Praziquantel

A to Z Drug Facts

 Actions Increases cell membrane permeability in susceptible worms, resulting in loss of intracellular calcium, massive contractions, and paralysis of their musculature. Phagocytes are thus able to attach to worms, causing their death.

 Indications Infections caused by Schistosoma mekongi, S. japonicum, S. mansoni, S. hematobium, liver flukes, Clonorchis sinensis, and Opisthorchis viverrini.

Treatment of neurocysticercosis, tissue flukes (opisthorchis, felineus, Paragonimus westermani, Fasciola hepatica), intestinal flukes (Heterophyes heterophyes, Fascilopsis buski), and intestinal cestodes (Diphyllobothrium latum, Taenia saginata, T. solium, Dipylidium caninum, Hymenolepsis nana), and schistosomiasis (in concurrent use with oxamniquine).

 Contraindications Ocular cysticercosis.

 Route/Dosage

Schistosomiasis

ADULTS and CHILDREN ³ 4 yr: PO 60 mg/kg in 3 equally divided doses q 4 to 6 hr for 1 day.

Clonorchiasis and Opisthorchiasis

ADULTS: PO 75 mg/kg in 3 equally divided doses q 4 to 6 hr for 1 day.

 Interactions

Cimetidine: Plasma levels of praziquantel may be elevated, increasing the pharmacologic and adverse effects.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Malaise; headache; fever; drowsiness; dizziness. DERMATOLOGIC: Urticaria. GI: Abdominal discomfort, with or without nausea. HEPATIC: Increased liver enzymes.

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Lactating women should avoid breastfeeding on day of treatment and for subsequent 72 hr. Children: Safety and efficacy not established in children < 4 yr.

 Administration/Storage

• Administer tablets during meals with liquids.
• Instruct patient not to chew tablets.
• Store at room temperature.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note history of seizures.
• Monitor for side effects, especially malaise, headache, dizziness, abdominal pain, nausea, or fever.

 Patient/Family Education

• Explain that treatment lasts only 1 day for most parasitic infections.
• Instruct patient to take drug with liquids during meals and not to chew tablets.
• Advise patient to have all family members examined for infestation.
• Emphasize need for follow-up examinations.
• Instruct patient to report the following symptoms to health care provider: malaise, headache, dizziness, abdominal pain, nausea, urticaria, or fever.
• Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts