Hesperian Health Guides

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Medicines for Worms

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HealthWiki > New Where There Is No Doctor > Caring for Children > Medicines for Worms


Medicines by themselves are not enough to get rid of worm infections for very long. Personal and public cleanliness is also necessary. Worm infections can spread easily among family members, so when one person has worms it is wise to treat the whole family.

Mebendazole


Mebendazole works against hookworm, whipworm, roundworm, and pinworm (threadworm). It may do some good against trichinosis, but is not the best medicine for this. Although side effects are not common, there may be some gut pain or diarrhea if the person is infected with a lot of worms.

Important

Avoid mebendazole during the first 3 months of pregnancy when it can harm the developing baby. Do not give to children under 1 year old.

How to use
For pinworm
1 year to adult: give 100 mg, one time by mouth. repeat in 2 weeks if necessary.
For roundworm (ascaris), whipworm (trichuris) and hookworm
1 year to adult: give 100 mg, 2 times a day for 3 days (6 tablets in all). OR
give one 500 mg tablet, one time only.
To prevent roundworm where this infection is common
1 year to adult: give 500 mg, every 3 to 6 months.
For trichinosis
1 year to adult: give 200 to 400 mg, 3 times a day for 3 days. then give 400 to 500 mg, 3 times a day for another 10 days. If there is pain or vision problems, also give a steroid, for example prednisolone, 40 to 60 mg, once a day for 10 to 15 days.

Albendazole


Albendazole is similar to mebendazole, but often more expensive. It works against hookworm, whipworm, roundworm, pinworm, and trichinosis. Side effects are rare.

Important

Avoid albendazole during the first 3 months of pregnancy when it can harm the developing baby. Do not give to children under 1 year old.

How to use
For pinworm, roundworm (ascaris), whipworm (trichuris), and hookworm
1 to 2 years: give 200 mg, one time.
Over 2 years: give 400 mg, one time. Repeat in 2 weeks if needed.

For trichinosis
Give 400 mg, 2 times a day for 8 to 14 days. If there are pain or vision problems, also give a steroid, for example prednisolone, 40 to 60 mg, once a day for 10 to 15 days.

Pyrantel pamoate, pyrantel embonate


Pyrantel works for pinworm, hookworm, and roundworm (Ascaris), but it may be expensive. It occasionally causes vomiting, dizziness, or headache. Do not give it to someone also taking piperazine (another anti-worm medicine).

How to use
For hookworm and roundworm: give one dose only.
For pinworm: give one dose, wait 2 weeks, then give another dose.
Give 10 mg per kg. If you cannot weigh the child, dose by age:
Under 2 years: give 62 mg (¼ of a 250 mg tablet).
2 to 5 years: give 125 mg (½ of a 250 mg tablet).
6 to 9 years: give 250 mg (one 250 mg tablet).
10 to 14 years: give 500 mg (two 250 mg tablets).
Over 14 years: give 750 mg (three 250 mg tablets).

For Tapeworm

There are several types of tapeworm. Praziquantel or niclosamide both work for all types. If the tapeworm infection is in the brain or causes seizures, the person needs albendazole and anti-seizure medicines instead, and should get help.

Praziquantel


Side effects

Praziquantel may cause tiredness, dizziness, headache, loss of appetite, and nausea, but these side effects are rare at the low doses used to treat tapeworm.

How to use
For most kinds of tapeworm, including beef and pork tapeworm
Use 5 to 10 mg per kg, one time only. Or dose by age:
4 to 7 years: give 150 mg (¼ tablet), one time only.
8 to 12 years: give 300 mg, one time only.
Over 12 years: give 600 mg, one time only.

For dwarf tapeworm (H. nana)
Use 25 mg per kg in one dose. Then repeat in 10 days. Or dose by age:
4 to 7 years: give 300 to 600 mg (½ to 1 tablet) per dose.
8 to 12 years: give 600 to 1200 mg per dose.
Over 12 years: give 1500 mg per dose.

Niclosamide


Niclosamide works against tapeworm in the gut, but not against cysts outside the gut.

How to use

Take niclosamide after a small morning meal. Tablets must be chewed well and swallowed. The dose may differ depending on the type of tapeworm, so your local health authority may have a good recommendation. If not, use the dose below.

Chew well and swallow the following doses. If a small child cannot yet chew, crush the tablet and mix with a little breast milk or food.
Under 2 years: give 500 mg, one time only.
2 to 6 years: give 1 gram (1000 mg), one time only.
Over 6 years: give 2 grams, one time only.


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