Praziquantel (anthelmintic, deworming agent)

Praziquantel is a medication under the class of drugs known as antihelminthics. Antihelminthics are drugs that eliminate parasites (“bulate sa tiyan’) such as tapeworms, pinworms, roundworms, and several others. Praziquantel is the drug of choice for treating schistosomiasis.

Schistosomiasis is also known as bilharzia or “snail fever.” The most common species of this blood fluke that infects humans are Schistosoma mansoni, S. haematobium, and S. japonicum. The worms initially infect fresh-water snails and eventually release free-swimming larva (cercariae) that can enter a human host through broken skin.

Uses

What is praziquantel used for?

Praziquantel primarily treats the following:

• Schistosomiasis
• Clonorchiasis
• Intestinal fluke infections
• Lung fluke infections
• Opistochiasis

How should I take Praziquantel?

Read the directions on the packaging for complete information. Check the label and expiration date.

Reconstitute the oral suspension with the appropriate amount of water. Only use a medical-grade measuring cup, not a household spoon. For tablets, swallow it whole without chewing, crushing, or dissolving it in liquid. It is best taken with meals.

How do I store praziquantel?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & Warnings

What should I know before using praziquantel?

Before using this drug, tell your doctor if you are/have:

• Pregnant or breastfeeding.
• Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
• An allergy to any of the ingredients of this product.
• Any other illnesses, disorders, or medical conditions.

Is it safe during pregnancy or breastfeeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A=No risk
• B=No risk in some studies
• C=There may be some risk
• D=Positive evidence of risk
• X=Contraindicated
• N=Unknown

Side Effects

What side effects can occur when using praziquantel?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Headache
• Drowsiness
• Dizziness
• Malaise
• Gastrointestinal discomfort
• Loss of appetite
• Nausea, vomiting, diarrhea
• Rash or itchiness
• Muscle pain

Rare side effects may include:

• Seizures
• Eosinophilia
• Elevated liver enzymes

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with praziquantel?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with praziquantel?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Avoid consuming grapefruit products or alcohol while taking this drug. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with praziquantel?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Heart problems
• Cerebral cysticercosis
• History of epilepsy
• Liver impairment

Dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

Schistosomiasis

• Take 20 mg/kg for 3 doses every 4 to 6 hours, or 40-60 mg/kg as a single dose.

Clonorchiasis, intestinal fluke infections, lung fluke infections, opisthorchiasis

• Take 25 mg/kg 3 times a day every 4 to 6 hours for 1 to 2 days, or 40 mg/kg as a single dose.

What is the dose for a child?

For children 4 years and above, administer the same dose as an adult. The dose for children under 4 years has not been established. Consult with your doctor or pharmacist for any necessary dose adjustments or alternatives.

How is praziquantel available?

This drug is available in the following brands, dosage forms, and strengths:

• Biltricide 600 mg tablet
• Endure Medical Praziquantel 600 mg tablet
• Fluxide 600 mg/5 mL suspension

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.