From the Guidelines
To treat internal parasites, the most effective approach is to consult a healthcare provider for proper diagnosis and treatment, with common medications including albendazole, mebendazole, praziquantel, and ivermectin, as recommended in the 2025 UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants 1.
Treatment Options
The treatment options for internal parasites vary depending on the type of parasite, infection severity, and patient health status.
- For Ascariasis (Ascaris lumbricoides), the recommended treatment is either albendazole PO 400 mg or mebendazole PO 500 mg or ivermectin PO 200 μg/kg as a single dose 1.
- For Taenia species, the treatment options include praziquantel PO 10 mg/kg as a single dose or niclosamide PO 2 g as a single dose 1.
- For other types of internal parasites, such as whipworm (Trichuris trichiura), the recommended treatment is mebendazole PO 100 mg twice daily in combination with ivermectin PO 200 μg/kg once daily for 3 days 1.
Important Considerations
It is essential to note that treatment typically lasts 1-3 days for common parasites, though some may require longer courses of 1-2 weeks.
- Patients should take medications as prescribed, complete the full course even if symptoms improve, and follow any dietary restrictions.
- Maintaining good hygiene practices during treatment helps prevent reinfection or transmission to others.
- Different parasites require different treatments because they have varying life cycles and vulnerabilities to medications, which is why proper diagnosis is essential for effective treatment.
Specialist Advice
In some cases, specialist advice may be necessary, particularly for immunocompromised patients or those with complex infections.
- For example, the treatment of echinococcosis should be managed in or under the guidance of specialist centres 1.
- Patients with strongyloidiasis should be cautious when using steroids, as they may cause hyperinfection 1.
From the FDA Drug Label
Mebendazole tablets are indicated for the treatment of Enterobius vermicularis (pinworm), Trichuris trichiura (whipworm), Ascaris lumbricoides (common roundworm), Ancylostoma duodenale (common hookworm), Necator americanus (American hookworm) in single or mixed infections. Efficacy rates derived from various studies are shown in the table below: Pinworm (enterobiasis)Whipworm (trichuriasis)Common Roundworm (ascariasis)Hookworm Cure rates mean95%68%98%96% Egg reduction mean—93%99%99% Drontal Plus Taste Tabs Tablets contain three active ingredients having different modes of action and spectra of activity. Praziquantel is active against cestodes (tapeworms). Pyrantel pamoate is active against hookworms and ascarids. Febantel is active against nematode parasites including whipworms.
Treatment of internal parasites can be achieved with:
- Mebendazole for the treatment of pinworm, whipworm, common roundworm, and hookworm infections.
- Praziquantel for the treatment of tapeworm infections.
- Pyrantel pamoate for the treatment of hookworm and ascarid infections.
- Febantel for the treatment of whipworm and other nematode parasite infections. 2 3 3
From the Research
Treatment Options for Internal Parasites
- The primary treatment options for internal parasites include anthelmintic drugs such as albendazole, mebendazole, ivermectin, and praziquantel 4, 5, 6, 7, 8.
- Albendazole and mebendazole are broad-spectrum anthelmintics that can be used to treat a variety of intestinal nematode infections, including ascariasis, hookworm infections, trichuriasis, and strongyloidiasis 4, 5, 6, 7, 8.
- Ivermectin is also effective against Strongyloides stercoralis and can be used in combination with albendazole to treat whipworm infections 7.
- Praziquantel is effective against intestinal trematode infections and tapeworms 7.
Efficacy and Safety of Anthelmintic Drugs
- Studies have shown that albendazole, mebendazole, and ivermectin are all effective against Ascaris lumbricoides infection, with high parasitological cure rates and large reductions in eggs excreted 8.
- The efficacy and safety of these drugs have been compared in several studies, with no significant differences detected between them in terms of cure rates or adverse events 8.
- However, it is noted that albendazole and mebendazole can cause liver toxicity and other side reactions if used for prolonged periods or in high doses 4.
Specific Treatment Recommendations
- Albendazole is recommended as the drug of choice for hookworm, Ascaris lumbricoides, and pinworm infections 7.
- Ivermectin is preferred for Strongyloides stercoralis infections, and praziquantel is effective against most nematodes and trematodes 7.
- Combination therapy with ivermectin and albendazole is recommended for whipworm infections 7.