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Pharmacological group: anthelmintic.
Active ingredient: Praziquantel.
Dosage form: tablets.
Release form: One package consists of 6 tablets оf 600 mg.
The drug is used to treat:
- infections caused by various types of schistosomes (Schistosoma haematobium, Schistosoma mansoni, Schistosoma intercalatum, Schistosoma japonicum, Schistosoma mekongi);
- infections caused by liver flukes (Clonorchis sinensis, Opistorchis viverrini) and lung flukes (including Paragonimus westermani)
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The active substance is Praziquantel. Praziquantel increases the permeability of helminth cell membranes for calcium ions, which causes a generalized contraction of the musculature of parasites. It also causes damage to the tegument (the outer covering of flatworms). It inhibits the uptake of glucose by helminth cells, while reducing the content of glycogen and stimulating the release of lactic acid compounds. As a result, the parasites die. Praziquantel is specifically active against trematodes and cestodes, not active against nematodes (including filariae). Safety data based on studies of systemic toxicity, genotoxicity, carcinogenicity, reproductive toxicity, did not reveal any danger of using praziquantel for humans.
- Trematodiasis (clonorchiasis, metagonimiasis, opisthorchiasis, paragonimiasis, fasciolosis, fasciolopsidiasis, schistosomiasis, including intestinal and genitourinary),
- cestodoses (hymenolepiasis, diphyllobothriasis, teniarinhoz, teniasis),
- cysticercosis,
- neurocysticercosis.
Side effects vary depending on the dose and duration of treatment with praziquantel. In addition, they depend on the types of helminths, the degree of infection, the duration of the infection and the localization of helminths in the body.
From the immune system: very rarely - allergic reactions - (including generalized allergic reactions), polyserositis, eosinophilia.
From the side of the central nervous system: very often - headache, dizziness; often - vertigo, drowsiness; very rarely - convulsions.
From the side of the cardiovascular system: very rarely - arrhythmia.
From the digestive system: very often - gastrointestinal pain and abdominal pain, nausea, vomiting; often - anorexia, diarrhea (very rarely with an admixture of blood).
From the skin and skin appendages: very often - urticaria; very rarely - itching.
From the musculoskeletal system: often - myalgia.
Systemic disorders and conditions: often - malaise, fever. Adverse reactions can be caused both by praziquantel itself (I, direct relationship with taking the drug), or as a result of an endogenous reaction to the death of parasites (II, indirect relationship with taking the drug), as well as symptoms of infection (III, no relationship with taking the drug). drug). It is very difficult to make a differential diagnosis between I, II and III options and to establish the exact cause of the development of adverse reactions.
- Hypersensitivity to any component of the drug;
- cysticercosis of the eye;
- combined use with strong inducers of cytochrome P450, such as rifampicin;
- children under 4 years of age (safety and efficacy not established).
In decompensated liver failure and hepatolienal schistosomiasis, Biltricid should be used with caution due to the risk of its longer presence in elevated concentrations in the vascular bed, including collateral vessels. Such patients may be hospitalized for treatment.
In cases of cardiac arrhythmias and while taking digitalis preparations, treatment with Biltricid should be carried out under the supervision of a physician.
Patients who live or have lived in areas endemic for cysticercosis and trematodosis are recommended to be treated in a hospital.
Since Biltricid can cause exacerbations of diseases of the central nervous system due to schistosomiasis, paragonimiasis or cysticercosis caused by Taenia solium, as a rule, this drug should not be prescribed to persons with a history of epilepsy and / or other symptoms of possible damage to the central nervous system, for example, subcutaneous nodules suggestive of cysticercosis.
Influence on the ability to drive a car / moving mechanisms: When using the drug Biltricid, you should refrain from driving a car / moving mechanisms on the day / days of taking the drug and for the next 24 hours.
The tablet should be taken orally, without chewing, with a small amount of liquid during or after a meal. If a single dose of the drug per day is recommended, then the tablet should be taken in the evening. With repeated use of the drug during the day, it is recommended that the interval between doses is at least 4 and not more than 6 hours. When dividing the tablet into 4 parts, each fragment contains 150 mg of the active ingredient, which makes it easy to select a dosage based on the patient's body weight.
Adults and children over 4 years of age: Doses of Biltricide are selected strictly individually and depend on the type of pathogen.
- Schistosoma haematobium: 40 mg/kg body weight once. The duration of treatment is 1 day.
- Schistosoma mansoni and Schistosoma intercalatum 40 mg/kg once daily or 20 mg/kg twice daily. The duration of treatment is 1 day.
- Schistosoma japonicum, Schistosoma mekongi 60 mg/kg once a day or 30 mg/kg twice a day. The duration of treatment is 1 day.
- Clonorchis sinensis, Opisthorchis viverrini 25 mg/kg 3 times a day for 1-3 days.
- Paragonimus westermani and other species 25 mg/kg 3 times a day for 2-3 days. Children under 4 years old.
The safety of the drug in children under 4 years of age has not been established.
With simultaneous use with drugs that induce cytochrome P450 liver enzymes, for example, with anticonvulsants, dexamethasone, the concentration of praziquantel in the blood plasma may decrease, and when combined with drugs that inhibit these enzymes, for example, with cimetidine, ketoconazole, itraconazole and erythromycin, increase.
It is necessary to avoid the simultaneous use of the drug with potent inhibitors of cytochrome P450, for example, rifampicin, as it may interfere with the achievement of therapeutic plasma concentrations of praziquantel.
Less than a two-fold increase in praziquantel exposure was observed in clinical studies when taken concomitantly with grapefruit juice.
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