Pharmacology for Dentistry

362 Section 9/ Chemotherapy

eradicating ascariasis and ancylostomiasis.
It acts by stimulating ganglia of the worm
which results in tonic paralysis, which are
subsequently eliminated from the intestines.

Adverse effects include nausea, epigastric
discomfort, insomnia, dizziness, weakness and
drowsiness.

If taken along with alcohol, it may
produce disulfiram like reaction.

NICLOSAMIDE

It is salicylamide derivative, act by

inhibiting anaerobic phosphorylation of

ADP by the mitochondria of the parasite.

It is devoid of any major toxicity except

minor gastrointestinal disturbances.

PIPERAZINE CITRATE

It is an alternative drug for treatment

of ascariasis and pinworms.

It possibly exerts its action by

antagonizing the action of acetylcholine

thus blocking neuromuscular transmission.

Hence, flaccid paralysis occurs. It is

considerably absorbed, partly metabolized

Table 9.10.1: Classification of anthelmintic agents.

Drug(s) Uses and Dose

1. Mebendazole (MEBEX) Ascariasis, ankylostomiasis: 100 mg BD × 3 days; Trichu-
   riasis: 400 mg single dose; Pinworm: 100 mg OD & repeat
   after 2 & 4 weeks; Intestinal capillariasis: 400 mg/d × 21 days;
   Taeniasis: 300 mg BD × 3 days.


2. Albendazole (ZENTEL) Ascariasis, ankylostomiasis and trichuriasis: 400 mg single
   dose; Taeniasis & strongyloidosis: 400 mg × 3 days;
   Neurocysticercosis: 15 mg/kg/daily × 1 month; Hydatid disease:
   400 mg BD × 1 month (if required repeat after 2 wks).


3. Thiabendazole (MINTEZOL) Trichinosis and strongyloidosis: 25 mg/kg/day in two divided
   doses × 2 days after meal (if required repeat after 2 days)


4. Levamisole (DECARIS) Ascariasis and hook worm infestation: 50-150 mg single dose.


5. Niclosamide (NICLOSAN) Taeniasis: 0.5-2 g (After breakfast 1 g to be chewed and
   swallowed with water followed by 1 g after 1 hr); For H. nana
   infestation: 2 g dose is repeated daily for 5 days.


6. Piperazine (as citrate) Ascariasis: 4.5 g OD × 2 days; in children 0.75 g/year of age
   (max 4.5 g); Enterobiasis: 4.5 g OD, repeat after 3 weeks.


7. Pyrantel pamoate For Ascaris, enterobius & ancylostoma: 10-15 mg/kg (max 1 g)
   single dose; Necator and strongyloides: 3 day course.


8. Diethyl carbamazine (HETRAZAN) Tropical eosinophilia: 4-6 mg/kg BD-TDS × 7-10 days; Filariasis:
   6-12 mg/kg OD-BD × 21 days; Also used in prophylaxis of filaria.


9. Ivermectin (IVERMECTOL) Onchocerciasis: 150 μg/kg single dose. Also used in intestinal
   nematode infection and enterobiasis. For scabies and
   strongyloidiasis: 200 μg/kg single dose.


10. Praziquantel (CYSTICIDE) Taeniasis: 10 mg/kg single dose; H. nana: 15-25 mg/kg single
    dose; Neurocysticercosis: 50 mg/kg in 3 divided doses × 15
    days; Schistosome and other flukes except Fasciola hepatica:
    75 mg/kg/day, can be repeated if needed.