Intestinal Flukes Medication

Updated: Feb 21, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity, to prevent complications, and to eradicate the infection.

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Anthelmintics

Class Summary

The biochemical pathways in parasites are different enough from those of the human host to allow selective interference with chemotherapeutic agents in relatively small doses.

Praziquantel (Biltricide)

DOC in most infections and active against all schistosomal species. Increases cell membrane permeability in susceptible worms, resulting in loss of intracellular calcium, massive contractions, and paralysis of their musculature. In addition, produces vacuolization and disintegration of schistosome tegument. This is followed by attachment of phagocytes to the parasites and death. Patients should swallow tabs whole with liquid during meals. Keeping tabs in the mouth may result in a bitter taste, which can produce nausea or vomiting.

Albendazole (Albenza)

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

Triclabendazole (Egaten)

Triclabendazole is an anthelmintic agent. The mechanism by which triclabendazole exhibits its effect against Fasciola species is not fully elucidated. Studies in vitro and/or in infected animals suggest that triclabendazole and its active metabolites (sulfoxide and sulfone) are absorbed by the tegument of the immature and mature worms, leading to a decrease of the resting membrane potential and inhibition of tubulin function, as well as protein and enzyme synthesis. It is indicated for the treatment of fascioliasis in patients aged 6 years or older.

Nitazoxanide (Alinia)

Limited data suggest nitazoxanide might be effective therapy in some patients with fascioliasis. Interferes with pyruvate:ferredoxin oxidoreductase (PFOR), essential to anaerobic energy metabolism.

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