Copyright © 2021 Elsevier B.V. or its licensors or contributors. Six months post-treatment, a cure rate of 87% was recorded, which was significantly higher than the cure rate of 73% obtained among 74 patients treated with racemic praziquantel at the same dose (Wang et al., 1987a,b). Single 100 mg/kg oral doses were rapidly absorbed. In mice harbouring adult S. japonicum treated with l-praziquantel or praziquantel treated at a daily dose of 50 mg/kg for 2 days, the respective worm burden reductions were 75% and 56%. There have been no controlled trials of praziquantel for other intestinal flukes. It should not be used for worm infections of the eye. PRECAUTIONS: Before taking praziquantel, tell your doctor or pharmacist if you are … The higher efficacy obtained with l-praziquantel compared to the racemic mixture against S. japonicum was confirmed in clinical trials in endemic areas (Wang et al., 1988). Concurrent administration may result in elevated praziquantel plasma concentrations. Praziquantel is not recommended in animals under 4 weeks of age. On the other hand, binding of d-praziquantel and l-praziquantel to human plasma proteins was similar, indicating species differences in the protein binding of the praziquantel enantiomers (He et al., 1991). Since a double-blind placebo-controlled trial that would resolve the issue of praziquantel in pregnant and lactating women is thought to be unethical, pregnant and lactating women should be treated with praziquantel. Even though the drug has not been found to cause any toxicity or serious negative effects in pregnant or nursing cats, it is always advisable to inform your vet about it [3]. motor activity, contraction and damage to the tegumental) and worm burden reductions (Liu et al., 1986; Wang et al., 1987a; Xiao et al., 1998a). Praziquantel is one of the anthelmintics with activity against the trematodes that can be associated with gastrointestinal disease (Alaria spp., N. salmincola, H. americana, P. fastosum).18 Praziquantel administration after fenbendazole administration has also be used successfully to treat peritoneal larval cestodiasis.25 However, optimal protocols are unknown and praziquantel is not labeled for these infections. Some praziquantel-containing products are also labeled for the removal and control of Echinococcus granulosa and Echinococcus multilocularis in dogs in some countries. Do not use in pets that are allergic to it, in puppies less than 3 weeks old, or kittens less than 6 weeks old. Levels of the drug are increased when it is taken with cimetidine and with food, particularly meals high in fat and carbohydrate. Objective: To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia. Copyright © 2001 - 2021 Pediatric Oncall All Rights Reserved. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. METHODS: In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Praziquantel is rapidly absorbed, with an estimated bioavailability of 80% to 100% but undergoes extensive first-pass hepatic metabolism to inactive metabolites so that most of the active drug does not reach the systemic circulation.196 Praziquantel is completely metabolized, with 80% of the dose recovered as metabolites in urine within 4 days. Common side effects are appetite loss, dizziness, drowsiness, headache, malaise, abdominal pain, nausea, vomiting, and diaphoresis. In vitro and in vivo investigations with mice and rabbits experimentally infected with S. japonicum confirmed that l-praziquantel was superior to racemic and d-praziquantel in terms of physiological responses on the worms (e.g. Triclabendazole (10 mg/kg for 1 or 2 days) is an alternative. During pregnancy, however, important physiological changes could affect drug pharmacokinetics. You may report side effects to FDA at 1-800-FDA-1088. These are not all of the side effects that may occur. Stool specimens were examined using a single Kato-Katz thick smear for … Praziquantel is excreted in small quantities in breast milk, but the dose would be considerably lower than that to which unborn children of mothers treated with praziquantel would be exposed. The only side effect of broad-spectrum praziquantel is just temporary ataxia. Side effects in humans may include poor coordination, abdo Call your doctor at once if you have: fever, chills, sore throat, headache, body aches, tiredness, not feeling well; slow or irregular heartbeats; stomach cramps, bloating, diarrhea, constipation, nausea; OBJECTIVE: To evaluate the efficacy and side effects of praziquantel (PZQ) in the treatment of schistosomiasis in Ethiopia. It has also been proposed that simultaneous administration of praziquantel and cimetidine could improve the efficacy of single-day therapy with praziquantel for cysticercosis and other parasitic diseases, such as schistosomiasis [49]. PZQ produces instantaneous contraction of the muscles of the parasite, followed by spastic paralysis of the worm, which is swept to the liver for phagocytosis; From: Zakim and Boyer's Hepatology (Sixth Edition), 2012, In Meyler's Side Effects of Drugs (Sixteenth Edition), 2016. Otherwise, this medicine is generally considered very safe for use in dogs. The effect is more marked on adult worms compared to young worms. Sign up now. l-Praziquantel has a better toxicological profile than d enantiomer or racemic praziquantel. Praziquantel is a drug that is commonly used in veterinary medicine. Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Side effects to watch in … All these signs resolve spontaneously within 24 hours. The cure rates 3 and 6 months post-treatment were 85–88% and 72–74%, respectively. Concurrent administration may result in elevated praziquantel plasma concentrations. Praziquantel is given on and off label and by mouth or injection to treat various internal parasites. Figure 10. The mechanism of action of praziquantel is incompletely understood, but evidence from animal models189 and study of the drug's relative efficacy in schistosomiasis-naïve and endemic human populations190 indicates that a preformed antiparasitic antibody response is required for optimal activity. METHODS: In a cross-sectional study, stool specimens were collected from randomly selected 299 school children in Shesha Kekele Elementary School, Wondo Genet, Southern Ethiopia, in April 2010. Since the differences in pharmacodynamics and pharmacokinetics among praziquantel and its enantiomers are prominent, their metabolism has been studied extensively. Secondary effects are inhibition of glucose uptake, lowering of glycogen levels and stimulation of lactate release. The action of praziquantel is limited very specifically to trematodes and cestodes; nematodes (including filariae) are not affected. Side Effects of Praziquantel Use. Since parasite destruction within the eye may cause irreparable lesions, ocular cysticercosis should not be treated with praziquantel. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Secondary effects are inhibition of glucose uptake, lowering of glycogen levels and stimulation of lactate release. Following extra-label treatment with Milbemax® to kill heartworm microfilaria, dogs should be carefully observed for shock-like reactions. Bithionol (30–50 mg/kg on alternate days for 10 to 15 doses) is a less commonly used alternative drug. While generally safe and effective when prescribed by a veterinarian, praziquantel can cause side effects in some animals. Fast Home Delivery with COD No Minimum Order Flat 18% OFF* on all medicines India's Most Trusted Medical Store Description and Brand Names. However, the apparent lack of teratogenic effects in mice, rats or rabbits given praziquantel while pregnant indicates that the drug may be safe to use during the classic teratogenic period of the human first trimester. Call your doctor for medical advice about side effects. Praziquantel is well absorbed after oral administration and undergoes extensive first-pass metabolism, especially when it is given simultaneously with corticosteroids and anticonvulsants [2].Cimetidine significantly increases praziquantel serum concentrations by inhibiting its first-pass metabolism [47].The concurrent … The Common and Uncommon Side Effects. Praziquantel (25 mg/kg given three times per day for 2 consecutive days) usually produces cure rates higher than 90%.13,14 For cerebral disease, a short course of corticosteroids should be given with the praziquantel to reduce the inflammatory response around dying flukes. Common sideeffects include abdominal discomfort, nausea, vomiting, malaise, headache,dizziness, drowsiness, and rectal bleeding.Rarer side effects include hypersensitivity reactions, such as fever,pruritus, and eosinophilia (may be due to dead and dying parasites) (WHOEMLib). Adverse reactions vary according to dose and duration of praziquantel medication. These results suggest that the first pass effect of praziquantel is pronounced and most likely steroselective (Qian et al., 1989). Excessive salivation as well as diarrhea is not uncommon side effects when praziquantel is used in felines with tapeworms. … It is the major drug used for treatment of schistosomiasis, including for community control programs for this disease. Undesirable effects are usually transitory and rarely of clinical importance. Billy Howard, in xPharm: The Comprehensive Pharmacology Reference, 2007, Shu-Hua Xiao, ... Jürg Utzinger, in Advances in Parasitology, 2010. Praziquantel should not be used in animals with known hypersensitivity or allergy to the drug. The site does not guarantee the accuracy or authenticity of the information. Praziquantel is given on and off label and by mouth or injection to treat various internal parasites. The side effects of praziquantel typically include the following: Diarrhea; There have been a few unconfirmed reports of seizures and other nervous system effects following administration of Milbemax®. Observations under a scanning electron microscope (SEM) underscored these findings; more pronounced tegumental alterations induced by l-praziquantel (Xiao and Shen, 1995b). Praziquantel may result in these side effects: Vomiting; Diarrhea or loose stool; Loss of appetite; Lethargy; Pain at the injection site; Drooling in cats; Please consult your veterinarian before giving any other antihelmintic (deworming) drug or herbal supplement to your pet while on, or before giving Praziquantel. PRAZIQUANTEL - Learn about PRAZIQUANTEL including its uses, composition, side-effects, dosage, precautions & FAQs. Arrhythmogenic effects of praziquantel may partly be mediated via the central nervous system (CNS), and the arrhythmogenic effects of praziquantel may be caused mainly by d-praziquantel (Qian and Quan, 1989). It also interferes with parasite metabolism, exposing concealed antigens in the parasite.191, Reports from Senegal192 and Egypt193 of Schistosoma mansoni infection resistant to praziquantel and animal models have documented decreased efficacy.194 The mechanisms of resistance remain unclear, but resistant strains were less susceptible to praziquantel-induced tegumental damage in vivo.195 There have been no plausible reports of resistance in Schistosoma haematobium or Schistosoma japonicum; oxamniquine would be a treatment option for treatment of praziquantel-resistant S. mansoni infection. Praziquantel is in the anthelmintic class of medications. Introduction Praziquantel is a systemic anthelmintic used primarily to treat worm infections. The most commonly reported side effects are relatively mild and include transient nausea, vomiting, abdominal pain, dizziness, headache, and lassitude. Praziquantel side effects during treatment of Schistosoma mansoni infected pupils in Kibwezi, Kenya. The drug is rapidly and reversibly taken up by flukes and tapeworms but not metabolized. While it's possible that your pet might have an allergic reaction to the medicine, this reaction is quite uncommon. In general, the adverse effects are related to the intensity and location of the infection, suggesting that they are due to the host immune response to release of parasite antigen.203 In one study undertaken in an African population heavily infected with S. mansoni, the frequency of GI symptoms, namely abdominal pain and bloody diarrhea, exceeded 50%.204 However, in a large retrospective study of patients infected with S. japonicum, less than 0.5% had significant side effects attributable to the drug.205, Jeffrey L. Jones, in Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), 2018. However praziquantel at 15, 25, or 40 mg/kg in a single oral dose has been used successfully [16]. Symptoms begin 30 minutes after ingestion, may require spasmolytics for relief, and usually disappear spontaneously after a few hours. If your cat shows severe symptoms, get them to a vet immediately to have a … While it's possible that your pet might have an allergic reaction to the medicine, this situation is very rare. Drug information provided by: IBM Micromedex. Hussein I. El-Subbagh, Abdullah A. Al-Badr, in Analytical Profiles of Drug Substances and Excipients, 1998. Yupaporn Wattanagoon, Danai Bunnag, in Hunter's Tropical Medicine and Emerging Infectious Disease (Ninth Edition), 2013. Lorlatinib: (Moderate) Monitor for reduced response to praziquantel if coadministered with lorlatinib. Side effects are uncommon but may include lack of appetite, vomiting, diarrhea, drooling, or tiredness. Risks and Side Effects of Praziquantel in Cats. Do not use in pets that are allergic to it, in puppies less than 3 weeks old, or kittens less than 6 weeks old. Alcohol: Potentiates CNS effects of praziquantel. The serum concentrations of the three drugs decreased markedly in the systemic circulation, especially that of d-praziquantel. It should be given with food and plenty of water because of its bitter taste. Praziquantel is considered safe in children older than 2 years. What are the possible side effects of praziquantel (Biltricide)? It is also recommended that mothers should not breastfeed for 3 days after drug ingestion. Use of any information is solely at the user's own risk. To avoid unwanted problems, lactating women can take curative therapy with praziquantel and refrain from breastfeeding for 48 hours. In a comparative study, 245 and 122 patients with schistosomiasis japonica were treated with a single 30 mg/kg oral dose of l-praziquantel and racemic praziquantel, respectively. Common side effects may include: general ill feeling; headache, dizziness; nausea, stomach discomfort; fever; or; rash. As illustrated in Figure 10, it has been reported that praziquantel is completely metabolized in humans, resulting in monohydroxylated product as a major metabolite and polyhydroxylated product as a minor metabolite [48]. If a negative reaction occurs, please call your veterinary office. As long as a short-term alternative (bottle feeding) exists, this seems a reasonable alternative, especially since schistosomiasis is rather uncommon in children under 2 years of age. Jaoko WG(1), Muchemi G, Oguya FO. <4 years, safety and efficacy not established. It was also found that the binding of praziquantel enantiomers to bovine serum albumin and rabbit plasma proteins was stereoselective. Side Effects and Drug Reactions. For example, there is a … Side Effects; Products and services. Praziquantel is safe to use in puppies over 4 weeks of age and … Praziquantel pharmacokinetics in non-pregnant adults are characterized by peak concentrations one to three hours after a dose and a terminal half-life that ranges between 0.8 and 1.5 hours. It is not known to what extent praziquantel crosses the placenta, but only a small amount (<0.001%) is excreted in breast milk.197 The bioavailability of praziquantel is influenced by other drugs. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. Praziquantel is used to treat schistosomiasis, also known as snail fever or bilharzia, an infection of the … Michael R. Lappin, in Canine and Feline Gastroenterology, 2013. Praziquantel Side Effects Headache, dizziness, stomach pain, nausea, tiredness, weakness, joint/muscle pain, loss of appetite, vomiting, and sweating may occur. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. It is currently the most effective drug for the treatment of schistosomiasis. 20 mg/kg (Oral) thrice a day for 1 day to be taken at intervals of 4-6 hours. Adverse Effects: Praziquantel is well tolerated. Cimetidine significantly increases praziquantel serum concentrations by inhibiting its first-pass metabolism [47]. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Zakim and Boyer's Hepatology (Sixth Edition), Meyler's Side Effects of Drugs (Sixteenth Edition), Analytical Profiles of Drug Substances and Excipients, xPharm: The Comprehensive Pharmacology Reference, Important Helminth Infections in Southeast Asia: Diversity and Potential for Control and Elimination, Part B, Liu et al., 1986; Wang et al., 1987a; Xiao et al., 1998a, Zhang and Quan, 1997; Zhang et al., 1996a, Zhao et al., 1995, Hunter's Tropical Medicine and Emerging Infectious Disease (Ninth Edition), Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), Clonorchis, Opisthorchis, Fasciola, and Paragonimus Species, Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), Co-administration of carbamazepine may decrease the effectiveness of praziquantel, Chloroquine may decrease the bioavailability of praziquantel, Cimetidine may decrease the metabolism of praziquantel, Dexamethasone may decrease plasma concentrations of praziquantel, Fosphenytoin may increase the metabolism of praziquantel, Phenytoin may increase the metabolism of praziquantel. In humans specifically, it is used to treat schistosomiasis, clonorchiasis, opisthorchiasis, tapeworm infections, cysticercosis, hydatid disease, and other fluke infections. The 4-Hydroxycyclohexylcarbonyl analogue of praziquantel has been identified to be the major metabolite-in serum, which is 400-fold less active than the parent drug and usually excreted as a mixture of glucuronides and/or sulfates [1, 49, 50]. The effect of encapsulating l-praziquantel and praziquantel with liposomes (l-praziquantel and praziquantel) on drug efficacy was investigated. If your pet is very young (under 2 months), it's generally not advisable to give him praziquantel. Adverse effects are uncommon; they include vomiting, lack of appetite, diarrhea … James S. McCarthy, Thomas A. Moore, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases (Eighth Edition), 2015. Read about its interactions, intake instructions and how PRAZIQUANTEL works only on Pharmasy. The concurrent administration of cimetidine with praziquantel in neurocysticercosis allows simplification of the effective praziquantel regimen from 50 mg/kg/day for 2 weeks to a one-day regimen of three doses of 25 mg/kg at 2-hour intervals; this regimen increases the time over which the parasite is exposed to high drug concentrations and produces similar benefits, and also reduces the cost, length of treatment, and total dose used [48]. See the earlier discussion on clonorchiasis and opisthorchiasis for additional information about praziquantel and the section on fascioliasis for additional information about triclabendazole and bithionol. No dose adjustment is required in renal failure.200 Serum praziquantel concentrations and side effects increase in proportion to the degree of hepatic impairment201; thus, dose reduction may be indicated in these individuals. Author information: (1)Department of Medical Microbiology, College of Health Sciences, University of Nairobi, Nairobi. In a rodent study, fetal death ensued when the drug was administered in high doses to pregnant rats between the 6th and 10th day of gestation.202 Although there have been no reports of adverse maternal and fetal outcome in large-scale treatment programs in which inadvertent administration to women in early pregnancy was likely, it is recommended that praziquantel be withheld during the first trimester.