Class: Anthelmintics
VA Class: AP200
CAS Number: 22204-24-6
Brands: Ascarel, Pin-X, Reese’s Pinworm Medicine
Introduction
Anthelmintic; pyrimidine-derivative.a
Uses for Pyrantel Pamoate
Enterobiasis
Treatment of enterobiasis caused by Enterobius vermicularis (pinworm infection).102 105 106 108 109 May be used for self-medication.100 103 108 109 Drugs of choice for enterobiasis are pyrantel, mebendazole, or albendazole.102 105
Ascariasis
Has been used for treatment of ascariasis† caused by Ascaris lumbricoides.106 Drugs of choice for ascariasis are albendazole, ivermectin, or mebendazole.102 105
Intestinal Hookworm Infections
Treatment of intestinal hookworm infections caused by Ancylostoma duodenale† or Necator americanus†.102 105 Drugs of choice for intestinal hookworm infections are albendazole, mebendazole, or pyrantel.102 105
Treatment of eosinophilic enterocolitis† caused by Ancylostoma caninum (dog hookworm).102 Drugs of choice are albendazole, mebendazole, or pyrantel.102 When indicated, endoscopic worm extraction also is considered a treatment of choice for eosinophilic enterocolitis.102
Trichostrongyliasis
Treatment of trichostrongyliasis† caused by Trichostrongylus†.102 Pyrantel is the drug of choice; albendazole and mebendazole are alternatives.102
Oesophagostomiasis
May be effective for treatment of oesophagostomiasis† caused by Oesophagostomum bifurcum.102 Albendazole is an alternative.102
Moniliformis Infections
Treatment of infections caused by Moniliformis moniliformis† (thorny-headed worm).102
Pyrantel Pamoate Dosage and Administration
Administration
Oral Administration
Administer orally.108 109 May be taken without regard to meals;108 109 may be taken or mixed with milk or fruit juice.102 108 109
Shake oral suspension well before using.108
Special diet, fasting, or purgation prior to administration not necessary.a 108 109
Presence of pinworms should be confirmed visually before initiating self-medication.100 108 109
Dosage
Available as pyrantel pamoate; dosage expressed in terms of pyrantel.108 109
Pediatric Patients
Enterobiasis
Oral
11 mg/kg administered as a single dose; repeat dose after 2 weeks.102
Self-medication in children ≥2 years of age: 11 mg/kg administered as a single dose.108 109 Do not repeat treatment unless directed by a clinician.100 108 109
Treatment of all household contacts may be warranted when multiple or repeated symptomatic infections occur.102 105
Intestinal Hookworm Infections†
Ancylostoma duodenale† or Necator americanus†
Oral
11 mg/kg once daily for 3 days.102
Perform a repeat stool examination 2 weeks after treatment; repeat dosing regimen if results are positive.105
Eosinophilic Enterocolitis Caused by Ancylostoma caninum† (Dog Hookworm)
Oral
11 mg/kg once daily for 3 days.102
Trichostrongyliasis†
Oral
11 mg/kg administered as a single dose.102
Moniliformis Infections†
Oral
11 mg/kg administered as a single dose; repeat dose twice at 2-week intervals for a total of 3 doses.102
Adults
Enterobiasis
Oral
11 mg/kg administered as a single dose; repeat dose after 2 weeks.102
Self-medication: 11 mg/kg administered as a single dose.108 109 Do not repeat treatment unless directed by a clinician.100 108 109
Treatment of all household contacts may be warranted when multiple or repeated symptomatic infections occur.102 105
Intestinal Hookworm Infections†
Ancylostoma duodenale† or Necator americanus†
Oral
11 mg/kg once daily for 3 days.102
Perform a repeat stool examination 2 weeks after treatment; repeat dosing regimen if results are positive.105
Eosinophilic Enterocolitis Caused by Ancylostoma caninum† (Dog Hookworm)
Oral
11 mg/kg once daily for 3 days.102
Trichostrongyliasis†
Oral
11 mg/kg administered as a single dose.102
Moniliformis Infections†
Oral
11 mg/kg administered as a single dose; repeat dose twice at 2-week intervals for a total of 3 doses.102
Prescribing Limits
Pediatric Patients
Maximum single dose 1 g.102
Adults
Maximum single dose 1 g.102
Special Populations
No special population dosage recommendations at this time.a
Cautions for Pyrantel Pamoate
Contraindications
Known hypersensitivity to pyrantel or any ingredient in the formulation.a
Warnings/Precautions
General Precautions
Patients with Severe Malnutrition or Anemia
Use caution in patients with severe malnutrition or anemia.a Ideally, anemic, dehydrated, or malnourished patients should receive supportive therapy prior to administration of pyrantel.a
Specific Populations
Pregnancy
Category C.107
Use during pregnancy only if benefits justify risks to the fetus and only when no alternative management is appropriate. a
Pregnant women considering self-medication for treatment of enterobiasis should do so only under the direction of a clinician.100 108 109
Pediatric Use
Safety and efficacy not established in children <2 years of age;a use in this age group only when potential benefits justify possible risks.a
Hepatic Impairment
Use with caution in patients with preexisting liver dysfunction.100
Individuals with liver disease considering self-medication for treatment of enterobiasis should do so only under direction of a clinician.108 109
Common Adverse Effects
GI disturbances (nausea,108 109 vomiting,108 109 tenesmus,a anorexia,a diarrhea,108 109 abdominal cramps,108 109 gastralgia), headache,108 109 dizziness. 108 109
Interactions for Pyrantel Pamoate
Specific Drugs
Drug | Interaction | Comments |
|---|---|---|
Piperazine (no longer commercially available in the US) | Decreased efficacy of pyrantel and piperazinea | Do not administer concomitantlya |
Pyrantel Pamoate Pharmacokinetics
Absorption
Bioavailability
Poorly absorbed from GI tract.a Peak serum concentrations occur 1–3 hours after a dose.a
Elimination
Metabolism
Partially metabolized in the liver.a
Elimination Route
Approximately 50% of an oral dose is excreted unchanged in feces; 7% excreted in urine as unchanged drug and metabolites.a
Stability
Storage
Oral
Suspension
<30°C, tight, light-resistant container.a
Actions and SpectrumActions
Pyrimidine-derivative anthelmintic agent.a
Depolarizing neuromuscular blocking agent.a Paralyzes worms which are then expelled from the GI tract by peristalsis.a
Active against Enterobius vermicularis (pinworm), Ascaris lumbricoides (roundworm), Ancylostoma duodenale (hookworm), Necator americanus (hookworm), and Trichostrongylus orientalis (hairworm).a
Advice to Patients
For self-medication of enterobiasis (pinworm infection), importance of providing patient a copy of manufacturer’s patient information.100
When using to treat enterobiasis, importance of treating all household members and importance of taking hygienic precautions to minimize reinfection, including wearing tight underpants both day and night, cleaning the bedroom floor by vacuuming or damp mopping for several days after treatment, washing and not shaking bed linens and night clothes after treatment, and keeping toilet seats clean.108 109 a
Importance of informing clinician if symptoms of enterobiasis persist after treatment.100 Importance of informing clinician if worms other than pinworms are present before or after therapy.100 108 109
Importance of informing clinician if abdominal disturbances (nausea, vomiting, diarrhea), headache, or dizziness persist or become bothersome after use of the drug.100 108 109
Importance of informing clinician of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses (e.g., anemia, hepatic disease).a
Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed.a
Importance of informing patients of other important precautionary information. (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
|---|---|---|---|---|
Oral | Powder* | |||
Suspension | 250 mg (of pyrantel) per 5 mL* | Ascarel | Pfeiffer | |
Pin-X | Effcon | |||
Pyrantel Pamoate Suspension | ||||
Reese’s Pinworm Medicine | Reese | |||
Tablets | 62.5 mg (of pyrantel) | Reese’s Pinworm Caplets | Reese |
Disclaimer
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions August 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
† Use is not currently included in the labeling approved by the US Food and Drug Administration.
References
100. Food and Drug Administration. Anthelmintic drug products for over-the-counter human use; final monograph. Fed Regist. 1986; 51:27756-60.
101. Food and Drug Administration. Anthelmintic drug products for over-the-counter human use; establishment of a monograph. Fed Regist. 1980; 45:59540-8.
102. Anon. Drugs for parasitic infections. From the Medical Letter website (). 2008 Aug.
103. Food and Drug Administration. Over-the-counter drug products; final monographs for antiemetic, antitussive, bronchodilator, and antihelmintic drug products; updating and technical changes; final rule. Fed Regist. 1988; 53:35808-10.
105. American Academy of Pediatrics. 2006 Red Book: Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2006.
106. Liu LX. Strongyloidiasis and other intestinal nematode infections. Infect Dis Clin North Am. 1993; 7:655-82. [PubMed 8254165]
107. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 8th ed. Baltimore, MD: Williams & Wilkins; 2008:1559.
108. Reese. Reese’s pinworm medicine (pyrantel pamoate) prescribing information. Cleveland, OH.
109. Reese. Reese’s pinworm caplets (pyrantel pamoate) prescribing information. Cleveland, OH.
a. AHFS drug information 2009. McEvoy GK, ed. Pyrantel. Bethesda, MD: American Society of Health-System Pharmacists; 2009:62-3.
More Pyrantel Pamoate resources
- Pyrantel Pamoate Side Effects (in more detail)
- Pyrantel Pamoate Dosage
- Pyrantel Pamoate Use in Pregnancy & Breastfeeding
- Pyrantel Pamoate Drug Interactions
- Pyrantel Pamoate Support Group
- 0 Reviews for Pyrantel Pamoate - Add your own review/rating
- Antiminth Concise Consumer Information (Cerner Multum)
- Ascarel Advanced Consumer (Micromedex) - Includes Dosage Information
- Pin-X Chewable Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
Compare Pyrantel Pamoate with other medications
- Ascariasis
- Enterobiasis
- Hookworm Infection, Necator or Ancylostoma
- Moniliformis Infection
- Pinworm Infection, Enterobius vermicularis
- Trichostrongylosis
No comments:
Post a Comment