Adult: 20 mg/kg tid at 4-6 hour intervals for 1 day only. Alternatively, 40-60 mg/kg as a single dose or in 2 divided doses. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines). Child: ≥4 years Same as adult dose.
Oral Clonorchiasis, Opisthorchiasis
Adult: 25 mg/kg tid at 4-6 hour intervals for 1-3 days. Dosage recommendations may vary among individual products or between countries (refer to detailed product guidelines). Child: ≥4 years Same as adult dose.
What are the brands available for Praziquantel in Thailand?
Praziquantel Should be taken with food. Swallow whole, do not chew/crush.
Contraindications
Hypersensitivity. Ocular cysticercosis. Concomitant use with strong CYP3A inducers (e.g. rifampicin).
Special Precautions
Patient with cardiac arrhythmias, cerebral cysticercosis, history of seizure, hepatosplenic schistosomiasis. Moderate to severe hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Cardiac effects (e.g. bradycardia, ectopic rhythm, AV block, ventricular fibrillation); exacerbation of CNS pathology. Ear and labyrinth disorders: Vertigo. Gastrointestinal disorders: Nausea, vomiting, abdominal pain or discomfort, diarrhoea. General disorders and administration site conditions: Malaise, fatigue, fever. Metabolism and nutrition disorders: Anorexia. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Headache, dizziness, drowsiness. Skin and subcutaneous tissue disorders: Rash, urticaria. Potentially Fatal: Jarisch-Herxheimer-like or paradoxical reactions (in patients with acute phase schistosomiasis).
This drug may cause dizziness or drowsiness, if affected, do not drive or operate machinery during and for 24 hours after the treatment.
Monitoring Parameters
Perform urine and faecal culture for ova prior to treatment initiation. Monitor LFTs during treatment; signs of cardiac irregularities or seizures.
Drug Interactions
Reduced plasma concentration with chloroquine and CYP450 inducers (e.g. dexamethasone, efavirenz). Increased plasma concentration with CYP450 inhibitors (e.g. itraconazole, ketoconazole, erythromycin, ritonavir). Potentially Fatal: Concomitant use with strong CYP3A inducers (e.g. rifampicin) may cause subtherapeutic concentration of praziquantel.
Food Interaction
Increased serum concentration with grapefruit juice.
Action
Description: Mechanism of Action: Praziquantel is an anthelmintic agent. It increases the cell permeability to Ca in schistosomes, resulting in strong contractions and paralysis of worm musculature. This effect causes the detachment of suckers from the walls of blood vessels and subsequent dislodgement by normal blood flow. Pharmacokinetics: Absorption: Rapidly absorbed from the gastrointestinal tract. Time to peak plasma concentration: 1-4 hours. Distribution: Distributed into the CSF; enters breast milk. Plasma protein binding: Approx 80%. Metabolism: Rapidly and extensively metabolised in the liver by CYP2B1 and CYP3A4 isoenzymes to form hydroxylated and conjugated metabolites; undergoes extensive first-pass metabolism. Excretion: Via urine (approx 80%, mainly as metabolites). Elimination half-life: Approx 1-1.5 hours (praziquantel); approx 4 hours (metabolites).
Chemical Structure
Praziquantel Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4891, Praziquantel. https://pubchem.ncbi.nlm.nih.gov/compound/Praziquantel. Accessed Nov. 25, 2024.
P02BA01 - praziquantel ; Belongs to the class of quinoline derivatives and related substances used as antitrematodals.
References
Anon. Praziquantel. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 05/11/2024.Bayer New Zealand Limited. Biltricide 600 mg Film Coated Tablet data sheet 03 July 2023. Medsafe. http://www.medsafe.govt.nz. Accessed 05/11/2024.Biltricide (Bayer HealthCare Limited). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 05/11/2024.Brayfield A, Cadart C (eds). Praziquantel. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/11/2024.Joint Formulary Committee. Praziquantel. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/11/2024.Praziquantel Tablet, Film Coated (Endo USA, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 05/11/2024.Praziquantel. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 05/11/2024.
Sign Out
