CW 48
CW 48 Uses, Dosage, Side Effects, Food Interaction and all others data.
CW 48 is a pyrimidine-derivative anthelmintic agent for the oral treatment of various parasitic worm infections including ascariasis, hookworm infections, enterobiasis (pinworm infection), trichostrongyliasis, and trichinellosis .
CW 48 was initially described in 1965 by researchers from Pfizer who sought cyclic amidines with suitable pharmacokinetic properties (specifically, duration of action) for use as an anthelmintic drug. CW 48 is mainly available in formulations for dogs and cats as the embonate salt, containing a 34.7% pyrantel base .
CW 48 is on the World Health Organization's List of Essential Medicines, which are the safest and most effective medicines required in a functioning health system , .
Trade Name | CW 48 |
Availability | Rx and/or OTC |
Generic | Pyrantel |
Pyrantel Other Names | Pirantel, Pyrantel, Pyrantelum |
Related Drugs | albendazole, mebendazole, nitazoxanide, piperazine, Albenza, Alinia, Emverm, Ascarel, Pinworm Medicine |
Type | |
Formula | C11H14N2S |
Weight | Average: 206.31 Monoisotopic: 206.087769633 |
Groups | Approved, Vet approved |
Therapeutic Class | |
Manufacturer | |
Available Country | USA |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
CW 48 is an anthelmintic used to treat helminth infections.
For the treatment of enterobiasis including roundworm (ascariasis), pinworm (enterobius) and hookworm (strongyloides) and hookworm (ancylostoma) in the pyrantel pamoate form .
CW 48 is available in various formulations for humans, dogs, and cats as the pamoate (US Pharmacopeia nomenclature) or embonate (European Pharmacopoeia nomenclature) salt, which contains 34.7% pyrantel base combined with pamoic acid . , .
CW 48 pamoate (embonate) ingested orally is effective for removal and control of ascarid and hookworm infections in puppies and dogs (adult Toxocara canis, Toxascaris leonina, Ancylostoma tubaeforme, An. braziliense, Uncinaria stenocephala), cats (adult Toxocara cati, Toxa. leonina, An. caninum, An. braziliense, U. stenocephala), horses and ponies (adult and immature Parascaris equorum, adult Strongylus vulgaris, S. edentatus, S. equinus, Cyathostomes (Triodontophorus spp., Cyathostomum spp., Cylicodontophorus spp., Cylicocyclus spp., Cylicostephanus spp., Poteriostomum spp.), Oxyuris equi, Anoplocephala perfoliata), swine (adult Ascaris suum, Oesophagostomum dentatum), and humans (adult A. lumbricoides, Enterobius vermicularis, An. duodenale, Necator americanus) .
CW 48 is also used to associated treatment for these conditions: Enterobiasis, Helminthic infection
How CW 48 works
By promoting the release of acetylcholine, inhibiting cholinesterase, and stimulating ganglionic neurons, pyrantel serves as a depolarizing neuromuscular blocking agent in helminths. This causes extensive depolarization of the helminth muscle membrane, resulting in tension to the helminth's muscles, leading to paralysis and release of their attachment to the host organism intestinal walls .
This action is unlike piperazine, which is a hyperpolarizing neuromuscular blocking agent that causes relaxation of the helminth muscles, leading to a subsequent detachment from the intestinal wall. Excretion of the parasites in the feces occurs by normal peristalsis .
Toxicity
Mild adverse effects include nausea, vomiting, diarrhea, headache, and dizziness .
LD50 in rats is 535 mg/kg .
Reported effects in humans in case of overdose include gastrointestinal disturbance, central nervous system effects, and superficial skin reactions. In one study, serum aspartate aminotransferase (AST) and serum alanine-aminotransferase (ALT) values were increased in approximately 2% of patients .
CW 48 should be used with caution in patients with severe malnutrition or anemia. Supportive therapy is recommended for anemic, dehydrated, or malnourished patients before administration of the drug .
CW 48 pamoate has been placed in pregnancy category C. This refers to the fact that animal studies have revealed adverse effects on the fetus (teratogenic/embryocidal, or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the fetus .Data on the use of pyrantel pamoate in pregnant women are quite limited. In mass treatment programs for which the World Health Organization (WHO) has observed that the benefits of treatment outweigh the risks, WHO allows the use of pyrantel pamoate in the 2nd and 3rd trimesters of pregnancy, due to the fact that the effects of pyrantel on birth outcome are uncertain. The risk of treatment in pregnant women already known to have an infection needs to be balanced with the risk of disease progression if treatment were to be omitted . Individuals with liver disease are more susceptible to the toxicity in cases of pyrantel overexposure , .
There are no data regarding the presence of pyrantel in breast milk. CW 48 is poorly absorbed from the GI tract; therefore, excretion into breast milk may be minimal. Some experts recommend that a single dose of pyrantel therapy may be given to breastfeeding women .
Food Interaction
No interactions found.CW 48 Disease Interaction
Elimination Route
CW 48 is poorly absorbed from the GI tract of humans , .
Peak serum concentrations occur 1–3 hours after a single dose .
Half Life
In pigs, following intravenous administration, pyrantel exhibited a half-life of 1.75 +/- 0.19 h .
Elimination Route
Approximately 50% of an oral dose is excreted unchanged in feces; 7% excreted in urine as unchanged drug and metabolites .
Innovators Monograph
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