Overview
11 DESCRIPTION Praziquantel, USP is an anthelmintic, trematodicide provided in tablet form for oral administration. Praziquantel, USP is 2-(cyclohexylcarbonyl)-1,2,3,6,7,11b-hexahydro-4H-pyrazino[2,1-a] isoquinolin-4-one with the molecular formula; C 19 H 24 N 2 O 2 . The structural formula is as follows: Praziquantel, USP is a white or almost white crystalline powder.
Mechanism of Action
12 CLINICAL PHARMACOLOGY 12.1 Mechanism of Action Praziquantel is an anthelmintic drug [see Microbiology (12.4) ] . 12.3 Pharmacokinetics Absorption After oral administration, 80% of an administered praziquantel dose is absorbed, with maximal serum concentrations of praziquantel achieved 1 to 3 hours after dosing. Elimination Following oral administration of praziquantel, the elimination half-life of praziquantel in serum ranges between 0.8 to 1.5 hours. Metabolism Praziquantel is rapidly metabolized by the cytochrome P450 enzyme system and undergoes a first pass effect after oral administration of praziquantel. Excretion Approximately 80% of an oral dose of praziquantel is excreted in the kidneys, almost exclusively (greater than 99%) in the form of praziquantel metabolites.
Indications
- 1 INDICATIONS AND USAGE Praziquantel tablets are indicated in patients aged 1 year and older for the treatment of the following infections: Schistosomiasis due to all species of schistosoma (for example, Schistosoma mekongi, Schistosoma japonicum, Schistosoma mansoni and Schistosoma hematobium ), and Clonorchiasis and Opisthorchiasis due to the liver flukes, Clonorchis sinensis/Opisthorchis viverrini (approval of this indication was based on studies in which the two species were not differentiated) Praziquantel tablets are an anthelmintic indicated in patients aged one year and older for the...
Common Doses
- 20 mg
- 25 mg
- 600 mg
- 150 mg
Dosage
2 DOSAGE AND ADMINISTRATION Schistosomiasis : 20 mg/kg body weight 3 times a day separated by 4 to 6 hours for 1 day only. ( 2.1 ) Clonorchiasis and Opisthorchiasis : 25 mg/kg 3 times a day separated by 4 to 6 hours for 1 day only. ( 2.1 ) Take with water during meals. Do not chew or keep segments in the mouth. ( 2.2 ) For pediatric patients under 6 years of age, the tablets may be crushed or disintegrated and mixed with semi-solid food or liquid. ( 2.2 ) For additional administration instructions see the full prescribing information. 2.
Contraindications
- 4 CONTRAINDICATIONS Praziquantel is contraindicated in: Patients who previously have shown hypersensitivity to praziquantel or any of the excipients in praziquantel tablets. Patients with ocular cysticercosis; since parasite destruction within the eye that occurs because of hypersensitivity reaction to the dead parasite after treatment may cause irreversible lesions, ocular cysticercosis must not be treated with praziquantel. Patients taking strong Cytochrome P450 3A enzyme (CYP 3A) inducers, such as rifampin [see Warnings and Precautions ( 5.6) and Drug Interactions ( 7.1 , 7.2 )] .
Side Effects
- 6 ADVERSE REACTIONS The following serious or otherwise important adverse reactions are discussed elsewhere in the labeling: Clinical Deterioration [see Warnings and Precautions (5.1) ] Central Nervous System (CNS) Effects [see Warnings and Precautions (5.2) ] Potential Lack of Efficacy During the Acute Phase of Schistosomiasis [see Warnings and Precautions (5.3) ] Cardiac Arrhythmias [see Warnings and Precautions (5.4) ] Hepatic Impairment in Hepatosplenic Schistosomiasis Patients [see Warnings and Precautions (5.
Interactions
- 7 DRUG INTERACTIONS Moderate CYP 3A Inducers : Avoid concomitant administration of moderate CYP 3A inducers, for example, efavirenz ( 5.6 , 7.1 ) 7.1 CYP 3A Inducers Strong and Moderate CYP 3A Inducers Concomitant administration of praziquantel with Strong and Moderate CYP 3A inducers decrease praziquantel AUC and C max [see Clinical Pharmacology (12.3) ] which may reduce the efficacy of praziquantel. Concomitant administration of a Strong CYP 3A inducer, such as rifampin, with praziquantel is contraindicated [see Contraindications (4) ].