c. Adverse Effects. Diethylcarbamazine citrate is a relatively safe drug. The
major problem is allergic reactions because of the foreign protein from the dying
microfilarial worms. The intensity of these reactions can be lessened by the
concomitant administration of antihistamines during the first 5 days of therapy.
d. Cautions and Warnings. If a client is suspected of having malaria, he
should be treated with chloroquine prior to the administration of diethylcarbamazine.
This drug may provoke a relapse of nonsymptomatic malaria.
e. Supply. Diethylcarbamazine citrate is supplied as 50-mg tablets.
6-30. PYRANTEL PAMOATE
a. Indications. Pyrantel pamoate (Antiminth) is a depolarizing neuromuscular
blocking agent, resulting in spastic paralysis of the worm. It is active against Enterobius
vermicularis (pinworm) and Ascaris lumbricoides (roundworm).
b. Dosage. A single dose of 11-mg/kg (maximum total dose of 1 gram) which
corresponds to a simplified dosage regimen of 1-ml/10-lb. Pyrantel may be administered
without regard to meals or time of day. Purging is not necessary. It may be taken with
milk or fruit juices.
c. Cautions and Warnings.
(1) Safety and efficacy for use in children under 2 years of age have not
Safety in pregnant women has not been established.
d. Adverse Effects. Anorexia, nausea, vomiting, abdominal cramps, diarrhea,
headache, dizziness, and skin rash have been observed with the administration of this
e. Supply. Pyrantel pamoate (Antiminth) is supplied as an oral suspension
containing 50-mg pyrantel per ml.
6-31. PIPERAZINE CITRATE
a. Indications. Piperazine citrate (Antepar) is an alternate drug of choice for
roundworms (Ascaris lumbricoides) and pinworms (Enterobius vermicularis).
Piperazine blocks the response of acetylcholine in the worm causing flaccid paralysis of
the worm. The worm is then dislodged and expelled by peristalsis.
b. Usual Dosage. Piperazine is best taken on an empty stomach. The surface
contact between drug and parasite is diminished in the presence of food.
(1) Roundworms can be treated with 75-mg/kg daily for two consecutive
days (maximum daily dose = 3.5-grams).