Biltricide

Generic Name: praziquantel (Oral route)

praz-i-KWON-tel

Commonly used brand name(s)

In the U.S.

  • Biltricide

Available Dosage Forms:

  • Tablet

Therapeutic Class: Anthelmintic

Uses For Biltricide

Praziquantel is used to treat infections caused by parasites such as liver flukes (worms) or schistosoma (blood fluke). These infections are also known as snail fever, schistosomiasis, or bilharziasis. Praziquantel may also be used for other worm infections as determined by your doctor. However, it will not work for pinworms or other roundworms.

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Praziquantel belongs to the family of medicines called anthelmintics. Anthelmintics are used in the treatment of worm infections. Praziquantel works by causing severe spasms and paralysis of the worms' muscles. Some kinds of worms are then passed in the stool. However, you may not notice them since they are sometimes completely destroyed in the intestine.

This medicine is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in the product labeling, praziquantel is used in certain patients with the following medical conditions:

  • Some kinds of fluke infections.
  • Some kinds of tapeworm infections.

Before Using Biltricide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of praziquantel in children. However, safety and efficacy have not been established in children younger than 4 years of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of praziquantel in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving praziquantel.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Carbamazepine
  • Dexamethasone
  • Fosphenytoin
  • Phenobarbital
  • Phenytoin
  • Rifampin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Chloroquine
  • Ketoconazole

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Heart disease or
  • Heart rhythm problems—Patients with these conditions should be monitored during treatment with this medicine.
  • Kidney disease or
  • Liver disease, moderate to severe—Use with caution. The effects may be increased by slower removal of the medicine from the body.
  • Seizures, history of or
  • Worm cysts in the eye—Should not be used in patients with these conditions.
  • Worm cysts in the brain—Your doctor may want you in the hospital to treat this infection.

Proper Use of Biltricide

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

No special preparations (for example, special diets, fasting, other medicines, laxatives, or enemas) are necessary before, during, or immediately after taking praziquantel.

Praziquantel has a bitter taste that may cause gagging or vomiting. The bitter taste may be more noticeable if the tablets are held in the mouth or chewed. Therefore, do not chew praziquantel tablets. Swallow the tablets whole with a small amount of liquid during meals.

Do not break the tablet unless your doctor tells you to. If you have been told to break your tablet, you can break off a part by pressing the notch with your thumbnails. If one-fourth of a tablet is required, break the tablet from the outer end.

Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For the treatment of schistosomiasis:
      • Adults, teenagers, and children 4 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 20 milligrams (mg) per kilogram (kg) of body weight taken three times a day for 1 day. Each dose should be at least 4 hours apart and not more than 6 hours apart.
      • Children younger than 4 years of age—Use and dose must be determined by the doctor.
    • For the treatment of clonorchiasis (Chinese or Oriental liver fluke) and opisthorchiasis (liver flukes):
      • Adults, teenagers, and children 4 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is 25 milligrams (mg) per kilogram (kg) of body weight taken three times a day for 1 day. Each dose should be at least 4 hours apart and not more than 6 hours apart.
      • Children younger than 4 years of age—Dose must be determined by the doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Biltricide

It is important that your doctor check the progress of you or your child after treatment. This is to make sure that the infection is cleared up completely.

If your or your child's symptoms do not improve, or if they become worse, check with your doctor.

Do not take rifampin (Rifadin®, Rimactane®) while you or your child are using this medicine. Using these medicines together may cause serious problems. However, if treatment with praziquantel is needed, stop taking rifampin 4 weeks before using this medicine. You may start taking rifampin one day after you have completed treatment with this medicine.

This medicine may cause some people to become dizzy, drowsy, or less alert than they are normally. If any of these side effects occur, do not drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert while you are taking praziquantel and for 24 hours after you stop taking it.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Biltricide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known
  • Abdominal or stomach discomfort with or without nausea
  • abdominal or stomach pain
  • black, tarry stools
  • bloody diarrhea
  • chest pain or discomfort
  • chills
  • convulsions
  • cough
  • dizziness
  • fainting
  • fast, slow, or irregular heartbeat
  • fever
  • hives
  • hoarseness
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • lightheadedness, dizziness, or fainting
  • painful or difficult urination
  • rash
  • redness of the skin
  • severe abdominal or stomach pain
  • shortness of breath
  • slow or irregular heartbeat
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • sweating
  • swelling of the eyelids, face, lips, hands, or feet
  • swollen glands
  • tightness in the chest
  • troubled breathing or swallowing
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Drowsiness
  • increased sweating
  • general feeling of discomfort or illness
  • nausea or vomiting
Less common
  • Skin rash, hives, or itching
Incidence not known
  • Difficulty with moving
  • dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • headache
  • hives or welts
  • joint pain
  • lack or loss of strength
  • loss of appetite
  • muscle aching or cramping
  • muscle pains or stiffness
  • redness of the skin
  • sensation of spinning
  • sleepiness or unusual drowsiness
  • swollen joints
  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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