praziquantel

Generic Name: praziquantel (PRAZ i KWON tel)
Brand Name: Biltricide

What is praziquantel?

Praziquantel is an anthelmintic (an-thel-MIN-tik) or anti-worm medication. It prevents newly hatched insect larvae (worms) from growing or multiplying in your body.

Praziquantel is used to treat infections caused by Schistosoma worms, which enter the body through skin that has come into contact with contaminated water. Schistosoma worms are found in Africa, South America, Middle Eastern countries, the Caribbean, and parts of Asia.

Praziquantel is also used to treat infection with liver flukes, caused by a type of worm found in East Asia. This worm enters the body while eating contaminated fish.

Praziquantel should not be used to treat parasitic infections in the eye.

Praziquantel may also be used for purposes not listed in this medication guide.

What is the most important information I should know about praziquantel?

You should not take this medicine if you are allergic to praziquantel, or if you have take rifampin (Rifadin, Rifater, Rifamate) in the last 4 weeks.

Before taking praziquantel, tell your doctor if you have kidney disease, heart disease, liver disease, or a history of seizures or epilepsy.

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Do not give this medication to a child younger than 4 years old.

Praziquantel may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Praziquantel should be taken with a meal.

Do not crush or chew the praziquantel tablet. Swallow the pill whole.

Take this medication with a full glass (8 ounces) of water.

What should I discuss with my healthcare provider before taking praziquantel?

You should not take this medicine if you are allergic to praziquantel, or if you have take rifampin (Rifadin, Rifater, Rifamate) in the last 4 weeks.

To make sure you can safely take praziquantel, tell your doctor if you have any of these other conditions:

  • headaches, confusion;

  • seizures (or a history of seizures or epilepsy);

  • lumps (nodules) under your skin;

  • kidney disease;

  • heart disease; or

  • liver disease.

FDA pregnancy category B. Praziquantel is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Praziquantel can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medication to a child younger than 4 years old.

How should I take praziquantel?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medication with a full glass (8 ounces) of water.

Praziquantel is usually taken 3 times in one day. Your doses should be taken 4 to 6 hours apart on that day.

Praziquantel should be taken with a meal.

You may need to break a praziquantel tablet in order to get the correct dose. Follow your doctor's instructions.

Do not crush or chew the praziquantel tablet or portion of a tablet. Swallow the pill whole.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking praziquantel?

Praziquantel may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Grapefruit and grapefruit juice may interact with praziquantel and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Praziquantel side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Less serious side effects may include:

  • tired feeling;

  • headache, dizziness;

  • nausea, upset stomach;

  • mild fever; or

  • mild skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Praziquantel Dosing Information

Usual Adult Dose for Nanophyetus salmincola:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma japonicum:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma mekongi:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Schistosoma haematobium:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Adult Dose for Schistosoma mansoni:

20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Adult Dose for Fasciolopsis buski (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Heterophyes heterophyes (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Metagonimus yokogawai (Intestinal Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Opisthorchis viverrini (Liver Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Clornorchis sinensis (Liver Fluke):

25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Adult Dose for Paragonimus westermani (Lung Fluke):

25 mg/kg orally every 4 hours for 6 doses (3 doses per day for 2 consecutive days)

Case Report (n=1)
75 mg/kg/day for 3 days

Usual Adult Dose for Diphyllobothrium latum (Fish Tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Dipylidium caninum (Dog Tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Taenia saginata (beef tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Taenia solium (pork tapeworm):

5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Adult Dose for Hymenolepis nana (Dwarf Tapeworm):

25 mg/kg orally one time

Since eradication may be difficult, retreatment is recommended if the infection persists.

Usual Adult Dose for Cysticercus cellulosae (Cysticercosis):

50 mg/kg/day orally in 3 divided doses for 15 days

Concomitant use of corticosteroids during praziquantel therapy for neurocysticercosis may reduce the frequency and severity of an inflammatory response to degeneration of cysts in the central nervous system.

Repeated courses of therapy may be considered in patients with only partial resolution of cysts 3 months after a course or whose condition deteriorates.

Usual Adult Dose for Echinococcus Infection:

Study (n=19)
50 mg/kg once daily, in combination with albendazole, to a maximum of 9 months

Patients unable to tolerate side effects took praziquantel once, twice weekly or once every two weeks.

Usual Pediatric Dose for Nanophyetus salmincola:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma japonicum:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma mekongi:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Schistosoma haematobium:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Pediatric Dose for Schistosoma mansoni:

4 years or older: 20 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Some clinicians recommend 20 mg/kg orally every 4 hours for 2 doses (as a 1 day treatment).

Usual Pediatric Dose for Fasciolopsis buski (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Heterophyes heterophyes (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Metagonimus yokogawai (Intestinal Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Opisthorchis viverrini (Liver Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Clornorchis sinensis (Liver Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 3 doses (as a 1 day treatment)

Usual Pediatric Dose for Paragonimus westermani (Lung Fluke):

4 years or older: 25 mg/kg orally every 4 hours for 6 doses (3 doses per day for 2 consecutive days)

Usual Pediatric Dose for Diphyllobothrium latum (Fish Tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Dipylidium caninum (Dog Tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Taenia saginata (beef tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Taenia solium (pork tapeworm):

4 years or older: 5 to 10 mg/kg orally one time

Up to 20 mg/kg given once has been recommended in the past for the treatment of most tapeworms.

Usual Pediatric Dose for Hymenolepis nana (Dwarf Tapeworm):

4 years or older: 25 mg/kg orally one time

Since eradication may be difficult, retreatment is recommended if the infection persists.

Usual Pediatric Dose for Cysticercus cellulosae (Cysticercosis):

4 years or older: 50 mg/kg/day orally in 3 divided doses for 15 days

Concomitant use of corticosteroids during praziquantel therapy for neurocysticercosis may reduce the frequency and severity of an inflammatory response to degeneration of cysts in the central nervous system.

What other drugs will affect praziquantel?

Tell your doctor about all other medications you are using, especially:

  • cimetidine (Tagamet);

  • chloroquine (Aralen);

  • itraconazole (Sporanox) or ketoconazole (Extina, Ketozole, Nizoral, Xolegal);

  • dexamethasone (Decadron, Hexadrol);

  • erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin);

  • St. John's wort;

  • rifabutin (Mycobutin) or rifapentine (Priftin);

  • a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton);

  • HIV medication such as efavirenz (Sustiva, Atripla), etravirine (Intelence), nevirapine (Viramune), or ritonavir (Norvir, Kaletra);

  • medicines to treat narcolepsy, such as armodafinil (Nuvigil) or modafinil (Progivil); or

  • seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), felbamate (Felbatol), oxcarbazepine (Trileptal), or phenytoin (Dilantin), or primidone (Mysoline).

This list is not complete and other drugs may interact with praziquantel. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about praziquantel.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.03. Revision Date: 2012-06-15, 12:42:12 AM.

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