Pirantel

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

Pirantel 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 .

Pirantel 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. Pirantel is mainly available in formulations for dogs and cats as the embonate salt, containing a 34.7% pyrantel base .

Pirantel 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 Pirantel
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
Last Updated: September 19, 2023 at 7:00 am
Pirantel
Pirantel

Uses

Pirantel 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 .

Pirantel 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 . , .

Pirantel 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) .

Pirantel is also used to associated treatment for these conditions: Enterobiasis, Helminthic infection

How Pirantel 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 .

Pirantel 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 .

Pirantel 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. Pirantel 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.

Elimination Route

Pirantel 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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*** Taking medicines without doctor's advice can cause long-term problems.
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