Biltricide Side Effects

Generic Name: praziquantel

Note: This page contains information about the side effects of praziquantel. Some of the dosage forms included on this document may not apply to the brand name Biltricide.

Not all side effects for Biltricide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to praziquantel: oral tablet

Along with its needed effects, praziquantel (the active ingredient contained in Biltricide) 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 while taking praziquantel:

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 of praziquantel 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

For Healthcare Professionals

Applies to praziquantel: compounding powder, oral tablet

General

Side effects varied according to dose and duration of praziquantel (the active ingredient contained in Biltricide) therapy. Side effects depended on parasite species, extent of infestation, infection duration, and parasite location in the body. Side effects occurred earlier and were more frequent and/or serious in patients with severe infestation.

Often, it was unclear if praziquantel, an endogenous reaction to parasites dying from the drug, or symptoms of the infestation caused the reported side effects.

Side effects included malaise, headache, dizziness, abdominal discomfort (with or without nausea), rise in temperature, and urticaria; generally in order of severity. Such side effects were more frequent and/or serious in patients with heavy worm burden.

Nervous system

The inflammatory reaction produced by antigenic substances released from dying cysts frequently involved increased intracranial pressure, seizures, severe headaches, nausea, and vomiting. In areas where Taenia solium was endemic, these reactions may occur as the result of undiagnosed cysticercosis in patients being treated for other parasitic infections. The duration of the reaction differs among patients. Delayed reactions have been reported.

Very common (10% or more): Headache, dizziness
Common (1% to 10%): Vertigo, somnolence (including drowsiness)
Very rare (less than 0.01%): Seizures
Frequency not reported: Cerebral inflammatory reaction
Postmarketing reports: Convulsion, somnolence, vertigo

Gastrointestinal

Very common (10% or more): Gastrointestinal and abdominal pains, nausea, vomiting
Common (1% to 10%): Diarrhea
Frequency not reported: Abdominal discomfort (with or without nausea), gagging
Postmarketing reports: Abdominal pain, bloody diarrhea, vomiting

A syndrome of severe abdominal pain and bloody diarrhea was reported less often during schistosomiasis therapy.

Gagging and vomiting have been reported due to the bitter taste of the tablets.

Other

Very common (10% or more): Fatigue
Common (1% to 10%): Feeling unwell (asthenia, malaise), fever
Frequency not reported: Rise in temperature, transient edema
Very rare (less than 0.01%): Polyserositis
Postmarketing reports: Asthenia, fatigue

Dermatologic

A 13-year-old male developed Mazzotti reaction after treatment with ivermectin, praziquantel (the active ingredient contained in Biltricide) and albendazole for presumptive schistosomiasis and strongyloidiasis. Six days after receiving standard empiric therapy, he developed epigastric pain, vomiting, and urticaria. This progressed in 4 hours and included fever, general myalgia, and edema of the face, lower extremities, and penis accompanied by urticaria of the arms, legs, and trunk. He was diagnosed with a Mazzotti reaction and treated with methylprednisolone; symptoms subsided within 12 hours.

Very common (10% or more): Urticaria
Common (1% to 10%): Rash
Very rare (less than 0.01%): Pruritus
Frequency not reported: Mazzotti-like reaction
Postmarketing reports: Pruritus, rash

Metabolic

Common (1% to 10%)/Postmarketing reports: Anorexia

Musculoskeletal

Common (1% to 10%)/Postmarketing reports: Myalgia
Frequency not reported: Musculoskeletal aches and fatigue

Hepatic

Frequency not reported: Mild increases in liver enzymes

Cardiovascular

Very rare (less than 0.01%): Unspecified arrhythmias
Postmarketing reports: Arrhythmia (including bradycardia, ectopic rhythms, ventricular fibrillation, atrioventricular blocks)

Hypersensitivity

Postmarketing reports: Allergic reaction (generalized hypersensitivity, including polyserositis)

Hematologic

Postmarketing reports: Eosinophilia

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