Praziquantel dosage

Albendazole is now the preferred drug, but when it is not appropriate or available, praziquantel has similar efficacy. Indications for praziquantel are similar to those for albendazole. The praziquantel dosage is 100 mg/kg/d in three divided doses for 1 day, then 50 mg/kg/d to complete a 2- to 4-week course. Clinical responses to therapy vary from dramatic improvements of seizures and other neurologic findings to no response and even progression of the disease. Praziquantel —but not albendazole—has diminished bioavailability when taken concurrently with a corticosteroid. Recommendations on use of both antihelminthics and corticosteroids in neurocysticercosis vary. 

Limited trials at a dosage of 25 mg/kg three times a day for 1-2 days indicate effectiveness of praziquantel against fasciolopsiasis, metagonimiasis, and other forms of heterophyiasis. Praziquantel was not effective for fascioliasis, however, even at dosages as high as 25 mg/kg three times daily for 3-7 days. 

Pharmacokinetic studies with sheep treated with the recommended dosage showed that praziquantel was rapidly absorbed, peak plasma concentration being reached within 2 h of dosing (72). A half-life of 4.2 h was determined and excretion from plasma was rapid, 98% being excreted within 72 h. At 8 h posttreatment, the maximum levels present in liver, kidneys, muscle, and fat were 2.87, 2.55, 0.19, and 0.1,3 ppb, respectively, of praziquantel equivalents. At 24 h post-... 

Praziquantel was not effective for fascioliasis, however, even at dosages as high as 25 mg/kg three times daily for 3-7 days. 

THERAPEUTIC USES Praziquantel is FDA approved for therapy of schistosomiasis and liver fluke infections, but also is used to treat infections with many other trematodes and cestodes. Praziquantel is the drug of choice for schistosomiasis caused by all Schistosoma species. Although dosage regimens vary, a single oral dose of 40 mg/kg or three doses of 20 mg/kg each, given 4-6 hours apart, generally produce cure rates of 70-95% and consistent reductions (>85%) in egg counts. Tablets of 600 mg are available. 

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