Praziquantel

Indications

Praziquantel is used for: Schistosomiasis, Intestinal fluke infections; Lung fluke infections; Clonorchiasis ; Opisthorchiasis, Tapeworm infections

Adult Dose

Oral Schistosomiasis Adult: 3 doses of 20 mg/kg every 4-6 hr or 40-60 mg/kg as a single dose. Intestinal fluke infections; Lung fluke infections; Clonorchiasis ; Opisthorchiasis Adult: 25 mg/kg tid for 1-2 days or 40 mg/kg as a single daily dose. Tapeworm infections Adult: 5-25 mg/kg as a single dose. Neurocysticercosis Adult: 50 mg/kg/day, given in 3 divided doses for 14 days. Alternatively, 3 doses of 25 mg/kg every 2 hr.

Child Dose

Oral Schistosomiasis Child: >4 yr: 3 doses of 20 mg/kg every 4-6 hr or 40-60 mg/kg as a single dose. Intestinal fluke infections; Lung fluke infections; Clonorchiasis ; Opisthorchiasis Child: >4 yr: 25 mg/kg tid for 1-2 days or 40 mg/kg as a single daily dose. Tapeworm infections Child: >4 yr: 5-25 mg/kg as a single dose.

Renal Dose

Administration

Should be taken with food. Swallow whole, do not chew/crush.

Contra Indications

Hypersensitivity, ocular cysticercosis.

Precautions

Driving or operating machinery during or for 24 hr after treatment. Severe hepatic disease. Do not breastfeed during or for 72 hr after treatment. Lactation: enters breast milk, do not nurse on the day of taking drug & 72 hr thereafter

Pregnancy-Lactation

Interactions

Reduced plasma concentrations when used with dexamethasone. Carbamazepine, phenytoin and chloroquine may reduce the bioavailability of praziquantel while cimetidine may increase the bioavailabilty of praziquantel.

Adverse Effects

Side effects of Praziquantel : 1-10% Appetite loss,Dizziness,Drowsiness,Headache,Malaise,CSF reaction syndrome in patients treated for neurocysticercosis,Abdominal pain,Nausea,Vomiting,Diaphoresis <1% Diarrhea,Fever,Itching,Rash,Urticaria

Mechanism of Action

Praziquantel is an anthelmintic with a broad spectrum of activity against trematodes (flukes) and cestodes (tapeworms). It increases the cell permeability to Ca in schistosomes, causing strong contractions and paralysis of worm musculature leading to detachment of suckers from the blood vessel walls and to dislodgement.