U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

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Praziquantel, marketed as Biltricide, is an anthelmintic used in humans and animals for the treatment of tapeworms and flukes. Specifically, it is effective against schistosoma, Clonorchis sinensis the fish tape worm Diphyllobothrium latum. Praziquantel works by causing severe spasms and paralysis of the worms' muscles. This paralysis is accompanied - and probably caused - by a rapid Ca 2+ influx inside the schistosome. Morphological alterations are another early effect of praziquantel. These morphological alterations are accompanied by an increased exposure of schistosome antigens at the parasite surface. The worms are then either completely destroyed in the intestine or passed in the stool. An interesting quirk of praziquantel is that it is relatively ineffective against juvenile schistosomes. While initially effective, effectiveness against schistosomes decreases until it reaches a minimum at 3-4 weeks. Effectiveness then increases again until it is once again fully effective at 6-7 weeks. Glutathione S-transferase (GST), an essential detoxification enzyme in parasitic helminths, is a major vaccine target and a drug target against schistosomiasis. Schistosome calcium ion channels are currently the only known target of praziquantel. The antibiotic rifampicin decreases plasma concentrations of praziquantel. Carbamazepine and phenytoin are reported to reduce the bioavailability of praziquantel. Chloroquine reduces the bioavailability of praziquantel. The drug cimetidine heightens praziquantel bioavailability.
Status:
US Approved OTC
Source:
21 CFR 357.110 anthelmintic pyrantel pamoate
Source URL:
First approved in 1971
Source:
Antiminth by Roerig (Pfizer)
Source URL:

Class (Stereo):
CHEMICAL (ACHIRAL)



Pyrantel is an anthelmintic, which acts as an agonist of nicotinic receptors (AChRs) of nematodes and exerts its therapeutic effects by depolarizing their muscle membranes. It is used to treat a number of parasitic worm infections. This includes ascariasis, hookworm infections, enterobiasis (pinworm infection), trichostrongyliasis and trichinellosis. Common adverse reactions include diarrhea, nausea, vomiting, dizziness, headache and somnolence.
Imidacloprid is a systemic, chloro-nicotinyl insecticide used for the control of sucking insects such as fleas, aphids, whiteflies, termites, turf insects, soil insects, and some beetles. It is used on co on and vegetable crops as foliar and seed treatments, soil, structures, indoor and outdoor insect control, home gardening and pet products. It is indicated for the prevention of heartworm disease caused by Dirofilaria immitis. It kills adult fleas and is indicated for the treatment of flea infestations (Ctenocephalides felis). It is also indicated for the treatment and control of the following intestinal parasites Hookworm species, Roundworm species, Whipworms. Adverse events in animals included: malaise, vomiting, diarrhea, shaking, mydriasis, hypersalivation with abnormal neurologic signs, seizures, death, generalized hematoma of the body, and alopecia at the treatment site. Adverse reactions in humans included: burning, tingling, numbness, bad taste in the mouth, dizziness, and headache.
Clorsulon is a compound belonging to the benzenesulphonamide family. It is used in veterinary medicine for the treatment of liver fluke (monotherapy), gasrtointestinal and lung worms, lice, grubs and mites (in combination with ivermectin) in cattles. Clorsulon inhibits the enzymes involved in the glycolytic pathways of the common liver fluke (Fasciola hepatica or Fasciola gigantica), namely phosphoglycerate kinase and phosphoglyceromutase.
Status:
Possibly Marketed Outside US
Source:
Canada:FENBENDAZOLE
Source URL:

Class (Stereo):
CHEMICAL (ACHIRAL)



Fenbendazole (FBZ) is a broad-spectrum benzimidazole antiparasitic drug currently approved for use in numerous animal species, including rodents. Although nematodes, and in particular pinworms, are the main endoparasites of concern in laboratory rodents, FBZ also is indicated for use in other animal species against a wide spectrum of nematodes, tapeworms, flukes, and protozoa (Giardia duodenalis, Encephalitozoon intestinalis). The molecular mode of fenbendazole action consists in binding of beta-tubulin monomer prior to dimerisation with alfa-tubulin which blocks subsequent microtubule formation. These microtubules are important organelles involved in the motility, the division and the secretion processes of cells in all living organisms. In the worms the blocking of microtubules perturbs the uptake of glucose, which eventually empties the glycogen reserves. This blocks the whole energy management mechanism of the worms that are paralyzed and die or are expelled. FBZ have a greater binding to nematode as compared to mammalian tubulin at 37°C. The oral LD50 of p-OH fenbendazole was >10 000 mg/kg b.w. in mice and rats.
Ivermectin is a broad-spectrum anti-parasite medication. It was first marketed under the name Stromectol® and used against worms (except tapeworms), but, in 2012, it was approved for the topical treatment of head lice infestations in patients 6 months of age and older, and marketed under the name Sklice™ as well. Ivermectin is mainly used in humans in the treatment of onchocerciasis but is also effective against other worm infestations (such as strongyloidiasis, ascariasis, trichuriasis, and enterobiasis). Ivermectin binds selectively and with high affinity to glutamate-gated chloride ion channels in invertebrate muscle and nerve cells of the microfilaria. This binding causes an increase in the permeability of the cell membrane to chloride ions and results in hyperpolarization of the cell, leading to paralysis and death of the parasite. Ivermectin also is believed to act as an agonist of the neurotransmitter gamma-aminobutyric acid (GABA), thereby disrupting GABA-mediated central nervous system (CNS) neurosynaptic transmission. Ivermectin may also impair the normal intrauterine development of O. volvulus microfilariae and may inhibit their release from the uteri of gravid female worms. It is sold under brand names Heartgard, Sklice and Stromectol in the United States, Ivomec worldwide by Merial Animal Health, Mectizan in Canada by Merck, Iver-DT in Nepal by Alive Pharmaceutical and Ivexterm in Mexico by Valeant Pharmaceuticals International. In Southeast Asian countries, it is marketed by Delta Pharma Ltd. under the trade name Scabo 6.