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BackPraziquantel Data - Uses, Dosage, Drug class, Brand name, Warnings, etc
| Pharmacology | Praziquantel, an anthelmintic, causes loss of intracellular calcium in parasites, leading to paralysis and dislodgement from attachment sites. At higher doses, it damages the parasite’s surface membrane, enabling host immune responses to destroy the worm. |
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| Administration and Adult Dosage |
- PO for schistosomiasis (Schistosoma haematobium or mansoni): 40 mg/kg in 2 divided doses on the same day; heavy infestations require 60 mg/kg in 3 doses at 4–6 hr intervals - PO for schistosomiasis (Schistosoma japonicum or mekongi): 60 mg/kg in 3 doses at 4–6 hr intervals - PO for flukes (clonorchiasis, opisthorchiasis): 25 mg/kg three times daily for 1 day - PO for flukes (paragonimiasis): 25 mg/kg three times daily for 2 days - PO for tapeworms (beef, dog, fish, pork): 5–10 mg/kg once - PO for dwarf tapeworm: 25 mg/kg once - PO for neurocysticercosis: 50–100 mg/kg/day in 3 doses for 30 days |
| Special Populations - Pediatric Dosage |
- <4 yr: Safety and efficacy not established - ≥4 yr: Same as adult dosage |
| Special Populations - Geriatric Dosage | Same as adult dosage. |
| Dosage Forms | - Tablet: 600 mg |
| Patient Instructions |
- Take with liquid during meals; do not chew tablets - May cause dizziness or drowsiness; use caution when driving or operating machinery |
| Missed Doses | - Take missed dose as soon as remembered; if near next dose, take only that dose; do not double dose |
| Pharmacokinetics - Fate |
- Absorption: ~80% absorbed orally, with extensive first-pass metabolism - Distribution: CSF levels 14–20% of serum - Metabolism: Hepatic - Excretion: Primarily urinary as metabolites |
| Pharmacokinetics - t¹⁄₂ | - 1.1 ± 0.3 hr |
| Adverse Reactions & Side Effects |
Frequent (large doses): - Dizziness, headache, malaise Occasional: - Abdominal discomfort, fever, sweating, eosinophilia, drowsiness, fatigue Rare: - Pruritus, rash Neurocysticercosis-specific: - Inflammatory response (headache, seizures, increased intracranial pressure) due to dead/dying organisms |
| Contraindications | - Ocular cysticercosis |
| Precautions & Warnings |
- Use cautiously in pregnancy - Use cautiously in liver disease - Avoid breastfeeding for 72 hr after last dose |
| Drug Interactions |
- CYP3A4 inducers (e.g., dexamethasone, carbamazepine, phenobarbital, phenytoin): Increase clearance, reduce bioavailability, may cause treatment failure - CYP3A4 inhibitors (e.g., cimetidine, ketoconazole, erythromycin): Decrease clearance, increase serum levels, prolong half-life |
| Parameters to Monitor | - Observe for CNS toxicity (e.g., seizures, headache) when treating neurocysticercosis |
| Class and Drug Brand Name |
- Class: Anthelmintics - Brand Name: Biltricide |
| Notes | - Concomitant corticosteroid therapy recommended for neurocysticercosis to manage inflammatory response |
References
Hand of Clinical Drug Data