Pharmacological properties
Pharmacodynamics. Helmintox is an anthelmintic drug that is active against Enterobius vermicularis, Ascaris lumbricoides, Ancylostoma duodenale, Necator americanus. Helmintox blocks the neuromuscular system, causing paralysis of helminths, as a result of which they are excreted from the body with feces under the action of peristalsis. Helmintox is active against sensitive sexually mature and immature forms. Larvae that migrate through tissues are insensitive to the drug.
Pharmacokinetics. Intraintestinal absorption of the drug is minimal due to the insolubility of pyrantel embonate. The concentration of the drug in the blood plasma is insignificant - from 0.05 to 0.13 mg/ml. The main absorption, which is estimated by the indicators of the unchanged substance and metabolites in the urine, is 3.8%. The main metabolite is N-methyl-1,3-propanediamine, the concentration of which in the urine is 1.2-4.6%. More than 93% of the drug is excreted unchanged in the feces.
Indication
Enterobiasis, ascariasis, hookworm, necatoriasis.
Application
Suspension. For enterobiasis and ascariasis, the average dose is 10-12 mg/kg of body weight per dose, i.e.:
children aged 6 months and over - 1 measuring spoon of suspension per 10 kg of body weight in one dose; adults with a body weight of up to 75 kg - 6 measuring spoons in one dose; adults with a body weight of 75 kg - 8 measuring spoons in one dose.
When treating enterobiasis, in order to improve the effect, strict adherence to personal hygiene rules is recommended (especially for children) and a repeated course of treatment 3 weeks after the previous one.
In case of hookworm infection in case of severe infestation or in endemic areas, the dose is 20 mg/kg of body weight per day in 1-2 doses for 2-3 days, i.e.:
children aged 6 months and over - 2 measuring spoons of suspension per 10 kg of body weight per day; adults with a body weight of up to 75 kg - 12 measuring spoons per day; adults with a body weight of 75 kg - 16 measuring spoons per day.
In the case of Ancylostoma duodenale infestation occurring in non-endemic areas, a single dose of 10 mg/kg body weight may be sufficient.
It is more advisable for adults to prescribe the drug in tablet form.
Tablets. For enterobiasis, ascariasis: children aged 6-18 years - 1 tablet (125 mg) per 10 kg of body weight, adults with a body weight of up to 75 kg - 6 tablets of 125 mg or 3 tablets of 250 mg. Adults with a body weight of 75 kg or more - 4 tablets of 250 mg.
For hookworm and necatoriasis, the same dosage changes or, in severe forms, 20 mg/kg/day in 1 or 2 divided doses for 2-3 days.
When treating enterobiasis, in order to improve the effect, strict adherence to personal hygiene rules is recommended, especially for children; as well as repeated administration of the drug 4 weeks after the treatment.
Contraindication
Hypersensitivity to the components of the drug, liver failure.
Side effects
From the side of the central nervous system: dizziness, drowsiness, insomnia, headache;
Skin and subcutaneous tissue disorders: rash, urticaria;
Gastrointestinal: anorexia, vomiting, abdominal cramps, diarrhea, tenesmus;
hepatobiliary disorders: increased liver enzymes;
others: weakness, increased fatigue.
Special instructions
Helmintox should be prescribed with caution to patients with impaired liver function. Helmintox is always taken once, regardless of mealtime and time of day; there is no need to use laxatives or abstain from eating.
The drug should be taken at the same time by all family members.
To prevent re-infection, strict adherence to personal hygiene rules is recommended.
Use during pregnancy and breastfeeding. Experimental studies have not revealed any teratogenic effects of pyrantel on the fetus, and in clinical practice no side effects have been reported in the treatment of pregnant women with the drug. During pregnancy and breastfeeding, the drug is used according to strict indications after a careful assessment of the benefit-risk ratio for the woman, determined by the doctor, and in strict compliance with dosage recommendations.
Children. Prescribed for children aged 6 months and over.
Ability to influence the reaction rate when driving vehicles or working with other mechanisms. Dizziness, drowsiness and weakness, which are sometimes noted during the treatment of helmintox, may affect the reaction rate when driving vehicles or working with machines and complex mechanisms.
Interactions
Do not use the drug together with levamisole, since simultaneous use may potentiate the toxicity of levamisole and increase theophylline levels in blood plasma. Do not use with piperazine, which is an antagonist of the anthelmintic action of pyrantel.
Overdose
Anorexia, nausea, vomiting, diarrhea, ataxia are possible, however, due to the minimal amounts of pyrantel that are adsorbed, even with a significant overdose, signs of intoxication rarely occur. Gastric lavage is recommended due to the lack of a specific antidote.
Precautions: monitoring of respiratory and cardiovascular system function.
Storage conditions
At a temperature not exceeding 25 °C.
