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Praziquantel

    Brands

    DEA Class; Rx

    Common Brand Names; Biltricide

    • Anthelmintics

    Oral anthelmintic agent (trematodicide)
    Used for schistosomiasis, clonorchiasis, and opisthorchiasis; also effective for certain cestode (tapeworm) infections
    Alternative to albendazole for cysticercosis, but associated with higher incidence of side effects

    Indicated for treatment for schistosomiasis caused by all species of Schistosoma

    Indicated for clonorchiasis and opisthorchiasis caused by liver flukes (Clonorchis sinensis, Opisthorchis viverrini)

    For the treatment of neurocysticercosis.

    For the treatment of taeniasis (tapeworm infection).

    Hypersensitivity

    Intraocular cysticercosis

    Concomitant use with strong CYP450 inducers

    • Appetite loss
    • Dizziness
    • Drowsiness
    • Headache
    • Malaise
    • CSF reaction syndrome in patients treated for neurocysticercosis
    • Abdominal pain
    • Nausea
    • Vomiting
    • Diaphoresis
    • Diarrhea
    • Fever
    • Itching
    • Rash
    • Urticaria

    Clinical deterioration may occur when treating schistosomiasis (eg, paradoxical reactions, serum sickness Jarisch-Herxheimer like reactions [sudden inflammatory immune response suspected to be caused by the release of schistosomal antigens]); reactions predominantly occur in patients treated during the acute phase of schistosomiasis

    Can exacerbate CNS pathology due to schistosomiasis, paragonimiasis, or Taenia solium cysticercosis; consider whether to treat with praziquantel in patients with epilepsy or other CNS diseases; hospitalize patient for duration of treatment if infection found to be associated with cerebral cysticercosis

    Evidence suggests treatment with praziquantel in the acute phase of infection may not prevent progression from asymptomatic infection to acute schistosomiasis, or from asymptomatic infection/acute schistosomiasis into chronic phase; may lead to potentially life-threatening events, for example, respiratory failure, encephalopathy, papilledema, and/or cerebral vasculitis

    Bradycardia, ectopic rhythms, ventricular fibrillation, and AV blocks observed; monitor patients with cardiac arrhythmias during treatment

    Reduced hepatic metabolism of praziquantel results in higher and sustained plasma concentrations of unmetabolized drug in patients with liver impairment; monitor for adverse reactions when administering the recommended dose to patients with hepatosplenic schistosomiasis who have moderate or severe liver impairment (Child-Pugh Class B or C)

    Published studies have not identified association with use during pregnancy and major birth defects, miscarriage or adverse maternal or fetal outcomes

    Limited data from published literature reports presence of drug in human milk at low concentrations; there is no information on effects of drug in breastfed infant or effects on milk production

    Adults

    75 mg/kg/day PO.

    Geriatric

    75 mg/kg/day PO.

    Adolescents

    75 mg/kg/day PO.

    Children

    75 mg/kg/day PO.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Praziquantel 

    tablet

    • 600mg