Elseal M

Elseal M Uses, Dosage, Side Effects, Food Interaction and all others data.

Levamisole is the active laevo-isomer of tetramisole. It works by paralysing susceptible intestinal worms which are then excreted from the intestines. Levamisole also enhances cellular immune responses in humans.

Levamisole is a synthetic imidazothiazole derivative that has been widely used in treatment of worm infestations in both humans and animals. As an anthelmintic, it probably works by targeting the nematode nicotinergic acetylcholine receptor. As an immunomodulator, it appears that Levamisole is an immunostimulant which has been shown to increase NK cells and activated T-cells in patients receiving this adjuvantly along with 5FU for Stage III colon cancer.

Mebendazole is a synthetic derivative of benzimidazole with a potent anthelmintic activity against the most common nematodes and some cestodes. It is highly effective against ascariasis, enterobiasis, trichuriasis and hookworm infections. It is equally effective in single or in mixed infections. The effect of the drug is due to its ability to inhibit glucose uptake irreversibly but it does not affect blood glucose concentration in the host, even in high doses. Mebendazole does not necessitate any dosage calculation since the same dosage is used for children and adults. It can be taken at any time and no special procedures such as purging, use of laxatives and/or dietary changes are required. Parasite immobilization and death occur slowly and clearance from the gastro-intestinal tract may not be completed up to 3 days after administration.

Mebendazole is a (synthetic) broad-spectrum anthelmintic. The principal mode of action for Mebendazole is by its inhibitory effect on tubulin polymerization which results in the loss of cytoplasmic microtubules.

Elseal M
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Elseal M
Generic	Mebendazole + Levamisole
Type	Tablet
Therapeutic Class
Manufacturer	Organic Laboratories
Available Country	India
Last Updated:	September 19, 2023 at 7:00 am

Uses

Levamisole is a fast acting drug which acts on nematode nerve ganglia paralysing the worm’s musculature within seconds of contact. Unable to maintain their position, the worms are then ejected by normal peristaltic movement, usually within 24 hours of levamisole administration. Although it is certain that levamisole primarily influences the neuromuscular system of nematodes, it is possible that in some helminthes the inhibition of the fumarate reductase system contributes to the anthelmintic efficacy of levamisole. Levamisole is used for the treatment of infections by the following gastrointestinal wormspecies:

Ascaris lumbricoides: Roundworm
Necator americanus: Hookworm
Ancylostoma duodenal: Hookworm
E nterobius vermicularis: Pinworm
Trichuris trichuria: Whipworm
Strongyloides stercoralis: Threadworm
Trichostrongylus colubriformis

Mebendazole is used for the treatment of pinworm (Enterobius vermicularis), round worm (Ascaris lumbricoides), hookworm (Ancylostoma duodenale and Necator americanus), whip worm (Trichuris trichiura), tape worm (Taenia solium and taenia saginata) and threadworm (Strongyloides stercoralis) in single or mixed infections

Elseal M is also used to associated treatment for these conditions: Adenocarcinoma of Colon, Ancylostoma duodenale infection, Ascaris lumbricoides infection, Carcinoma, Colorectal, Enterobius vermicularis infection, Necatoriasis due to necator americanus, Strongyloides Stercoralis Infection, Trichuris InfectionAncylostoma caninum infection, Ancylostoma duodenale infection, Ascaris lumbricoides infection, Capillariasis, Enterobius vermicularis infection, Filariasis, Giardiasis, Necatoriasis due to necator americanus, Strongyloides Stercoralis Infection, Taenia solium infection, Toxocariasis, Whipworm infection

How Elseal M works

The mechanism of action of levamisole as an antiparasitic agent appears to be tied to its agnositic activity towards the L-subtype nicotinic acetylcholine receptors in nematode muscles. This agonistic action reduces the capacity of the males to control their reproductive muscles and limits their ability to copulate. The mechanism of action of Levamisole as an anticancer drug in combination with fluorouracil is unknown. The effects of levamisole on the immune system are complex. The drug appears to restore depressed immune function rather than to stimulate response to above-normal levels. Levamisole can stimulate formation of antibodies to various antigens, enhance T-cell responses by stimulating T-cell activation and proliferation, potentiate monocyte and macrophage functions including phagocytosis and chemotaxis, and increase neutrophil mobility, adherence, and chemotaxis.

Mebendazole causes degenerative alterations in the tegument and intestinal cells of the worm by binding to the colchicine-sensitive site of tubulin, thus inhibiting its polymerization or assembly into microtubules. The loss of the cytoplasmic microtubules leads to impaired uptake of glucose by the larval and adult stages of the susceptible parasites, and depletes their glycogen stores. Degenerative changes in the endoplasmic reticulum, the mitochondria of the germinal layer, and the subsequent release of lysosomes result in decreased production of adenosine triphosphate (ATP), which is the energy required for the survival of the helminth. Due to diminished energy production, the parasite is immobilized and eventually dies.

Dosage

Elseal M dosage

The following doses of Levamisole are given as a single administration, preferably after a light meal.

Age 1-4 year: 1 Tablets or5 mlSyrup
Age 5-15 year: 2 Tablets or10 mlSyrup
Age 16year and over: 3 Tablets or 15 mlSyrup

In cases of severe hookworm infection it is suggested that a second standard dose be given one or seven days after the first, whichever timing is feasible.

Mebendazole 100 mg tablet and suspension: This have the same dosage schedule applies to adults & children.

Enterobiasis: A single tablet or 1 teaspoonful of the suspension.

Ascariasis, Ancylostomiasis, Trichuriasis: 2 tablets, one in the morning, the other in the afternoon for 3 consecutive days or 1 teaspoonful in the morning & 1 teaspoonful in the afternoon for 3 consecutive days

Taeniasis & strongyloidiasis:

Adults: 2 tablets twice daily for 3 consecutive days.
Children: 1 tablet twice daily or 1 teaspoonful twice daily for 3 consecutive days.

Mebendazole 500 mg tablet: One Mebendazole 500 mg tablet in a single intake regardless of body weight, for all nematode and some cestode infestations. The same dosage applies to adults and children age two years and above.

May be taken with or without food.

Side Effects

Side-effects are infrequent. They are usually mild and transient and include nausea, vomiting, abdominal pain, giddiness(dizziness) and headache. An encephalopathylike syndrome has been reported to have occurred in a few patients two or three weeks after treatment.

Mebendazole is well tolerated by adults and children. It has virtually no side effects. Transient abdominal pain and diarrhoea have been reported only rarely, in case of massive infestation and expulsion of worms.

Toxicity

LD₅₀ = 40 mg/kg (Pigs, subcutaneous); LD₅₀ = 180 mg/kg (rat, oral)

Acute oral toxicity (LD₅₀): 620 mg/kg [Mouse]. Symptoms of overdose include elevated liver enzymes, headaches, hair loss, low levels of white blood cells (neutropenia), fever, and itching.

Precaution

Effect on ability to drive or operate machinery: There is no evidence to suggest that Levamisole , used for anthelmintic purpose, will produce sedation. Mild and transient giddiness is an infrequent side-effect of treatment. No precautions are suggested concerning the ability to drive or operate machinery.

In case of concurrent microfilaraemia transient fever may occur.

Hepatic impairment. Children. Pregnancy and lactation.

Interaction

May increase toxicity of phenytoin. Increases bioavailability of ivermectin; decreases bioavailability of albendazole. Alcohol causes disulfiram-like reaction.

Concomitant treatment with cimetidine may inhibit the metabolism of mebendazole in the liver, resulting in increased plasma concentrations of the drug especially during prolonged treatment.

Elimination Route

Levamisole is rapidly absorbed (2 hours) from the gastrointestinal tract.

Poorly absorbed (approximately 5 to 10%) from gastrointestinal tract. Fatty food increases absorption.

Half Life

4.4-5.6 hours (biphasic)

2.5 to 5.5 hours (range 2.5 to 9 hours) in patients with normal hepatic function. Approximately 35 hours in patients with impaired hepatic function (cholestasis).

Elimination Route

In man, approximately 2% of administered mebendazole is excreted in urine and the remainder in the feces as unchanged drug or a primary metabolite.

Pregnancy & Breastfeeding use

Although studies in animals have shown that Levamisole produces no teratogenic effects, current medical practice requires that the benefits of any drug used during pregnancy should be weighed against the possible dangers.

Mebendazole should not be administered during pregnancy and in women thought to be pregnant. It is not known whether mebendazole or its metabolites are secreted in human breast milk. Thus Mebendazole should not be used during lactation unless the potential benefits are considered to outweigh the potential risk associated with treatment.

Contraindication

There is no absolute contra-indication to the use of Levamisole

Mebendazole is contraindicated in pregnancy and in patients who have shown hypersensitivity to the product or any of its components.

Acute Overdose

Counter possible anticholinesterase activity with e.g. atropine. Control blood pressure and respiration . Do not use sedatives.

Symptoms: Alopecia, reversible liver function disturbances, hepatitis, agranulocytosis, neutropenia, glomerulonephritis, abdominal cramps, nausea, vomiting and diarrhoea.

Management: Within the 1st hr after ingestion, gastric lavage may be performed. Activated charcoal may be given if considered appropriate.