Pediatric Toxocariasis Medication

Updated: Dec 21, 2020
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Medication Summary

Anthelmintic agents are used primarily for severe complications of VLM, such as cerebral, cardiac, and pulmonary involvement.


Anthelmintic agents

Class Summary

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

- Inhibition of microtubules 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

Diethylcarbamazine (Hetrazan)

The DOC in most textbooks, but the FDA does not list toxocariasis as an indication. It is obtained only through the manufacturer.

Thiabendazole (Mintezol)

Broad-spectrum anthelmintic drug; mechanism of action is unclear, but may inhibit the helminth-specific enzyme fumarate reductase.

Albendazole (Albenza)

Has poor PO bioavailability; absorption is enhanced by fatty meals; systemic anthelmintic effect is attributed to its sulfoxide metabolite; albendazole may induce its own metabolism.

Mebendazole (Vermox)

Synthetic broad-spectrum anthelmintic. Likely the drug for which the most experience exists and the safest drug in its class. Inhibits microtubule formation and causes glucose depletion in the worms.