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Indications and Dosage
Oral
Clonorchiasis, Intestinal fluke infections, Lung fluke infections, Opisthorchiasis Adult: 25 mg/kg tid at intervals of 4-6 hour for 1-2 days or 40 mg/kg as a single dose. Child: ≥4 year Same as adult dose. Oral Schistosomiasis Adult: 20 mg/kg 4-6 hourly for 3 doses or 40-60 mg/kg as a single dose.
Child: ≥4 year Same as adult dose. |
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Administration
Should be taken with food. Swallow whole, do not chew/crush.
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Contraindications
Ocular cysticercosis. Concomitant admin of strong CYP inducers (e.g. rifampicin). Lactation.
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Special Precautions
Patient w/ cardiac abnormalities, cerebral cysticercosis, history of epilepsy and/or other signs of potential CNS involvement (e.g. subcutaneous nodules suggestive of cysticercosis). Moderate to severe hepatic impairment. Pregnancy.
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Adverse Reactions
Headache, drowsiness, dizziness, malaise, abdominal discomfort, anorexia, nausea, vomiting, diarrhoea, urticaria, rash, fever, asthenia, malaise, fatigue, myalgia. Rarely, seizures, eosinophilia, pruritus, raised liver enzyme values.
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Patient Counseling Information
This drug may cause dizziness or drowsiness, if affected, do not drive or operate machinery during or 24 hr after treatment.
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Monitoring Parameters
Monitor LFTs; patients w/ cardiac irregularities during therapy; monitor for seizures; culture urine or faeces for ova prior to treatment.
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Drug Interactions
CYP enzyme-inducing drugs (e.g. carbamazepine, dexamethasone, phenobarbital, phenytoin) may decrease plasma concentrations of praziquantel. CYP enzyme inhibitors (e.g. cimetidine, erythromycin, itraconazole, ketoconazole) may increase plasma concentrations of praziquantel.
Potentially Fatal: Concomitant use w/ rifampicin may cause subtherapeutic concentrations of praziquantel. |
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Action
Description: Praziquantel is a pyrazinoisoquinoline anthelmintic agent w/ 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.
Pharmacokinetics: Absorption: Rapidly absorbed from the GI tract (>80%). Time to peak plasma concentration: 1-4 hr. Distribution: Distributed into the CSF and enters breast milk. Plasma protein binding: Approx 80%. Metabolism: Undergoes rapid and extensive hepatic metabolism via hydroxylation by CYP2B1 and CYP3A4 isoenzymes to inactive metabolites. Excretion: Via urine, mainly as metabolites. Plasma elimination half-life: Approx 1-1.5 hr (parent drug); approx 4 hr (metabolites). |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Praziquantel, CID=4891, https://pubchem.ncbi.nlm.nih.gov/compound/Praziquantel (accessed on Jan. 23, 2020) |
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Storage
Store below 30°C.
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MIMS Class
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ATC Classification
P02BA01 - praziquantel ; Belongs to the class of quinoline derivatives and related substances used as antitrematodals.
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References
Anon. Praziquantel. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 17/02/2016. Biltricide Tablets (Bayer HealthCare Pharmaceuticals Inc.). U.S. FDA. https://www.fda.gov/. Accessed 17/02/2016. Buckingham R (ed). Praziquantel. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 17/02/2016. McEvoy GK, Snow EK, Miller J et al (eds). Praziquantel. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 17/02/2016.
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