Buy Praziquantel Online

Biltricide (praziquantel)

THERAPEUTIC CLASS

Antiparasitic agent

DEA CLASS

RX

INDICATIONS

Treatment of infections due to all species of schistosoma (eg, Schistosoma mekongiSchistosoma japonicumSchistosoma mansoni, Schistosoma hematobium), and infections due to the liver flukes, Clonorchis sinensis/Opisthorchis viverrini.

ADULT DOSAGE

Schistosomiasis

20mg/kg tid for 1 day; dosage intervals should be 4-6 hrs

Clonorchiasis/Opisthorchiasis

25mg/kg tid for 1 day; dosage intervals should be 4-6 hrs

PEDIATRIC DOSAGE

Schistosomiasis

≥4 Years:
20mg/kg tid for 1 day; dosage intervals should be 4-6 hrs

Clonorchiasis/Opisthorchiasis

≥4 Years:
25mg/kg tid for 1 day; dosage intervals should be 4-6 hrs

ADMINISTRATION

Oral route

Do not chew
Take w/ water during meals

HOW SUPPLIED

Tab: 600mg* *scored

CONTRAINDICATIONS

Ocular cysticercosis. Concomitant administration w/ strong CYP450 inducers, such as rifampin.

WARNINGS/PRECAUTIONS

Excretion may be delayed w/ impaired renal function. Caution in hepatosplenic schistosomiasis patients w/ moderate to severe liver impairment (Child-Pugh class B and C); reduced metabolism in these patients may lead to considerably higher and longer lasting plasma levels of unmetabolized drug. Minimal increases in liver enzymes reported in some patients. Monitor patients w/ cardiac irregularities during treatment. May exacerbate CNS pathology due to schistosomiasis; do not administer to patients w/ history of epilepsy and/or other signs of potential CNS involvement such as SQ nodules suggestive of cysticercosis. Hospitalization of patient for the duration of treatment is advised if schistosomiasis or fluke infection is associated w/ cerebral cysticercosis. Potential lack of efficacy against migrating schistosomulae reported; treatment 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. Use in patients w/ schistosomiasis may be associated w/ clinical deterioration (paradoxical reactions, serum sickness Jarisch-Herxheimer like reactions) that may lead to potentially life-threatening events (eg, respiratory failure, encephalopathy, cerebral vasculitis); reactions predominantly occur in patients treated during the acute phase of schistosomiasis. May impair physical/mental abilities.

ADVERSE REACTIONS

Malaise, headache, dizziness, abdominal discomfort (w/ or w/o nausea), rise in temperature, urticaria.

DRUG INTERACTIONS

See Contraindications. In patients receiving rifampin, alternative agents for schistosomiasis should be considered; if treatment w/ praziquantel is necessary, rifampin should be discontinued 4 weeks before administration and may be restarted 1 day after completion of treatment. CYP450 inducers (eg, phenytoin, phenobarbital, carbamazepine, dexamethasone) may reduce plasma levels. CYP450 inhibitors (eg, cimetidine, ketoconazole, itraconazole, erythromycin) may increase plasma levels. Grapefruit juice reported to increase levels.

PREGNANCY AND LACTATION

Category B, not for use in nursing.

MECHANISM OF ACTION

Antiparasitic agent; antihelminthic that induces rapid contraction of schistosomes by a specific effect on permeability of the cell membrane. Drug further causes vacuolization and disintegration of the schistosome tegument.

PHARMACOKINETICS

Absorption: Rapid (80%). Distribution: Found in breast milk. Elimination: Urine (80%, >99% as metabolites); T1/2=0.8-1.5 hrs. Administration in varying degrees of hepatic dysfunction resulted in different pharmacokinetic parameters.

ASSESSMENT

Assess for ocular cysticercosis, cardiac irregularities, cerebral cysticercosis, history of epilepsy, hepatic/renal impairment, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for hypersensitivity reactions, exacerbation of CNS pathology, increases in liver enzymes, clinical deterioration in patients w/ schistosomiasis, and other adverse events.

PATIENT COUNSELING

Counsel about possible side effects; advise to seek medical attention if any develop. Advise to avoid driving or operating machinery on the day of treatment and the following day. Advise to avoid nursing on day of treatment and for the subsequent 72 hrs.

STORAGE

Store below 30°C (86°F).

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