometry method for the determination of mebendazole and its hydrolysed and reduced metabolites in sheep liver has been developed and validated. The benzimidazole substances were extracted with ethyl acetate after the sample mixture had been made alkaline. The HPLC separation was performed on a reversed-phase C18 column with gradient elution using a mobile phase consisting of water containing 0.1% formic acid and acetonitrile. The analytes were detected after atmospheric pressure electrospray ionization on a tandem quadrupole mass spectrometer in MS-MS mode. The components were measured by the MS-MS transitions of the molecular ion to the two most abundant daughter ions. The detection limits are lower than 1 microg kg(-1). For this application, the validation limit was set at 50 microg kg(-1). The examined validation parameters were in accordance with the permitted tolerances ranges stipulated in the proposed new European validation criteria for residue surveillance. For the three analytes, the overall recovery was higher than 90%. The RSD for the repeatability ranged from 5 to 11%. The range for the within-laboratory reproducibility was between 2 and 17%. The decision limits for mebendazole, the hydrolysed and the reduced metabolite were 56.6, 61.8 and 64.2 microg kg(-1), respectively. The detection capabilities for these substances were 60.0, 86.1 and 90.9 microg kg(-1), respectively.

[Effect of temperature on drug solubility in complex formation of flubendazole and 2-hydroxypropyl-beta-cyclodextrin]

Flubendazol is a veterinary antiparasitic agent which acts toxically on both adult and larval stages of round worms. It is nearly insoluble in water and it influences not only the selection of the dosage form, but also its biological availability. Its solubility can be increased by adding solutizers and tensides, or by complex-formation with cyclodextrins. In the published experimental paper the method of complex-formation of flubendazol with 2-hydroxypropyl-beta-cyclodextrin was employed and the effect of temperature on the resultant solubility of the active ingredient was examined. The final dosage form was pellets produced with the use of the method of extrusion and spheronisation.

Simultaneous determination of thiabendazole and mebendazole in tablets by high-performance liquid chromatography

Reversed-phase high performance liquid chromatography using an RP 18 column (4 x 125 mm), tetrahydrofuran-acetonitrile-0.5% formic acid (5:25:70, v/v/v) as mobile phase and UV detection at 254 nm enabled the simultaneous determination of thiabendazole (TZ) and mebendazole (MZ) in tablets. The method showed linearity over 4.0 to 40.0 micrograms TZ/ml and 6.0 to 60.0 micrograms MZ/ml. The correlation coefficient r was .9999 for both TZ and MZ. The coefficient of variation (CV) was 0.59-0.80% for TZ and 0.49-0.67% for MZ. The average recovery was 100.54-101.17% for TZ and 100.35-101.13% for MZ. The excipients of the tablets did not interfere in the proposed method. The developed method is precise, accurate, and selective for the determination of both benzimidazoles analyzed.

Solubility, 1H-NMR, and molecular mechanics of mebendazole with different cyclodextrins

The solubility behavior and binding constants (Kass) of mebendazole with alpha-, beta-, gamma-, and hydroxypropyl-beta-cyclodextrins (HP-beta-CD) have been investigated in simulated intestinal juice by the Higuchi and Connors method. AL diagrams have been obtained. The equilibrium has also been studied in simulated gastric fluid with HP-beta-CD. The phase solubility, 1H-NMR, and molecular mechanics studies revealed the formation of a 1:1 complex.

Identification of the mebendazole polymorphic form present in raw materials and tablets available in South Africa

A preformulation study of four different raw materials of mebendazole showed that three samples were polymorph C and the other polymorph A, or a mixture of form A and B. X-ray powder diffractometry and infrared spectroscopy indicated that this powder could be form B, but powder dissolution, for which a much slower dissolution was obtained, suggests polymorph A. Literature prescribes the use of polymorph C pharmaceutically, but generic manufacturers should be aware that forms other than C are still available on the market. The four mebendazole tablets currently available in South Africa were also tested and it was found that all of them contained polymorph C.

Molecular modeling: a tool for predicting anthelmintic activity in vivo

The structural and electronic features of the broad-spectrum benzimidazole anthelmintic mebendazole [MBZ, methyl 5-(benzoyl)-benzimidazole-2-carbamate] have been determined using a combination of quantum mechanics, molecular graphics, and molecular modeling techniques. Using conformational analyses and quantum mechanics, we found that the three-dimensional structure and electronic features of MBZ were consistent with those previously reported for highly active broad-spectrum benzimidazole anthelmintics and that in vivo drug efficacy against Hymenolepis diminuta depends upon the orientation of the benzoyl group at position 5 on the heterocyclic ring system, the magnitude of the molecular dipole moment, and the percentage of polar surface area. The chemotherapeutic actions of MBZ on H. diminuta in vivo were accompanied by marked changes in worm weight and chemical composition. Tapeworms recovered from rats that had received a therapeutically effective dose of MBZ 24 h earlier were significantly smaller and contained much less glycogen (as a percentage of the wet weight) than worms from untreated controls. In MBZ-treated worms, protein concentrations rose at a rate sufficient to offset the decline in glycogen concentration. Glycogen/protein ratios in MBZ-treated worms were considerably lower than the corresponding control values. Differences in the absolute amounts of glycogen between control and drug-treated worms were even more profound. Administration of a curative dose of MBZ to the rat host produced in H. diminuta another change, the onset of which coincided with the gross alterations in worm weight and chemical composition.(ABSTRACT TRUNCATED AT 250 WORDS)

Improvement of dissolution and bioavailability for mebendazole, an agent for human echinococcosis, by preparing solid dispersion with polyethylene glycol

The solid dispersion of mebendazole was prepared with polyethylene glycol (PEG) to enhance the dissolution rate of mebendazole, an agent for the chemotherapy of human echinococcosis. The dissolution rate of the solid dispersion increased compared with the physical mixture, and also increased with the incorporation of an increasing amount of PEG-6000. An extensive improvement of the dissolution rate was observed when the ratio of the solid dispersion of mebendazole to PEG-6000 was more than 1: 2. Furthermore, greater bioavailability in rabbits was obtained after oral administration of the solid dispersion compared with the physical mixture.