Hymenolepiasis Medication

Updated: Dec 21, 2020
  • Author: Harbir Singh Arora, MD; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

The 3 drugs that are used for the treatment of hymenolepiasis are praziquantel, nitazoxanide, and niclosamide. In a comparative study done in Peru among children 2-11 years of age, a cure rate of 89% was achieved with 3 day regimen of nitazoxanide in the treatment of 39 children with hymenolepiasis as compared to cure rate of 96% in the treatment of 49 children with a single dose (25 mg/kg) of praziquantel. [15]

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Anthelmintics

Class Summary

Parasite biochemical pathways are different from the human host; thus, toxicity is directed to the parasite, egg, or larvae. The mechanism of action varies within the drug class. Antiparasitic actions may include the following:

- Inhibition of microtubules, which causes irreversible block of glucose uptake

- Tubulin polymerization inhibition

- Depolarizing neuromuscular blockade

- Cholinesterase inhibition

- Increased cell membrane permeability, resulting in intracellular calcium loss

- Vacuolization of the schistosome tegument

- Increased cell membrane permeability to chloride ions via chloride channels alteration

Praziquantel (Biltricide)

It is FDA approved in the United States for the treatment of schistosomiasis and liver flukes only and not hymenolepiasis. [16] A cure rate of 96% was obtained among 49 children aged 2-11 years with hymenolepiasis who received a single dose of praziquantel (25 mg/kg) in Peru. [14]

Nitazoxanide

Nitazoxanide is available for use in USA. It is FDA approved for use in the treatment of giardiasis in both adults and children; and cryptosporidiosis in children only. [19] It is used as off label for the treatment of hymenolepiasis in the United States. The mechanism of action of Nitazoxanide against helminthes is unknown. The efficacy with nitazoxanide was found to be 75-82 % in the treatment of hymenolepiasis in studies done in Peru. [14, 17]

Niclosamide

Niclosamide is not commercially available in the USA. It is manufactured as 500 mg tablet, is poorly absorbed and should be thoroughly chewed before swallowing for maximum efficacy. Treatment for H. nana infection requires a course of 7 days to eradicate the maturing H. nana cysts which are not affected by this drug until they are matured. [21, 20]

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