No special preparations or other steps (for example, special diet, fasting, other medicines, laxatives, or enemas) are necessary before, during, or immediately after you take piperazine. Piperazine may be taken with or without food or on a full or empty stomach. However, if your doctor tells you to take the medicine a certain way, take it exactly as directed. For patients taking the granules for oral solution form of piperazine: Dissolve the contents of 1 packet of granules in 57 mL (about 2 ounces) of water, milk, or fruit juice. Be sure to drink all of the liquid to get the full dose of medicine. Take this medicine only as directed. Do not take more of it and do not take it more often than your doctor ordered. To do so may increase the chance of serious side effects. To help clear up your infection completely, take this medicine in regularly spaced doses as ordered by your doctor. In some infections, a second treatment with this medicine may be required to clear up the infection completely. Do not miss any doses. For patients taking piperazine for pinworms: Pinworms may be easily passed from one person to another, especially among persons in the same household. Therefore, all household members may have to be treated at the same time to prevent their infection or reinfection. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For granules for oral solution dosage form: For common roundworms or pinworms: Adults and teenagers—2 grams three times a day for one day. Treatment may need to be repeated in two weeks. Children—Dose is based on age and/or body weight. Treatment may need to be repeated in two weeks. Up to 2 years of age: Dose must be determined by your doctor. 2 to 8 years of age: 2 grams once a day for one day. 8 to 14 years of age: 2 grams two times a day for one day. For oral suspension dosage form: For common roundworms or pinworms: Adults and teenagers—1.8 grams every four hours for a total of three doses in one day. Treatment may need to be repeated in two weeks. Children—Dose is based on age. Treatment may need to be repeated in two weeks. Up to 2 years of age: 600 milligrams (mg) every four hours for a total of three doses in one day. 2 to 8 years of age: 1.2 grams every six hours for a total of two doses in one day. 8 to 14 years of age: 1.2 grams every four hours for a total of three doses in one day. For tablet dosage form: For common roundworms: Adults and teenagers—3.5 grams (piperazine hexahydrate) per day for two days in a row. Treatment may need to be repeated in one week. Children—Dose is based on body weight and must be determined by your doctor. However, the usual dose is 75 mg (piperazine hexahydrate) per kilogram (34 mg per pound) of body weight per day for two days in a row. Treatment may need to be repeated in one week. For pinworms: Adults and children—Dose is based on body weight and must be determined by your doctor. However, the usual dose is 65 mg (piperazine hexahydrate) per kilogram (29.5 mg per pound) of body weight per day for seven days in a row. Treatment may need to be repeated in one week. Missed Dose If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

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