Praziquantel

Praziquantel is a prescription drug used as an 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 available under the following different brand names: Biltricide.

Dosages of Praziquantel:

Adult and Pediatric Dosages:

Tablet

• 600 mg

Dosage Considerations – Should be Given as Follows:

Schistosomiasis

Adult Dosage:

• 20 mg/kg orally three times per day for 1 day, every 4-6 hours

Pediatric Dosage:

• Children under 4 years old: safety and efficacy not established
• Children 4 years and older: 20 mg/kg orally three times daily for 1 day, every 4-6 hours

Clonorchiasis, Opisthorchiasis

Adult Dosage:

• 75 mg/kg/day divided orally three times daily for 1 day, every 4-6 hours

Pediatric Dosage:

• Children under 4 years old: safety and efficacy not established
• Children 4 years and older: 75 mg/kg orally three times daily for 1 day, every 4-6 hours

Cysticercosis (off-label)

Adult Dosage:

• 50-100 mg/kg per day divided every 8 hours orally for 14 days

Pediatric Dosage:

• Children under 4 years old: safety and efficacy not established
• Children 4 years and older: 50-100 mg/kg orally three times daily for 30 days

Flukes (off-label)

Adult Dosage:

• 75 mg/kg per day orally divided three times per day for 1-2 days

Pediatric Dosage:

• Children under 4 years old: safety and efficacy not established
• Children 4 years and older: 75 mg/kg orally three times daily for 1-2 days

Tapeworms (off-label)

Adult Dosage:

• 5-10 mg/kg as single dose or 25 mg/kg if hymenolepsis nana

Pediatric Dosage:

• Children under 4 years old: safety and efficacy not established
• Children 4 years and older: 5-10 mg/kg as a single dose or 25 mg/kg if hymenolepsis nana

Common side effects of praziquantel include:

• abdominal pain
• allergic reaction
• cerebrospinal reaction syndrome
• diarrhea
• dizziness
• drowsiness
• feeling unwell (malaise)
• fever
• headache
• hives
• itching
• mild fever
• mild skin rash
• nausea
• rash
• sweating
• tired feeling
• upset stomach
• vomiting

Postmarketing effects of praziquantel include:

• abdominal pain
• allergic reaction
• bloody diarrhea
• convulsions (seizures)
• fatigue
• increased white blood cells
• irregular heartbeat
• loss of appetite
• muscle pain
• rash
• severe itching
• sleepiness
• spinning sensation (vertigo)
• vomiting
• weakness

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Severe interactions of praziquantel include:
  • bosentan
  • carbamazepine
  • dabrafenib
  • dexamethasone
  • efavirenz
  • enzalutamide
  • eslicarbazepine acetate
  • etravirine
  • fosphenytoin
  • mitotane
  • nafcillin
  • nevirapine
  • oxcarbazepine
  • pentobarbital
  • phenobarbital
  • phenytoin
  • primidone
  • rifabutin
  • rifampin
  • rifapentine
• Serious interactions of praziquantel include:
  • idelalisib
  • ivacaftor
  • Moderate interactions of praziquantel include:
  • cimetidine
  • crizotinib
  • crofelemer
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • grapefruit
  • iloperidone
• Mild interactions of praziquantel include:
  • albendazole
  • chloroquine
  • hydroxychloroquine sulfate

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

This medication contains praziquantel. Do not take Biltricide if you are allergic to praziquantel or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity
• Intraocular cysticercosis
• Strong CYP450 inducers
  • Coadministration with strong CYP450 inducers (rifampin) is contraindicated since therapeutically effective blood levels of praziquantel may not be achieved
  • In patients receiving rifampin who need immediate treatment for schistosomiasis, alternative agents for schistosomiasis should be considered
  • If treatment with praziquantel is necessary, rifampin should be discontinued 4 weeks before praziquantel administration
  • Treatment with rifampin can be restarted 1 day after the completion of praziquantel treatment.

Effects of Drug Abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Praziquantel?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Praziquantel?"

Cautions

• Swallow quickly with water, otherwise the risk of regurgitation due to bitter taste
• Coadministration with moderate CYP3A4 inducers (phenytoin, phenobarbital, carbamazepine, dexamethasone) may reduce blood levels

Pregnancy and Lactation

• Praziquantel use during pregnancy may be acceptable. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risk.
• Praziquantel enters breast milk; do not nurse on the day of taking the drug and for 72 hours thereafter if breastfeeding.