Trematode Infection Medication

Updated: Nov 23, 2015
  • Author: Subhash Chandra Parija, MD, MBBS, PhD, DSc, FRCPath; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Medication Summary

Chemotherapy objectives in trematode infections are to cure the disease, to reduce morbidity, and to prevent transmission of parasitic infection in endemic areas.

Bithionol (Lorothidol, Bitin) is the drug of choice for Fasciola infections; however, it is an investigational drug with distribution limited to physicians with patients who are unable to take praziquantel. Doses of 30-50 mg/kg/d PO for 5-15 days have been used to treat Fasciola infections. Repeat doses may be administered to some patients. Pediatric patients have been administered the same weight-based dosing used in adults. Adverse effects include nausea, vomiting, diarrhea, and abdominal pain.



Class Summary

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

Praziquantel (Biltricide)

Praziquantel is drug of choice in most trematode infections. It is safe and effective (less effective against Fasciola infections; reserved for situations in which bithionol is not available).

Praziquantel increases cell membrane permeability in susceptible worms, resulting in loss of intracellular calcium, massive contractions, and paralysis of musculature. In addition, it produces vacuolization and disintegration of the schistosome tegument. This is followed by attachment of phagocytes to the parasite and death.

The tablet should be swallowed whole with some liquid during meals. Keeping the tablet in the mouth may reveal bitter taste, which can produce nausea or vomiting.