Ermox 500 mg Tablet

Ermox 500 mg tablet by Square Pharmaceuticals PLC, Gazipur contains Mebendazole, a broad-spectrum anthelmintic (deworming) medicine. It is used to treat common intestinal worm infections in Bangladesh — roundworm, pinworm (threadworm), hookworm and whipworm. Worm infections spread easily through soil, unwashed hands and contaminated food or water, and in children they cause poor appetite, stomach pain, anaemia and slowed growth.

Mebendazole works by blocking the worms' ability to absorb glucose (sugar), their main source of energy. Starved of energy, the worms become paralysed, die and are passed out of the bowel naturally over a few days. Because it acts mainly inside the gut and very little is absorbed into the body, Ermox is generally well tolerated.

Ermox is used to treat:

• Roundworm (Ascaris) — the most common large intestinal worm
• Pinworm/threadworm (Enterobius) — causing night-time anal itching, especially in children
• Hookworm (Ancylostoma, Necator) — an important cause of iron-deficiency anaemia
• Whipworm (Trichuris) — causing abdominal symptoms and sometimes diarrhoea
• Mixed worm infections — when more than one type is present

It is also used in routine periodic deworming of children and family members, as advised by health programmes and doctors.

Adults and children over 2 years: for most worm infections the usual dose of Ermox is 100 mg twice daily for 3 days, or a single 500 mg dose, as advised. For pinworm, a single 100 mg dose is often used and repeated after 2 weeks to kill newly hatched worms.

• Ermox can be taken with or without food; tablets may be chewed or swallowed.
• Treat the whole family together for pinworm, as it spreads easily between family members.
• For school-age children, routine deworming every 6 months is commonly advised in Bangladesh.
• Children under 2 years: only on a doctor's advice. If symptoms persist, consult your doctor — a repeat course may be needed.

Ermox is usually very well tolerated because little is absorbed into the body. Possible effects include:

• Mild stomach pain or discomfort, especially when many worms are being expelled
• Nausea, wind or diarrhoea (transient)
• Headache or dizziness (uncommon)
• Rarely: skin rash or other allergic reactions
• Very rarely with high prolonged doses: liver enzyme changes or low blood counts

Seeing worms in the stool after treatment is normal and means the medicine is working. Seek medical advice if you develop a widespread rash, fever with sore throat, or yellowing of the eyes.

• Deworming works best when the whole family takes the medicine at the same time, since worms pass easily between members.
• Prevent reinfection: wash hands with soap before eating and after toilet, trim nails, wash vegetables well, drink safe water and wear sandals outside.
• Wash bedsheets and underclothes in hot water during pinworm treatment.
• Tell your doctor if you have liver disease or blood disorders before prolonged use.
• Not recommended in children under 2 years or in early pregnancy unless a doctor specifically advises.
• If anaemia is present with hookworm, the doctor may also prescribe iron — complete that course too.

Mebendazole has few significant drug interactions because it is poorly absorbed. Points to note:

• Cimetidine — can increase mebendazole levels in the blood.
• Carbamazepine and phenytoin (epilepsy medicines) — can lower its effectiveness.
• Metronidazole — combined use has rarely been linked to severe skin reactions; tell your doctor if you are taking it.
• Inform your doctor or pharmacist about all medicines you take, including herbal products.

• Known hypersensitivity to Mebendazole or any component of the preparation
• Children under 2 years of age, unless specifically advised by a doctor
• First trimester of pregnancy — avoid unless the doctor judges it essential
• Use with caution in significant liver disease

Avoid Ermox in the first trimester of pregnancy; animal studies showed risk at high doses, so deworming is usually postponed until after the first three months. In the second and third trimesters, health authorities do permit deworming where worm infection and anaemia are common — but only on a doctor's or health worker's advice. Very little mebendazole reaches breast milk, and breastfeeding is generally considered compatible; still, consult your doctor before use while nursing.

Store Ermox below 30°C in a dry place, protected from light and moisture. Keep in the original pack and out of the reach of children. Do not use after the expiry date printed on the pack.