c. Cautions and Warnings.
Safety for use during pregnancy has not been established.
(2) Safety and efficacy for use in children under 2 years of age have not
d. Adverse Reactions. Nausea and vomiting, abdominal discomfort, loss of
appetite, drowsiness, dizziness, and skin rash have been observed.
e. Supply. Niclosamide (Niclocide) is supplied as 500-mg chewable tablets.
a. Indications. Quinacrine (Atabrine), once used extensively in the suppression
and treatment of malaria, is an alternate agent used to treat infections of Taenia
saginata (beef tapeworm), T. solium (pork tapeworm), and Diphyllobothrium latum (fish
tapeworm). It is also an alternate drug for the treatment of Hymenolepis nana (dwarf
tapeworm), H. diminuta (rat tapeworm), and Dipylidium caninum.
b. Administration for Treatment of Taenia saginata, T. solium, and
Diphyllobothrium latum. The client is placed on a semisolid, bland, nonfat diet for 1 day
prior to administration. The client must fast at least from suppertime the evening before
because the gastrointestinal tract should be as empty as possible. A saline laxative
should be given about an hour before therapy is begun. Four doses of 200-mg each
should be administered orally 10 minutes apart. Sodium bicarbonate, 600-mg in about
75 ml of water, should be given with each dose to reduce the tendency to nausea and
vomiting. Enough saline laxative should be given 1 to 2 hours after the last dose to
produce a copious evacuation, removing the worm, alive and stained yellow, from the
GI tract within 4 to 10 hours. Since only one worm is usually present in Taenia
infections, the discovery of the scolex (head and neck) in the stool usually indicates that
the client is cured.
c. Administration for Treatment of H. nana, H. diminuta, and D. caninum. The
initial treatment of these tapeworms is the same as for Taenia infections above.
However, on the following three days after the initial treatment, 100-mg (adult dose) of
quinacrine, three times daily, must be administered. It may be necessary to repeat the
entire course of treatment 2 weeks later.
d. Adverse Effects. The use of quinacrine may result in toxic reactions such as
gastrointestinal upset, skin eruptions, and mental disorders. These effects are
reversible when administration of the drug is stopped. The client's skin and his urine
may become stained yellow, although these effects are not toxic.
e. Cautions and Warnings. The drug should not be given to clients with a
history of psychosis or to people with psoriasis. It is also contraindicated in clients who