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Treatment

Praziquantel , adults, 75 mg/kg/day orally in three divided doses for 1 day; the dosage for children is the same.

(Note: praziquantel should be taken with liquids during a meal.)

*Not FDA-approved for this indication

Praziquantel

Oral praziquantel is available for human use in the United States.

Note on Treatment in Pregnancy

Praziquantel is pregnancy category B. There are no adequate and well-controlled studies in pregnant women. However, the available evidence suggests no difference in adverse birth outcomes in the children of women who were accidentally treated with praziquantel during mass prevention campaigns compared with those who were not. In mass prevention campaigns for which the World Health Organization (WHO) has determined that the benefit of treatment outweighs the risk, WHO encourages the use of praziquantel in any stage of pregnancy. For individual patients in clinical settings, the risk of treatment in pregnant women who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment.

Pregnancy Category B: Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).

Note on Treatment During Lactation

Praziquantel is excreted in low concentrations in human milk. According to WHO guidelines for mass prevention campaigns, the use of praziquantel during lactation is encouraged. For individual patients in clinical settings, praziquantel should be used in breast-feeding women only when the risk to the infant is outweighed by the risk of disease progress in the mother in the absence of treatment.

Note on Treatment in Pediatric Patients

The safety of praziquantel in children aged less than 4 years has not been established. Many children younger than 4 years old have been treated without reported adverse effects in mass prevention campaigns and in studies of schistosomiasis. For individual patients in clinical settings, the risk of treatment of children younger than 4 years old who are known to have an infection needs to be balanced with the risk of disease progression in the absence of treatment.

References

  • Keiser J, Utzinger J. The drugs we have and the drugs we need against major helminth infections. Adv Parasitol 2010;73:197-230.
  • Sripa B, Kaewkes S, Intapan PM, Maleewong W, Brindley PJ. Food-borne trematodiases in Southeast Asia epidemiology, pathology, clinical manifestation and control. Adv Parasitol 2010;72:305-50.
  • Keiser J, Utzinger J. Food-borne tremadodiases. Clin Microbiol Rev 2009;22:466-83.
  • WHO, 2009. WHO Model Formulary. In: World Health Organization. WHO Press, Geneva.
  • Keiser J, Utzinger J. Chemotherapy for major food-borne trematodes: a review. Expert Opin Pharmacother 2004; 5: 1711–26.
  • Graczyk TK, Gilman RH, Fried B. Fasciolopsiasis: is it a controllable food-borne disease? Parasitol Res 2001;87:80-3.
 
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  • Page last updated: January 10, 2012
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