praziquantel
Praziquantel (Biltricide) is the first-choice medication used to treat parasitic infections caused by flukes (worms) typically found in unclean drinking water or raw fish. This medication is a tablet that's taken by mouth, and treatment typically lasts only 1 day. Praziquantel (Biltricide) for humans is available only by prescription and is safe to use. Some common side effects include feeling tired, headache, dizziness, or belly discomfort.
What is Praziquantel (Biltricide)?
What is Praziquantel (Biltricide) used for?
- Treatment of blood fluke infections (schistosomiasis)
- Treatment of liver fluke infections (clonorchiasis or opisthorchiasis)
How Praziquantel (Biltricide) works
Praziquantel (Biltricide) is an antiparasitic medication. It treats infections caused by flukes that infect human blood, liver, or bile duct. The exact way that praziquantel (Biltricide) works isn't known at this time. But it’s thought to kill the flukes by causing severe spasms in their muscles and paralyzing them.
Drug facts
Side effects of Praziquantel (Biltricide)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Feeling tired
- Headache
- Dizziness
- Stomach discomfort
- Nausea
- Itchiness
- Drowsiness
- Fever
Less Common Side Effects
- Difficulty keeping your balance
- Ringing in one or both of your ears
- Changes in vision
- Bloody diarrhea
- Vomiting
- Loss of appetite
- Muscle pain or weakness
- Tremor
- Shortness of breath or wheezing
- Itching
Praziquantel (Biltricide) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Stevens-Johnson syndrome: skin pain, rash, large blisters, fever, sore throat, fatigue, facial swelling, swollen lips
- Irregular heart rhythm problems: heart flutter, slow or fast heartbeat, lightheadedness, dizziness, shortness of breath
- Seizures
- Brain or nervous system problems: severe headaches, confusion, lack of attention to people and surroundings, fainting
The following Praziquantel (Biltricide) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Black, tarry stools
blistering, peeling, or loosening of the skin
bloody diarrhea
blurred or loss of vision
chest pain or discomfort
chills
dark urine
difficulty swallowing
difficulty with moving
disturbed color perception
dizziness
double vision
fainting
fast, slow, or irregular heartbeat
general feeling of discomfort or illness
general tiredness and weakness
halos around lights
joint pain, stiffness, or swelling
light-colored stools
lightheadedness, dizziness, or fainting
muscle pains, cramps, or stiffness
night blindness
overbright appearance of lights
painful or difficult urination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
severe abdominal or stomach pain
seizures
sleepiness or unusual drowsiness
sores, ulcers, or white spots on the lips or in the mouth
stomach discomfort with or without nausea
stomach pain
sweating
swelling of the eyelids, face, lips, hands, or feet
swollen glands
thickening of bronchial secretions
tightness in the chest
troubled breathing
tunnel vision
unusual bleeding or bruising
unusual tiredness or weakness
upper right abdominal pain
vomiting
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Change in walking and balance
clumsiness or unsteadiness
continuing ringing or buzzing or other unexplained noise in the ears
dizziness or lightheadedness
feeling of constant movement of self or surroundings
headache
hearing loss
lack or loss of strength
loss of appetite
sensation of spinning
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Praziquantel (Biltricide)
Pros
- Works well to treat most types of blood flukes in humans
- The only FDA-approved medication for treating liver flukes in humans
- Tablets can be crushed and mixed with food or liquid, so it's a good option for people who can't swallow tablets
- Available as a lower-cost generic medication
Cons
- Tablets taste bitter and can cause you to gag or vomit
- Risk of more side effects for people with liver problems
- Interacts with grapefruit juice and some common medications, such as diltiazem (Cardizem), verapamil, and carbamazepine (Tegretol)
Pharmacist tips for Praziquantel (Biltricide)
- Take praziquantel (Biltricide) with meals. Use water to help you swallow the tablet quickly. Avoid chewing the tablet because it tastes bitter and can cause you to gag or vomit.
- If you have trouble swallowing, you can crush the praziquantel (Biltricide) tablet and mix it with semi-solid food, such as applesauce, oatmeal, or various pureed vegetables. This can also be helpful for young children to make sure they don't choke on the tablet. Make sure to take the entire mixture within 1 hour of mixing.
- The praziquantel (Biltricide) tablet has score lines that make it easier for you to split the medication based on your provider's directions. You can break off the parts evenly by pressing down on the score from the outer end of the tablet. If you're not sure how to get the dose you need, please ask your local pharmacist for assistance.
- Praziquantel (Biltricide) can put you at higher risk for seizures. If you have a history of seizures, be very careful and watch out for symptoms, such as seizures, severe headaches, confusion, unable to focus, or difficulty with balance. If possible, make sure you’re near a clinic or hospital on the day of or for a few days after treatment with praziquantel (Biltricide) so that you can get medical help if needed.
- Praziquantel (Biltricide) can put you at higher risk of heart rhythm problems. If you experience symptoms of heart flutter, slow or fast heartbeat, dizziness, or shortness of breath while taking praziquantel (Biltricide), please let your provider know so they can check your heart for problems.
- Don't drive a car or operate machinery on the day of or the day following treatment with praziquantel (Biltricide). This medication can make you sleepy or dizzy.
- Don't take praziquantel (Biltricide) with rifampin (Rifadin), an antibiotic that's used for tuberculosis and other infections. Rifampin (Rifadin) can make praziquantel (Biltricide) work less well and put you at risk for serious infection from liver or blood flukes. If you need to take rifampin (Rifadin), your provider will give you instructions on when to stop rifampin (Rifadin) before praziquantel (Biltricide) treatment and when to restart it after finishing praziquantel (Biltricide) treatment. If you can't stop rifampin (Rifadin), ask your provider about other medications to treat your blood or liver fluke infection.
- Praziquantel (Biltricide) might not prevent all infections from getting worse, especially if it's your first time getting a blood fluke infection (acute phase schistosomiasis). Please let your provider know if you develop symptoms, such as rash, fever, headache, muscle or stomach pain, trouble breathing, diarrhea, or bloody stool. These might be signs that your infection is getting worse.
Common questions about Praziquantel (Biltricide)
Typically, taking one treatment of praziquantel (Biltricide) is enough to kill most or all the blood flukes or liver flukes in your body. One study found that most blood fluke infections were gone 2 to 8 weeks after one treatment of medication using the World Health Organization's recommended dosing. The CDC recommends that some people might need a second treatment with praziquantel (Biltricide) 2 to 4 weeks after their first treatment to make sure the infection is completely gone. Follow up with your provider after your first treatment to see if you need to take praziquantel (Biltricide) again.
No, praziquantel (Biltricide) isn't an antibiotic. It's an antiparasitic medication. It only works against infections caused by certain parasites or worms. Don't use praziquantel (Biltricide) to treat a bacterial infection even if you already have it at home. Praziquantel (Biltricide) won't help with your infection since it doesn't fight bacteria.
Praziquantel (Biltricide) might be safe to take during pregnancy, but please ask your provider first to see whether it's a good option for you. So far, studies show that babies born to mothers who took praziquantel (Biltricide) while pregnant didn’t experience any more harm than those born to mothers who didn't take the medication. But praziquantel (Biltricide) might not be appropriate for all pregnant mothers. If you're pregnant and worried that you have an infection from blood or liver flukes, please talk with your provider about the benefits and risks of taking praziquantel (Biltricide).
Praziquantel (Biltricide) might be safe to take if you're breastfeeding, but you should talk with your provider first to see if doing so is a good option for you. Studies show that a small amount of praziquantel (Biltricide) is found in breast milk, but there haven't been any recorded reports of the medication causing harm in breastfed babies. If you're breastfeeding, please talk with your provider about the benefits and risks of taking praziquantel (Biltricide).
There are slight differences between the CDC and the manufacturer's recommendations for praziquantel (Biltricide). One difference is the dose of medication. Compared to the manufacturer's guidance, the CDC recommends a lower dose for certain types of blood flukes and a higher dose and longer treatment for certain types of liver flukes. The exact reason for the differences isn't clear. But it's possible that parasites in certain parts of the world might need different doses to be properly treated. Another difference is the age-cut offs for use in children. The manufacturer states that children as young as 1 year old can take praziquantel (Biltricide), but the CDC says more research is needed to treat children who are younger than 4 years old. The reason for this difference also isn't clear. But it's probably because there haven't been reports of harm in children younger than 4 years old who've taken this medication. If you have any questions about the right dose of praziquantel (Biltricide) for you or your child, please talk with your provider.
Currently, praziquantel (Biltricide) is only FDA approved to kill infections caused by types of worms called blood flukes and liver flukes. But providers sometimes also prescribe praziquantel (Biltricide) for treating tapeworm infections. This is considered an off-label (not FDA-approved) use of praziquantel (Biltricide). More research is needed to understand using this medication for tapeworm infections. If you're worried that you have a tapeworm infection, please call your provider to see what your treatment options are.
No, you must get a prescription for praziquantel (Biltricide) from your provider to treat your blood or liver fluke infection. There are over-the-counter products that contain praziquantel, but they're for pets and aren't safe for humans. Taking pet praziquantel can cause you serious and possibly life-threatening harm. If you're worried that you have an infection from blood or liver flukes, please call your provider for treatment options.
Yes, praziquantel (Biltricide) is safe for humans. It's FDA approved to treat blood or liver fluke infections in humans. This means that the medication works well and is safe to use for this purpose. Don't confuse praziquantel (Biltricide) with over-the-counter products that contain praziquantel. These over-the-counter products are for pets, are sold in pet stores, and can be harmful if you take them.
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Risks and warnings for Praziquantel (Biltricide)
Praziquantel (Biltricide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suddenly feeling very sick
- Risk factors: New blood fluke infection
Very rarely, your body can react to praziquantel (Biltricide) in a way that causes you to suddenly feel extremely sick. If not treated, it can be life-threatening. You’re at higher risk for this type of harmful reaction if you’re taking praziquantel (Biltricide) to treat your very first blood fluke infection (acute phase schistosomiasis). Contact your provider right away if you experience worsening rash, fever, headache, muscle pain, stomach upset, and trouble breathing.
Brain and nervous system problems
- Risk factors: History of seizures | Fluke infections
Parasites (such as blood flukes, liver flukes, or tapeworms) can sometimes cause problems to your brain or nervous system. These problems can lead to seizures, confusion, or headaches. If you have these symptoms, taking praziquantel (Biltricide) can make them feel worse. Please ask your provider if praziquantel (Biltricide) is the best option for you if you have a history of seizures or you have these symptoms.
More side effects in people with liver problems
- Risk factors: Blood fluke infection | Moderate or severe liver problems
Praziquantel (Biltricide) might cause more side effects if you have a history of liver problems. This is because the medication is broken down by your liver. When your liver has problems, praziquantel (Biltricide) stays in your body longer. Please call your provider right away if you experience any side effects that bother you or don’t go away, such as feeling tired or weak, dizziness, headache, or belly discomfort.
Heart rhythm problems
Praziquantel (Biltricide) can cause heart rhythm problems, such as slow or fast heartbeat. Please let your provider know if you have a history of irregular heartbeat or if you have symptoms of lightheadedness or dizziness during treatment with praziquantel (Biltricide). Your provider might want to check your heart rhythm.
Interactions with other medications
Certain medications can get in the way of how your body gets rid of praziquantel (Biltricide). It affects the amount of praziquantel in your body, how well the medication works, and the risk of side effects. In particular, praziquantel (Biltricide) shouldn't be taken with rifampin (Rifadin), an antibiotic that's commonly used to prevent and treat tuberculosis and other infections. Rifampin (Rifadin) can cause praziquantel (Biltricide) to work less well. Your provider should ask you to stop rifampin (Rifadin) 4 weeks before starting praziquantel (Biltricide). You'll be able to restart rifampin (Rifadin) a day after finishing treatment with praziquantel (Biltricide). If it isn't possible for you to stop your rifampin (Rifadin) therapy, you'll need to take a different medication to treat your worm infection. Before starting treatment with praziquantel (Biltricide), please let your provider know about all the medications you take so they can make sure they're safe for you.
Praziquantel (Biltricide) dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6 tablets of 600mg | 1 dose pack | $132.74 | $132.74 |
Typical dosage for Praziquantel (Biltricide)
Dosing for praziquantel (Biltricide) is based on body weight. Your healthcare provider will determine the appropriate dose for you. All following dosages are for adults and children aged 1 year and older.
-
Blood fluke infections: The typical dose is 20 mg/kg of weight by mouth three times a day (4 to 6 hours apart) for 1 day only.
-
Liver fluke infections: The typical dose is 25 mg/kg of weight by mouth three times a day (4 to 6 hours apart) for 1 day only.
Please note: The CDC's current dosing recommendations for praziquantel (Biltricide) are different for blood flukes and certain types of liver flukes compared with the manufacturer's guidelines. Please read the FAQ section for details.
Interactions between Praziquantel (Biltricide) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Chloroquine
- Ketoconazole
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Praziquantel (Biltricide) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Praziquantel (Biltricide) will not be safe for you to take.
- Fluke infection of the eye
- Take rifampin (Rifadin), an antibiotic used for tuberculosis and other infections
