II. Indications

  1. Schistosomiasis
  2. Liver Flukes (Clonorchiasis, opisthorchiasis)
  3. Intestinal Tapeworms (off-label)
  4. Neurocysticercosis (off-label, with >2 viable parenchymal cysticerci)

III. Contraindications

  1. Ocular Cysticercosis

IV. Mechanism

  1. Antihelminth, Pyrazinoisoquinoline derivative
  2. Increases worm tegument and cell membrane permeability
    1. Allows for rapid influx of Calcium (including into muscle Sarcoplasmic Reticulum)
    2. Leads to rapid muscular contractions and then paralysis
  3. Breaks down worm tegument
    1. Allows for host responses against the worm including Phagocytosis

V. Medications

  1. Tablet: 600 mg
    1. Do not chew

VI. Dosing: Adults (and Children age >=1 year old)

  1. Schistosomiasis
    1. Praziquantel 20 mg/kg orally every 4 to 6 hours for 3 doses with both food and liquids
  2. Liver Flukes
    1. Praziquantel 25 mg/kg orally every 4 to 6 hours for 3 doses with both food and liquids
  3. Intestinal Tapeworms (off-label)
    1. Praziquantel 10 mg/kg orally for 1 dose
  4. Neurocysticercosis (off-label, with >2 viable parenchymal cysticerci)
    1. Praziquantel 50 mg/kg/day divided three times daily orally with both food and liquids for 10 days AND
    2. Albendazole AND
    3. Pretreatment with Corticosteroids

VII. Adverse Effects

  1. Flu-like symptoms
  2. Sedation
    1. May persist for up to 48 hours after dose

VIII. Safety

  1. May be used in pregnancy
  2. Manufacturer recommends against use in Lactation until >72 hours after last dose
    1. However, has been used in Lactation

IX. Drug Interactions

  1. Strong CYP3A4 Inducers
    1. Risk of treatment failure due to low serum levels of Praziquantel
  2. CYP3A4 Inhibitors
    1. May increase drug levels and toxicity

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Ontology: Praziquantel (C0032911)

Definition (NCI) A pyrazinoisoquinoline derivative with anthelminthic property. Praziquantel increases the permeability of the tegument of susceptible worms, resulting in an influx and increase in intra-tegumental calcium leading to rapid contractions and paralysis of the worm's musculature through a subsequent increase in levels of calcium in the sarcoplasmic reticulum. In addition, vacuolization of the tegumental syncytium and blebbing results in tegument disintegration, leads to antigen exposure and elicit host defense responses to the worm. The result is the formation of granulomas and phagocytosis.
Definition (MSH) An anthelmintic used in most schistosome and many cestode infestations.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D011223
SnomedCT 387310003, 55889005
English Prasiquantel, Praziquantel, 4H-Pyrazino(2,1-a)isoquinolin-4-one, 2-(cyclohexylcarbonyl)-1,2,3,6,7,11b-hexahydro-, praziquantel, praziquantel (medication), PRAZIQUANTEL, Praziquantel [Chemical/Ingredient], Praziquantel (product), Praziquantel (substance)
Swedish Prazikvantel
Czech praziquantel
Finnish Pratsikvanteli
Russian PRAZIKVANTEL, ПРАЗИКВАНТЕЛ
Japanese プラジクワンテル, プラジカンテル
Polish Prazykwantel
Spanish praziquantel (producto), praziquantel (sustancia), praziquantel, Praziquantel
French Praziquantel
German Praziquantel
Italian Praziquantel
Portuguese Praziquantel