Tungiasis Medication

Updated: May 01, 2018
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: John L Brusch, MD, FACP  more...
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Medication Summary

See Table 1, below.

Table 1. Medication Summary (Open Table in a new window)

Medication Name





Dimethicone  [53]

Apply directly to the affected area once or twice daily.

No known contraindications. Shown to be safe for extended use.

Available under the brand name NYDA®.


Topical Antibiotic Lotions  [55, 52]

0.8% ivermectin, 0.2% metrifonate and 5% thiabendazole lotions, applied two consecutive days.

No contraindications reported.

Readily available.


Zanzarin  [54, 12]

Apply to all infected areas and areas at risk for tungiasis infection twice daily.

No known contraindications.

No longer commercially available, but made of ingredients that could be locally manufactured in areas where tungiasis is common.


Oral Niridazole  [60]

Single or double dose of niridazole (Ambilhar) at 30 mg kg−1 body weight. If necessary, second dose should be given one week after the first.

Abdominal pain, nausea, and vomiting may occur. Has some neurotoxicity and has been known to cause hallucinations, so is not safe for long-term use.

This is not available in the United States.

Use of systemic therapy for primary treatment has not been advocated for US travelers, particularly if infestation involves only a small number of lesions.



Class Summary

The biochemical pathways of the parasitic flea are sufficiently different from those of its human host to allow selective interference in the flea’s pathways by relatively small doses of chemotherapeutic agents. A combination of direct toxic action on the flea and anti-inflammatory action on the surrounding tissue is postulated. [60]

Niridazole (Ambilhar)

This agent is not available in United States. Niridazole has been reported to be completely effective in lysing imbedded fleas in infected children. The response was quicker when a second dose was given 1 week after the first dose.