praziquantel (Rx)

Brand and Other Names:Biltricide
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 600mg

Schistosomiasis

Indicated for treatment for schistosomiasis caused by all species of Schistosoma

20 mg/kg PO TID for 1 day (at intervals of 4-6 hr)  

Clonorchiasis, Opisthorchiasis

Indicated for clonorchiasis and opisthorchiasis caused by liver flukes (Clonorchis sinensis, Opisthorchis viverrini)

25 mg/kg PO TID for 1 day (at intervals of 4-6 hr)  

Cysticercosis (Off-label)

50-100 mg/kg/day PO divided q8hr for 14 days  

Tapeworms (Off-label)

5-10 mg/kg as single dose or 25 mg/kg if caused by Hymenolepis nana  

Dosage Forms & Strengths

tablet

  • 600mg

Schistosomiasis

Indicated for treatment for schistosomiasis caused by all species of Schistosoma

<1 year: Safety and efficacy not established

≥1 year: 20 mg/kg PO TID for 1 day (at intervals of 4-6 hr)  

Clonorchiasis, Opisthorchiasis

Indicated for clonorchiasis and opisthorchiasis caused by liver flukes (Clonorchis sinensis, Opisthorchis viverrini)

<1 year: Safety and efficacy not established

≥1 year: 25 mg/kg PO TID for 1 day (at intervals of 4-6 hr)  

Cysticercosis (Off-label)

≥1 year: 50-100 mg/kg/day PO divided TID for 30 days  

Tapeworms (Off-label)

≥1 year: 5-10 mg/kg as single dose or 25 mg/kg if caused by Hymenolepis nana  

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Interactions

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            Contraindicated (20)

            • bosentan

              bosentan decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • carbamazepine

              carbamazepine decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • dabrafenib

              dabrafenib decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • dexamethasone

              dexamethasone decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • efavirenz

              efavirenz decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • enzalutamide

              enzalutamide decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • eslicarbazepine acetate

              eslicarbazepine acetate will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels

            • etravirine

              etravirine will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Etravirine should be discontinued 2 weeks prior to starting praziquantel. Etravirine may be restarted one day after last praziquantel dose.

            • fosphenytoin

              fosphenytoin decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • mitotane

              mitotane decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

            • nafcillin

              nafcillin decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • nevirapine

              nevirapine will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nevirapine should be discontinued 2 weeks prior to starting praziquantel. Nevirapine may be restarted one day after last praziquantel dose.

            • oxcarbazepine

              oxcarbazepine decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • pentobarbital

              pentobarbital decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • phenobarbital

              phenobarbital decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • phenytoin

              phenytoin decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • primidone

              primidone decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • rifabutin

              rifabutin decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • rifampin

              rifampin decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            • rifapentine

              rifapentine decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Strong CYP450 inducers significantly decrease praziquantel blood levels.

            Serious - Use Alternative (7)

            • abametapir

              abametapir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • apalutamide

              apalutamide will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • fexinidazole

              fexinidazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

            • idelalisib

              idelalisib will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

            • ivosidenib

              ivosidenib will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • tucatinib

              tucatinib will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

            • voxelotor

              voxelotor will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

            Monitor Closely (31)

            • atazanavir

              atazanavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cenobamate

              cenobamate will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

            • cimetidine

              cimetidine increases levels of praziquantel by decreasing metabolism. Use Caution/Monitor.

            • clarithromycin

              clarithromycin will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cobicistat

              cobicistat will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conivaptan

              conivaptan will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • crizotinib

              crizotinib increases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

            • crofelemer

              crofelemer increases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

            • darunavir

              darunavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • elagolix

              elagolix decreases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

            • encorafenib

              encorafenib, praziquantel. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

            • fedratinib

              fedratinib will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

            • grapefruit

              grapefruit will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • iloperidone

              iloperidone increases levels of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

            • indinavir

              indinavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • itraconazole

              itraconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketoconazole

              ketoconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lopinavir

              lopinavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lorlatinib

              lorlatinib will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • mifepristone

              mifepristone will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nefazodone

              nefazodone will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nelfinavir

              nelfinavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • posaconazole

              posaconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ritonavir

              ritonavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • saquinavir

              saquinavir will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • stiripentol

              stiripentol, praziquantel. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

            • tazemetostat

              tazemetostat will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tecovirimat

              tecovirimat will decrease the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

            • voriconazole

              voriconazole will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            Minor (4)

            • albendazole

              praziquantel increases levels of albendazole by unspecified interaction mechanism. Minor/Significance Unknown.

            • chloroquine

              chloroquine decreases levels of praziquantel by unspecified interaction mechanism. Minor/Significance Unknown.

            • hydroxychloroquine sulfate

              hydroxychloroquine sulfate increases levels of praziquantel by unspecified interaction mechanism. Minor/Significance Unknown.

            • ribociclib

              ribociclib will increase the level or effect of praziquantel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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            Adverse Effects

            1-10%

            Appetite loss

            Dizziness

            Drowsiness

            Headache

            Malaise

            CSF reaction syndrome in patients treated for neurocysticercosis

            Abdominal pain

            Nausea

            Vomiting

            Diaphoresis

            <1%

            Diarrhea

            Fever

            Itching

            Rash

            Urticaria

            Postmarketing Reports

            Eosinophilia

            Pruritus, rash Abdominal pain, anorexia, bloody diarrhea, vomiting

            Allergic reaction (generalized hypersensitivity, including polyserositis)

            Arrhythmia (including bradycardia, ectopic rhythms, ventricular fibrillation, AV blocks)

            Fatigue, somnolence, asthenia, vertigo

            Convulsions

            Myalgia

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            Warnings

            Contraindications

            Hypersensitivity

            Intraocular cysticercosis

            Concomitant use with strong CYP450 inducers

            Cautions

            Clinical deterioration may occur when treating schistosomiasis (eg, paradoxical reactions, serum sickness Jarisch-Herxheimer like reactions [sudden inflammatory immune response suspected to be caused by the release of schistosomal antigens]); reactions predominantly occur in patients treated during the acute phase of schistosomiasis

            Can exacerbate CNS pathology due to schistosomiasis, paragonimiasis, or Taenia solium cysticercosis; consider whether to treat with praziquantel in patients with epilepsy or other CNS diseases; hospitalize patient for duration of treatment if infection found to be associated with cerebral cysticercosis

            Evidence suggests treatment with praziquantel in the acute phase of infection may not prevent progression from asymptomatic infection to acute schistosomiasis, or from asymptomatic infection/acute schistosomiasis into chronic phase; may lead to potentially life-threatening events, for example, respiratory failure, encephalopathy, papilledema, and/or cerebral vasculitis

            Bradycardia, ectopic rhythms, ventricular fibrillation, and AV blocks observed; monitor patients with cardiac arrhythmias during treatment

            Reduced hepatic metabolism of praziquantel results in higher and sustained plasma concentrations of unmetabolized drug in patients with liver impairment; monitor for adverse reactions when administering the recommended dose to patients with hepatosplenic schistosomiasis who have moderate or severe liver impairment (Child-Pugh Class B or C)

            Drug interaction overview

            • Coadministration with strong CYP450 inducers (eg, rifampin) is contraindicated since therapeutically effective blood levels of praziquantel may not be achieved
            • In patients receiving rifampin who need immediate treatment for schistosomiasis, alternative agents for schistosomiasis should be considered
            • If treatment with praziquantel is necessary, rifampin should be discontinued 4 weeks before praziquantel administration
            • Treatment with rifampin can be restarted 1 day after completion of praziquantel treatment
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            Pregnancy & Lactation

            Pregnancy

            Published studies have not identified association with use during pregnancy and major birth defects, miscarriage or adverse maternal or fetal outcomes

            Animal data

            • In animal reproduction studies conducted in pregnant rats and rabbits no adverse developmental outcomes were observed with oral administration of drug during organogenesis at approximately 0.65 times (rats) or 1.3 times (rabbits) the highest recommended human daily dose of 75 mg/kg/day, based on body surface area

            Lactation

            Limited data from published literature reports presence of drug in human milk at low concentrations; there is no information on effects of drug in breastfed infant or effects on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed infant from drug or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Increases cell membrane permeability to calcium in schistosomes causing the worm to dislodge following the paralysis of worm musculature

            Pharmacokinetics

            Absorption: ~80% (oral)

            Peak Plasma Time: 1-3 hr

            Distribution: CSF concentration is 14-20% of plasma concentration

            Protein Bound: ~80%

            Metabolism: Extensive first-pass effect

            Half-life 0.8-1.5 hr (parent drug); 4.5 hr (metabolites)

            Excretion: Urine (99% as metabolites)

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            Administration

            Oral Administration

            Swallow tablets with water during meals

            Do not chew or keep tablets in the mouth; bitter taste may cause gagging or vomiting

            Doses less than or greater than 600 mg

            • 600-mg tablets have 3 scores which can be split into 4 segments at the scores
            • When broken, each of the 4 segments contains 150 mg so that the dosage can be adjusted to the patient’s bodyweight
            • Segments are broken off by pressing the score (notch) with thumbnails
            • If one-quarter of a tablet is required, this is best achieved by breaking the segment from the outer end

            Unable to swallow tablet

            • Tablets may be crushed or disintegrated and mixed with semi-solid food or liquid
            • Use crushed or disintegrated tablets within 1 hr of mixing
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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            praziquantel oral
            -
            600 mg tablet
            Biltricide oral
            -
            600 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            praziquantel oral

            PRAZIQUANTEL - ORAL

            (prazz-ih-KWAN-tull)

            COMMON BRAND NAME(S): Biltricide

            USES: This medication is used to treat infections of certain parasites (such as Schistosoma and liver flukes). Curing parasitic infections helps to improve your health and quality of life. Praziquantel belongs to a class of drugs known as anthelmintics. It works by killing the parasites. It also paralyzes the parasites, causing them to release their hold on the blood vessel walls so the body can remove them naturally.

            HOW TO USE: Take this medication by mouth with a meal as directed by your doctor, usually 3 times a day (4 to 6 hours apart) for 1 day. Quickly swallow the tablets or tablet segments with a full glass of water (8 ounces or 240 milliliters). Do not chew or suck the tablets because the bitter taste of praziquantel may cause gagging or vomiting. Your doctor may direct you to take this medication fewer than 3 times a day or to take it for longer than 1 day. Follow your doctor's directions exactly.If you have trouble swallowing the tablets or tablet segments, you may crush the medication and mix it in soft foods or liquids. Take the mixture within 1 hour of mixing.Dosage is based on your medical condition, weight, and response to treatment. Tablets are scored with lines. You may need to break the tablet to get the correct dose. Ask your pharmacist for directions on breaking the tablet to get the right dose for you.Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.Your symptoms may worsen when you start taking praziquantel. Tell your doctor right away if your condition lasts or worsens.

            SIDE EFFECTS: Headache, dizziness, stomach pain, nausea, tiredness, weakness, joint/muscle pain, loss of appetite, vomiting, and sweating may occur. These side effects are usually mild and temporary and may be symptoms of your parasite infection and/or the dying parasites. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: bloody diarrhea, fever, irregular/slow heartbeat, seizures.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking praziquantel, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, heart disease (irregular heart rhythm), parasitic eye infection (ocular cysticercosis), parasitic brain infection (cerebral cysticercosis), seizures.This drug may make you dizzy during treatment until the day after treatment. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Other medications can affect the removal of praziquantel from your body, which may affect how praziquantel works. Examples include azole antifungals (such as itraconazole, ketoconazole), chloroquine, cimetidine, dexamethasone, macrolide antibiotics (such as erythromycin), rifamycins (such as rifampin), St. John's wort, and some drugs used to treat seizures (such as carbamazepine, phenytoin, phenobarbital, primidone), among others.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Do not share this medication with others.Laboratory and/or medical tests (such as examination of urine/stool, biopsy of infected tissue) should be performed periodically to monitor your progress or check for side effects. If you have a heart condition, you may need additional monitoring. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.