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Ascaris Lumbricoides Medication

  • Author: Aaron Dora-Laskey, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
Updated: May 18, 2016

Medication Summary

Benzimidazoles are effective for the treatment of intestinal ascariasis, although some authors recommend against their use in the first year of life and during pregnancy due to their teratogenic effects in animal studies. The most commonly recommended agents are albendazole and mebendazole. Ivermectin and pyrantel pamoate are alternatives, the latter having been suggested for pregnant patients in whom benzimidazoles are contraindicated. An anthelmintic agent from China, tribendimidine (at a dose of 300 mg), has been shown to be as efficacious as albendazole.[19, 20]



Class Summary

Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.

Albendazole (Albenza)


Decreases ATP production in worm, causing energy depletion, immobilization, and finally death.

Mebendazole (Vermox)


Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell.

Piperazine citrate


Recommend for GI or biliary obstruction secondary to ascariasis; causes flaccid paralysis of the helminth by blocking response to worm muscle to acetylcholine.

Pyrantel pamoate (Antiminth)


Depolarizing neuromuscular blocking agent; inhibits cholinesterases, resulting in spastic paralysis of worm.

Ivermectin (Stromectol)


Binds selectively with glutamate-gated chloride ion channels in invertebrate nerve and muscle cells, causing cell death.

Levamisole (Ergamisol)


May inhibit worm copulation via agonism of L-subtype nicotinic acetylcholine receptors in male nematode muscles.

Contributor Information and Disclosures

Aaron Dora-Laskey, MD Clinical Assistant Professor, Department of Emergency Medicine, Wright State University, Boonshoft School of Medicine

Aaron Dora-Laskey, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.


Eric L Weiss, MD, DTM&H Medical Director, Office of Service Continuity and Disaster Planning, Fellowship Director, Stanford University Medical Center Disaster Medicine Fellowship, Chairman, SUMC and LPCH Bioterrorism and Emergency Preparedness Task Force, Clinical Associate Professor, Department of Surgery (Emergency Medicine), Stanford University Medical Center

Eric L Weiss, MD, DTM&H is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, American Medical Association, American Society of Tropical Medicine and Hygiene, Physicians for Social Responsibility, Southeastern Surgical Congress, Southern Oncology Association of Practices, Southern Clinical Neurological Society, Wilderness Medical Society

Disclosure: Nothing to disclose.

Ugo Anthony Ezenkwele, MD, MPH Vice Chief of Emergency Medicine, Woodhull Medical and Mental Health Center; Associate Professor of Clinical Emergency Medicine, Department of Emergency Medicine, New York University School of Medicine

Ugo Anthony Ezenkwele, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, National Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jon Mark Hirshon, MD, MPH, PhD Professor, Department of Emergency Medicine, University of Maryland School of Medicine

Jon Mark Hirshon, MD, MPH, PhD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Jeter (Jay) Pritchard Taylor, III, MD Assistant Professor, Department of Surgery, University of South Carolina School of Medicine; Attending Physician, Clinical Instructor, Compliance Officer, Department of Emergency Medicine, Palmetto Richland Hospital

Jeter (Jay) Pritchard Taylor, III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Columbia Medical Society, Society for Academic Emergency Medicine, South Carolina College of Emergency Physicians, South Carolina Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Employed contractor - Chief Editor for Medscape.

Additional Contributors

Mark Louden, MD Assistant Professor of Clinical Medicine, Division of Emergency Medicine, Department of Medicine, University of Miami, Leonard M Miller School of Medicine

Mark Louden, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the medical review of this article by Joseph U Becker, MD.

  1. Crompton DW. How much human helminthiasis is there in the world?. J Parasitol. 1999 Jun. 85(3):397-403. [Medline].

  2. Albonico M, Ramsan M, Wright V, et al. Soil-transmitted nematode infections and mebendazole treatment in Mafia Island schoolchildren. Ann Trop Med Parasitol. 2002 Oct. 96(7):717-26. [Medline].

  3. Luoba AI, Wenzel Geissler P, Estambale B, et al. Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Trop Med Int Health. 2005 Mar. 10(3):220-7. [Medline].

  4. Mishra PK, Agrawal A, Joshi M, Sanghvi B, Shah H, Parelkar SV. Intestinal obstruction in children due to Ascariasis: a tertiary health centre experience. Afr J Paediatr Surg. 2008 Jul-Dec. 5 (2):65-70. [Medline].

  5. Haque M, Kamal F, Chowdhury S, Uzzaman M, Aziz I. Non Obstetric Causes and Presentation of Acute Abdomen among the Pregnant Women. J Family Reprod Health. 2014 Sep. 8 (3):117-22. [Medline].

  6. Williams-Blangero S, Subedi J, Upadhayay RP, et al. Genetic analysis of susceptibility to infection with Ascaris lumbricoides. Am J Trop Med Hyg. 1999 Jun. 60(6):921-6. [Medline].

  7. Finsnes KD. Laryngeal spasm after general anaesthesia due to Ascaris lumbricoides. Acta Anaesthesiol Scand. 2013 Aug. 57(7):944-5. [Medline].

  8. Mwanza JC. Lacrimal drainage obstruction by Ascaris lumbricoides. Bull Soc Belge Ophtalmol. 2004. 71-3. [Medline].

  9. Karatepe O, Tukenmez M, Salmashogul A, et al. Ascaris as a leading point for small-bowel intussusception in an adult: a rare cause of intussusception. Am J Emerg Med. Mar 1 2008. 26(3):381.e3-381.e4.

  10. Jung O, Ditting T, Grone HJ, Geiger H, Hauser IA. Acute interstitial nephritis in a case of Ascaris lumbricoides infection. Nephrol Dial Transplant. 2004 Jun. 19(6):1625-8. [Medline].

  11. Selimoglu MA, Ozturk CF, Ertekin V. A rare manifestation of ascariasis: encephalopathy. J Emerg Med. 2005 Jan. 28(1):87-8. [Medline].

  12. Lamberton PH, Jourdan PM. Human Ascariasis: Diagnostics Update. Curr Trop Med Rep. 2015. 2 (4):189-200. [Medline].

  13. Pratt LT, Blachar A. Computed tomography diagnosis of intestinal ascariasis: incidental finding in a trauma patient. Isr Med Assoc J. 2007 Sep. 9 (9):688-9. [Medline].

  14. Kessler DO, Gurwitz A, Tsung JW. Point-of-care sonographic detection of intestinal ascaris lumbricoides in the pediatric emergency department. Pediatr Emerg Care. 2010 Aug. 26(8):586-7. [Medline].

  15. Ramareddy RS, Alladi A, Siddapa OS, Deepti V, Akthar T, Mamata B. Surgical complications of Ascaris lumbricoides in children. J Indian Assoc Pediatr Surg. 2012 Jul. 17 (3):116-9. [Medline].

  16. Arya PK, Kukreti R, Arya M, Gupta SN. Magnetic resonace appearance of gall bladder ascariasis. Indian J Med Sci. 2005 May. 59(5):208-10. [Medline].

  17. Sanai FM, Al-Karawi MA. Biliary ascariasis: report of a complicated case and literature review. Saudi J Gastroenterol. 2007 Jan-Mar. 13(1):25-32. [Medline].

  18. Wickramasinghe DP, Samarasekera DN. Intestinal helminths detected in capsule endoscopy. Dig Endosc. 2012 Sep. 24 (5):388. [Medline].

  19. Xiao SH, Hui-Ming W, Tanner M, Utzinger J, Chong W. Tribendimidine: a promising, safe and broad-spectrum anthelmintic agent from China. Acta Trop. 2005 Apr. 94(1):1-14. [Medline].

  20. Steinmann P, Zhou XN, Du ZW, Jiang JY, Xiao SH, Wu ZX, et al. Tribendimidine and Albendazole for Treating Soil-Transmitted Helminths, Strongyloides stercoralis and Taenia spp.: Open-Label Randomized Trial. PLoS Negl Trop Dis. 2008. 2(10):e322. [Medline]. [Full Text].

  21. Bell DR. Soil transmitted helminths. Lecture Notes on Tropical Medicine. Boston: Blackwell Science; 1985. 167-192.

  22. Cappello M, Hotez PJ. Intestinal Nematodes. Philadelphia: Churchill-Livingstone; 2003. 1331-1333.

  23. Freedman DO. Intestinal nematodes. Gorbach, ed. Infectious Diseases. Philadelphia: WB Saunders; 1992. 2003-2008.

  24. Gilles HM. Intestinal nematode infections. GT Strickland, ed. Hunter's Tropical Medicine. Philadelphia: WB Saunders; 1984. 620-644.

  25. Liu LX, Weller PF. Antiparasitic drugs. N Engl J Med. 1996 May 2. 334(18):1178-84. [Medline].

  26. Muennig P, Pallin D, Sell RL, Chan MS. The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants. N Engl J Med. 1999 Mar 11. 340(10):773-9. [Medline].

  27. Talaat KR, Nutman TB. Parasitic Diseases. Mason, ed. Murray & Nadel's Textbook of Respiratory Medicine. Philadelphia: Saunders; 2003. 1090-1092.

  28. Urbani C, Albonico M. Anthelminthic drug safety and drug administration in the control of soil-transmitted helminthiasis in community campaigns. Acta Trop. 2003 May. 86(2-3):215-21. [Medline].

  29. Agrawal R, Mittal S, Jain M, Lamba GS. Severe acute pancreatitis caused by Ascaris lumbricoides. Trop Gastroenterol. 2012 Jul-Sep. 33 (3):235-6. [Medline].

  30. Sotto Mayor J, Esperança S. IMAGES IN CLINICAL MEDICINE. Gastric Ascaris Infection. N Engl J Med. 2015 Oct 8. 373 (15):e18. [Medline].

Adult Ascaris lumbricoides.
Life cycle of Ascaris lumbricoides.
Ascaris lumbricoides egg.
Adult Ascaris lumbricoides in biliary system.
The roundworm Ascaris lumbricoides causes ascariasis. Worms can reach 10-30 cm in length. Clinical disease results from effects of pulmonary larval migration, intestinal obstruction, or migration through the biliary tree.
Ascaris lumbricoides egg in feces (formalin-ethyl acetate sedimentation method).
Endoscopic retrograde cholangiogram shows long, linear, filling defect in common bile duct. Image courtesy of
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