Clonorchiasis Infection by Opisthorchis viverrini Schistosomiasis

Anthelmintic Systemic: Vermicidal; precise mechanism of action unknown, but may involve synergy between praziquantel and the host's humoral immune response in S. mansoni; praziquantel is rapidly taken up by helminths and also appears to increase permeability of helminth's cell membrane, leading to a loss of intracellular calcium; massive contraction and paralysis of the helminth's musculature rapidly result; after exposure to praziquantel, tegument in neck region of adult helminths develops blebs, which appear to burst and disintegrate; praziquantel also produces intense vacuolization at several sites in tegument of adult schistosomes; in S. mansoni, this is followed by phagocytic attachment to parasite and, ultimately, death.

Absorption Systemic: Rapidly absorbed
Metabolism Systemic: Hepatic: First-pass
Excretion Systemic: Fecal: small amounts; Renal: 72 to 80% Elimination Half Life Systemic: Praziquantel: 0.8 to 1.5 h Metabolites: 4 to 6 h

concomitant use with strong CYP inducers such as rifampin hypersensitivity to praziquantel or any excipients ocular cysticercosis

B(FDA) B1(AUS)

WHO: Compatible with breastfeeding. Micromedex: Infant risk cannot be ruled out.

Common Gastrointestinal: Abdominal pain, Nausea, Vomiting
Neurologic: Dizziness (36% )
Other: Fever (10% )
Serious Cardiovascular: Cardiac dysrhythmia
Immunologic: Hypersensitivity reaction
Neurologic: Inflammatory disease, acute, CNS, Seizure

Clonorchiasis 25 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals) Infection by Opisthorchis viverrini 25 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals) Schistosomiasis 20 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals)

General Dosage Information Safety in children less than 4 yr old has not been established
Clonorchiasis 25 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals)
Infection by Opisthorchis viverrini 25 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals)
Schistosomiasis 20 mg/kg ORALLY 3 times over 1 day (at 4 to 6 hr intervals)

Dose adjustments for renal impairment are not considered necessary

A) Patients with hepatosplenic schistosomiasis and moderate to severe liver impairment (Child-Pugh classes B and C) may experience reduced metabolism of praziquantel resulting in higher and more prolonged plasma concentrations. B) Liver blood flow is reduced in advanced stages of schistosomiasis. Antipyrine clearance may remain unchanged or be slightly reduced. Chronic liver disease secondary to schistosomiasis is not true cirrhosis and hepatocyte dysfunction is reported to be minimal until the very last stages of the disease. Dosage recommendations for patients with liver disease are controversial

Oral route 1) Praziquantel (Biltricide(R)) tablets should be stored at temperatures below 86 degrees Fahrenheit (30 degrees Celsius)