Pharm

Praziquantel

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Praziquantel, Biltricide

  • See Also
  1. Schistosomiasis
  2. Tapeworm
  3. Neurocysticercosis
  • Indications
  1. Schistosomiasis
  2. Liver Flukes (Clonorchiasis, opisthorchiasis)
  3. Intestinal Tapeworms (off-label)
  4. Neurocysticercosis (off-label, with >2 viable parenchymal cysticerci)
  • Contraindications
  1. Ocular Cysticercosis
  • Mechanism
  1. Antihelminth, Pyrazinoisoquinoline derivative
  2. Increases worm tegument and cell membrane permeability
    1. Allows for rapid influx of Calcium (including into muscle Sarcoplasmic Reticulum)
    2. Leads to rapid muscular contractions and then paralysis
  3. Breaks down worm tegument
    1. Allows for host responses against the worm including Phagocytosis
  • Medications
  1. Tablet: 600 mg
    1. Do not chew
  • Dosing
  • Adults (and Children age >=1 year old)
  1. Schistosomiasis
    1. Praziquantel 20 mg/kg orally every 4 to 6 hours for 3 doses with both food and liquids
  2. Liver Flukes
    1. Praziquantel 25 mg/kg orally every 4 to 6 hours for 3 doses with both food and liquids
  3. Intestinal Tapeworms (off-label)
    1. Praziquantel 10 mg/kg orally for 1 dose
  4. Neurocysticercosis (off-label, with >2 viable parenchymal cysticerci)
    1. Praziquantel 50 mg/kg/day divided three times daily orally with both food and liquids for 10 days AND
    2. Albendazole AND
    3. Pretreatment with Corticosteroids
  • Adverse Effects
  1. Flu-like symptoms
  2. Sedation
    1. May persist for up to 48 hours after dose
  • Safety
  1. May be used in pregnancy
  2. Manufacturer recommends against use in Lactation until >72 hours after last dose
    1. However, has been used in Lactation
  • Drug Interactions
  1. Strong CYP3A4 Inducers
    1. Risk of treatment failure due to low serum levels of Praziquantel
  2. CYP3A4 Inhibitors
    1. May increase drug levels and toxicity
  • Resources
  1. Praziquantel Tablet (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=16f2b9c4-a260-4a31-bd52-e5945913246c