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Praziquantel is an oral medication used to treat certain parasitic infections, in combination with other drugs to treat tapeworms and roundworms. The following article will provide you with some information about how to take Praziquantel, as well as the dosage and possible side effects when using the drug.1. Indications and contraindications when using Praziquantel
1.1 Indications Praziquantel has a spectrum of action on many flukes, the drug is commonly used to treat the following flukes:Schistosoma of all types (S. japonicum, S. haematobium, S. mekongi, S. mansoni), used in both acute and chronic phases, including neurogenic Schistosoma infections. Praziquantel is the mainstay of treatment for human schistosomiasis, often effective with a single dose. Clonorchis sinensis (Chinese small liver fluke), Opisthorchis viverrini (Southeast Asian liver fluke). Some other types of fluke: Heterophyes heterophyes (intestinal fluke), Fasciolopsis buski (intestinal fluke), Paragonimus westermani (lung fluke). Praziquantel has no effect on Fasciola hepatica (sheep liver fluke). Tapeworms that cause disease in humans: Taenia saginata (beef tapeworm), T. solium (pork tapeworm), Dipylidium caninum (dog tapeworm), Hymenolepsis nana (dwarf tapeworm), Diphyllobothrium latum (fish tapeworm). Praziquantel can be combined with pyrantel to treat ringworm. 1.2 Contraindications Hypersensitivity or allergy to the components of the drug Praziquantel Cystic disease in the eye Cystic disease in the spinal cord.
Thuốc Praziquantel cần được bác sĩ chỉ định sau khi qua thăm khám
2. Dosage and how to use Praziquantel
2.1. How to take Praziquantel Praziquantel is taken by mouth with meals, usually 3 times a day (4 to 6 hours apart). Take the tablet or each broken dose with a full glass of water, do not chew or suck the medicine because the bitter taste of the medicine can cause vomiting. If the patient has difficulty swallowing the medicine, you can crush it and mix it with food. However, you must use it within 1 hour of mixing the medicine. Dosage is based on your medical condition, weight, and your body's response to the drug. The medicine has notches that help break it up to get the correct dose. Avoid drinking grapefruit juice or eating grapefruit while using this medicine. Grapefruit juice may increase the risk of side effects with Praziquantel. To reduce the risk of adverse effects on the nervous system in patients with brain fluke larvae, use in combination with dexamethasone 6-24 mg/day or prednisolone 30-60 mg/day.
2.2. Dosage: For both adults and children Schistosomiasis: For adults and children over 4 years old: 60 mg/kg/day in 3 divided doses or 40 mg/kg/day in 2 divided doses at 4-6 intervals hourly (or a single dose of 40-60 mg/kg/day). Use for 1 day. Small liver fluke Clonorchis sinensis and Opisthorchis viverrini: Adults and children over 4 years old: use the drug for 1-2 days, a single dose of 40 - 50 mg/kg/day or 75 mg/kg/day in 3 divided doses. Other tapeworms (Fasciolopsis buski, Metagonimus yokogawai, Heterophyes heterophyes): 75 mg/kg/day, divided into 3 times. Nanophyetus salmincola: 60 mg/kg/day, divided into 3 times a day. Paragonimus westermani: take the drug for 1-2 days, 25 mg/kg/time x 3 times/day. P. uterobilateralis: 25 mg/kg/time x 3 times/day, used for 2 days. Tapeworms: adult and intestinal stage (fish tapeworm, beef tapeworm, dog fluke, pork fluke): 5-25 mg/kg, single dose. Hymenolepis nana: 25 mg/kg/time, single dose. Larval and tissue stage: Treatment of larval stage of swine flu: 50 mg/kg/day, divided into 3 times, for 15 days. Brain fluke larvae: 50-100mg/kg/day, divided into 3 equal doses, taken daily, for 30 days.
3. Undesirable effects
Most of the side effects appear due to the release of substances inside the parasites when they die and the body's immune response to these substances. The more severe the infection, the more common and severe the side effects. Adverse effects when using Praziquantel are common but are usually mild and quickly disappear. Contact your doctor if you experience any side effects that are unusual, persistent, or more serious.
Central Nervous System: Common side effects are dizziness, headache, irritability. Patients may also experience drowsiness, fatigue, high fever, convulsions, or increased intracranial pressure. Most patients with brain fluke larvae experience CNS side effects due to cell death of the parasite. These side effects can be life-threatening and are alleviated when corticosteroids are used concurrently. All patients with brain fluke larvae are recommended to be hospitalized during treatment. Gastrointestinal tract: Approximately 90% of patients experience abdominal pain, distension, nausea and vomiting. Diarrhea may occur and get worse; sometimes accompanied by low-grade fever and bloody stools. Hepatic: Asymptomatic and transient elevations of liver enzymes (AST and ALT) were observed frequently (up to 27% of cases). To date, no cases of symptomatic liver injury have been reported. Body reactions: Urticaria, rash, pruritus and eosinophilia. Other parts: Back pain, muscle pain, joint pain, fever, sweating, arrhythmia and hypotension. Serious allergic reactions are rare and only a few cases of anaphylaxis have been reported worldwide. However, if they do occur, they can be life-threatening if not treated promptly. Contact your doctor immediately if you experience symptoms such as: shortness of breath, rapid heart rate, edema...
Praziquantel có thể gây tác dụng phụ như rối loạn nhịp tim ở một số người bệnh
4. Be careful when taking the drug Praziquantel
Praziquantel may cause dizziness and drowsiness during treatment and up to 24 hours after taking it. Do not drive, operate machinery or do anything that requires alertness during this time. Alcohol or stimulants can increase the side effects of the drug. Patients with brain fluke larvae need to be hospitalized for treatment and monitoring. Before using the drug, it is necessary to inform the doctor about the patient's medical history. With caution in patients with irregular heartbeat, during treatment must monitor the heart rate. The drug should be used with caution in patients with a history of convulsions or epilepsy. Praziquantel drug is metabolised in the liver, in case of patients with hepatomegaly due to schistosomiasis, drug metabolism may be reduced, resulting in high and prolonged drug concentrations in unchanged form. People over 65 years old and patients with kidney failure because kidney function may decline, the risk of drug toxicity is higher. Pregnancy: Praziquantel can cause abortion in rats at doses up to 3 times the human dose. One study found that treatment with praziquantel in pregnant women did not increase the incidence of preterm birth, stillbirth, low birth weight or birth defects. However, the drug should not be used because there is not enough evidence yet. During pregnancy, Praziquantel should only be used after consulting a doctor to fully weigh the benefits and risks when treating the disease. Breast-feeding: Low amounts of Praziquantel can pass into breast milk, although it is not known if this will harm your baby. It is best to stop breastfeeding and express discarded milk on the day of treatment and for 72 hours after stopping the drug.
5. Drug interactions
The drug is metabolised by the liver enzyme cytochrome P450 (CYP450). Therefore, concomitant use of Praziquantel with certain drugs and changes in CYP450 activity may increase or decrease plasma concentrations of Praziquantel. Reduced plasma concentrations of Praziquantel make it less effective.
Do not use Rifampicin with Praziquantel: Rifampicin is a strong inducer of CYP450, causing Praziquantel drug concentrations to fall below therapeutic levels. Studies have shown that Rifampin can reduce Praziquantel levels to undetectable levels in some people. Chloroquine: Reduces praziquantel concentrations. Carbamazepine and phenytoin have been reported to decrease the bioavailability of praziquantel. The drug cimetidine increases the bioavailability of praziquantel. The way praziquantel is used can determine the effectiveness or counterproductive effects of disease treatment. Therefore, patients should consult a doctor or pharmacist before taking the drug.
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