lPREGNANCYEmbryotoxic inanimalstudies, avoid if
possible.
lBREAST FEEDINGNo information available.
lHEPATIC IMPAIRMENT
Dose adjustmentsUse with caution—dose adjustment may
be necessary.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Levamisole for nephrotic
syndromewww.medicinesforchildren.org.uk/levamisole-for-
nephrotic-syndromelMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet
Tablet
CAUTIONARY AND ADVISORY LABELS 4
▶Ergamisol (Imported (Belgium))
Levamisole (as Levamisole hydrochloride) 50 mgErgamisol 50 mg
tablets| 20 tabletPsMebendazole
lINDICATIONS AND DOSE
Threadworm infections
▶BY MOUTH
▶Child 6 months–17 years: 100 mg for 1 dose, if
reinfection occurs, second dose may be needed after
2 weeks
Whipworm infections|Hookworm infections
▶BY MOUTH
▶Child 1–17 years: 100 mg twice daily for 3 days
Roundworm infections
▶BY MOUTH
▶Child 1 year: 100 mg twice daily for 3 days
▶Child 2–17 years: 100 mg twice daily for 3 days,
alternatively 500 mg for 1 doselUNLICENSED USENot licensed for use as a single dose of
500 mg in roundworm infections. Not licensed for use in
children under 2 years.
lINTERACTIONS→Appendix 1 : mebendazole
lSIDE-EFFECTS
▶Common or very commonGastrointestinal discomfort
▶UncommonDiarrhoea.flatulence
▶Rare or very rareAlopecia.dizziness.hepatitis.
neutropenia.seizure.severe cutaneous adverse reactions
(SCARs).skin reactions
lPREGNANCYManufacturer advises avoid—toxicity in
animalstudies.
lBREAST FEEDINGAmount present in milk too small to be
harmful but manufacturer advises avoid.
lPRESCRIBING AND DISPENSING INFORMATIONFlavours of
oral liquid formulations may include banana.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Mebendazole for worm
infectionswww.medicinesforchildren.org.uk/mebendazole-for-
worm-infections
lEXCEPTIONS TO LEGAL CATEGORYMebendazole tablets can
be sold to the public if supplied for oral use in the
treatment of enterobiasis in adults and children over
2 years provided its container or package is labelled to
show a max. single dose of 100 mg and it is supplied in a
container or package containing not more than 800 mg.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Oral suspension
▶Ovex(McNeil Products Ltd)
Mebendazole 20 mg per 1 mlOvex 100 mg/ 5 ml oral suspension|
30 mlp£ 6. 74 DT = £ 1. 55
▶Vermox(Janssen-Cilag Ltd)
Mebendazole 20 mg per 1 mlVermox 100 mg/ 5 ml oral suspension
| 30 mlP£ 1. 55 DT = £ 1. 55
Chewable tablet
▶Ovex(McNeil Products Ltd)
Mebendazole 100 mgOvex 100 mg chewable tablets sugar-free|
1 tabletp£ 2. 37 sugar-free| 4 tabletp£ 5. 55
▶Vermox(Janssen-Cilag Ltd)
Mebendazole 100 mgVermox 100 mg chewable tablets sugar-free|
6 tabletP£ 1. 34 DT = £ 1. 34Praziquantel
lINDICATIONS AND DOSE
Tapeworm infections (Taenia solium)
▶BY MOUTH
▶Child 4–17 years: 5 – 10 mg/kg for 1 dose, to be taken
after a light breakfast
Tapeworm infections (Hymenolepis nana)
▶BY MOUTH
▶Child 4–17 years: 25 mg/kg for 1 dose, to be taken after a
light breakfast
Schistosoma haematobiumworm infections|Schistosoma
mansoniworm infections
▶BY MOUTH
▶Child 4–17 years: 20 mg/kg, followed by 20 mg/kg after
4 – 6 hours
Schistosoma japonicumworm infections
▶BY MOUTH
▶Child 4–17 years: 20 mg/kg 3 times a day for 1 daylUNLICENSED USEPraziquantel is an unlicensed drug.
lINTERACTIONS→Appendix 1 : praziquantellMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: tablet
Tablet
▶Cesol (Imported (Germany))
Praziquantel 150 mgCesol 150 mg tablets| 6 tabletPs
▶Biltricide (Imported (Germany))
Praziquantel 600 mgBiltricide 600 mg tablets| 6 tabletPs
▶Cysticide (Imported (Germany))
Praziquantel 500 mgCysticide 500 mg tablets| 90 tabletPs5 Protozoal infection
Antiprotozoal drugs
Amoebicides
Metronidazole p. 333 is the drug of choice foracute invasive
amoebic dysenterysince it is very effective against vegetative
forms ofEntamoeba histolyticain ulcers. Tinidazole p. 335 is
also effective. Metronidazole and tinidazole are also active
against amoebae which may have migrated to the liver.
Treatment with metronidazole (or tinidazole) is followed by
a^10 -day course of diloxanide furoate p.^300.
Diloxanide furoate is the drug of choice for asymptomatic
patients withE. histolyticacysts in the faeces; metronidazole
and tinidazole are relatively ineffective. Diloxanide furoate is
relatively free from toxic effects and the usual course is of384 Protozoal infection BNFC 2018 – 2019
Infection5