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Pronunciation
(pi RAN tel PAM oh ate)
Generic Available (U.S.)
No
Brand Names: U.S.
Brand Names: Canada
Pharmacologic Category
Use: Labeled Indications
Treatment of pinworms caused by Enterobius vermicularis (alternative agent; not preferred therapy)
Use: Unlabeled
Treatment of hookworms caused by Ancylostoma caninum, Ancylostoma duodenale, and Necator americanus); Moniliformis; roundworms caused by Ascaris lumbricoides; Trichostrongylus
Pregnancy Considerations
Pyrantel pamoate has minimal systemic absorption. Systemic absorption would be required in order for pyrantel pamoate to cross the placenta and reach the fetus.
Contraindications
Hypersensitivity to pyrantel pamoate or any component of the formulation
Warnings/Precautions
Disease-related concerns:
• Hepatic impairment: Use with caution in patients with hepatic impairment.
Dosage form specific issues:
• Aspartame: Some products may contain aspartame.
• Sodium benzoate: Some products may contain sodium benzoate; may cause allergic reactions in susceptible individuals.
Other warnings/precautions:
• Household contacts: Since pinworm infections are easily spread to others, treat all family members in close contact with the patient.
• Self-medication (OTC use): When used for self-medication, patients should be instructed to contact healthcare provider if symptoms or pinworm infection persists after treatment or if any worms other than pinworms are present before or after treatment. Patients should not repeat dose unless directed to do so by their healthcare provider.
Adverse Reactions
Frequency not defined.
Central nervous system: Dizziness, headache
Gastrointestinal: Abdominal cramps, diarrhea, nausea, vomiting
Metabolism/Transport Effects
Substrate of CYP2D6 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Drug Interactions
Aminoquinolines (Antimalarial): May decrease the serum concentration of Anthelmintics. Risk C: Monitor therapy
Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates. Risk C: Monitor therapy
Storage
Store at 15°C to 30°C (59°F to 86°F).
Mechanism of Action
Causes the release of acetylcholine and inhibits cholinesterase; acts as a depolarizing neuromuscular blocker, paralyzing the helminths
Pharmacodynamics/Kinetics
Absorption: Oral: Poor
Metabolism: Partially hepatic
Time to peak, serum: 1-3 hours
Excretion: Feces (>50% as unchanged drug); urine (7% as unchanged drug and metabolites)
Dosage
Oral: Children ≥2 years and Adults: Note: Dose is expressed as pyrantel base; not preferred therapy since newer treatments are available.
Enterobius vermicularis (pinworm): 11 mg/kg administered as a single dose; maximum: 1 g/dose
Ancylostoma caninum (hookworm) (unlabeled use): 11 mg/kg (maximum: 1 g/dose) administered once daily for 3 days
Ancylostoma duodenale (hookworm), Ascariasis lumbricoides (roundworm), Necator americanus (hookworm) (unlabeled use): 11 mg/kg (maximum: 1 g/dose) administered once daily for 3 days (Kappagoda, 2011)
Moniliformis (unlabeled use): 11 mg/kg administered as a single dose; repeat twice 2 weeks apart
Trichostrongylus (unlabeled use): 11 mg/kg administered as a single dose; maximum: 1 g/dose
Administration: Oral
May be mixed with milk or fruit juice. May be administered without regard to meals. Purgation is not required prior to, during, or after use.
Suspension: Shake well before use.
Tablet: Chewable tablet must be chewed thoroughly before swallowing
Monitoring Parameters
Stool for presence of eggs, worms, and occult blood
Dietary Considerations
May take without regard to meals.
Dental Health: Effects on Dental Treatment
No significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic Precautions
No information available to require special precautions
Mental Health: Effects on Mental Status
May cause dizziness, drowsiness, or insomnia
Mental Health: Effects on Psychiatric Treatment
None reported
Dosage Forms
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Suspension, oral, as pamoate:
Pin-X®: 144 mg/mL (30 mL, 60 mL) [sugar free; contains sodium benzoate; caramel flavor; equivalent to pyrantel base 50 mg/mL]
Reese's Pinworm Medicine: 144 mg/mL (30 mL, 60 mL, 240 mL) [equivalent to pyrantel base 50 mg/mL]
Tablet, chewable, oral, as pamoate:
Pin-X®: 720.5 mg [scored; contains aspartame; equivalent to pyrantel base 250 mg]
References
Bethony J, Brooker S, Albonico M, et al, "Soil-Transmitted Helminth Infections: Ascariasis, Trichuriasis, and Hookworm," Lancet, 2006, 367(9521):1521-32.
“Drugs for Parasitic Infections,” Med Lett Drugs Ther, 1998, 40(1017):1-12.
Kappagoda S, Singh U, and Blackburn BG, "Antiparasitic Therapy," Mayo Clin Proc 2011, 86(6):561-83.
Keiser J and Utzinger J, "Efficacy of Current Drugs Against Soil-Transmitted Helminth Infections: Systematic Review and Meta-Analysis," JAMA, 2008, 299(16):1937-48.
Kunst H, Mack D, Kon OM, et al, "Parasitic Infections of the Lung: A Guide for the Respiratory Physician," Thorax, 2011, 66(6):528-36.
International Brand Names
Lexi-Comp.com
Last full review/revision February 2012
Content last modified February 2012
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