What medications are used to treat tapeworms and other parasitic infections?

From the Guidelines

Praziquantel is the recommended first-line treatment for most tapeworm infections, given as a single oral dose of 10 mg/kg, as supported by the most recent and highest quality evidence 1.

Treatment Options for Tapeworms and Other Parasitic Infections

Several medications are effectively used to treat tapeworms and other parasitic infections. The choice of medication depends on the specific type of parasite and the severity of the infection.

• Praziquantel is typically used for intestinal tapeworms, such as Taenia saginata and Taenia solium, with a recommended dose of 10 mg/kg as a single dose 1.
• Albendazole is also effective against tapeworms and roundworm infections, with a recommended dose of 400 mg twice daily for 1-28 days depending on the parasite 1.
• Other medications, such as niclosamide, mebendazole, ivermectin, and metronidazole, may be used to treat specific types of parasitic infections.

Importance of Accurate Diagnosis and Treatment

Accurate diagnosis and treatment of tapeworm infections are crucial to prevent complications, such as cysticercosis, and to reduce the risk of transmission to others.

• Stool microscopy and serology tests can be used to diagnose tapeworm infections 1.
• Treatment should always be accompanied by good hygiene practices to prevent reinfection, including thorough handwashing, proper food preparation, and avoiding consumption of undercooked meat or contaminated water.

Public Health Considerations

Tapeworm carriers pose a public health risk, especially if they are food handlers, and can transmit the infection to others through contaminated food or water.

• Local public health authorities should be notified of cases of neurocysticercosis (NCC) or tapeworm carriage, as these are reportable in many states and regions 1.
• Screening for tapeworm carriers may be recommended in certain cases, especially in areas where the infection is endemic.

From the FDA Drug Label

INDICATIONS: Drontal Plus (praziquantel/pyrantel pamoate/febantel) Taste Tabs Broad Spectrum Chewable Anthelmintic Tablets are indicated for removal of Tapeworms (Dipylidium caninum, Taenia pisiformis, Echinococcus granulosus, and removal and control of Echinococcus multilocularis) and for removal of Hookworms (Ancylostoma caninum, Uncinaria stenocephala), Ascarids (Toxocara canis, Toxascaris leonina), and Whipworms (Trichuris vulpis) in dogs. The medications used to treat tapeworms and other parasitic infections are:

• Praziquantel: for removal of Tapeworms (Dipylidium caninum, Taenia pisiformis, Echinococcus granulosus) and control of Echinococcus multilocularis 2
• Drontal Plus: a broad-spectrum anthelmintic that contains praziquantel, pyrantel pamoate, and febantel, for removal of Tapeworms, Hookworms, Ascarids, and Whipworms in dogs 2

From the Research

Medications for Tapeworms and Other Parasitic Infections

• Praziquantel is a highly effective medication against a broad range of trematodes and cestodes, including tapeworms, and is relatively nontoxic 3.
• Albendazole and mebendazole are benzimidazole broad-spectrum anthelmintics used to treat intestinal nematode infections, intestinal tapeworm infections, and tissue nematode/cestode infections 4.
• Niclosamide is an anthelmintic drug of choice for tapeworm infections, while thiabendazole is used for trichinosis 5.
• Nitazoxanide is a safe and effective treatment for niclosamide- and praziquantel-resistant beef tapeworm infection 6.
• Praziquantel has been shown to be effective in single-dose treatments for human cestodiasis caused by Diphyllobothrium pacificum 7.

Treatment Options

• Praziquantel can be given orally in one dose or several doses in a single day 3.
• Albendazole and mebendazole are generally safe with few side effects, but liver toxicity and other side reactions may occur with prolonged use 4.
• Nitazoxanide is administered twice daily for 3 days in 500-mg doses for adults and at 20mg/kg body weight/day in children aged 5-14 years 6.
• A treatment scheme incorporating a purge may be best for recovering the parasite in its entirety and ascertaining cure with no repeated controls 7.

Efficacy and Safety

• Praziquantel has been shown to be highly effective against all Schistosoma species that infect humans, as well as other flukes and tapeworms 3.
• Albendazole and mebendazole exhibit ovicidal, larvicidal, and vermicidal effects on parasites, and tumoricidal effects on hosts 4.
• Nitazoxanide cured 51 of 52 (98.1%) patients with niclosamide- and praziquantel-resistant beef tapeworm infection, with mild side effects occurring in seven patients 6.
• Praziquantel was effective in all cases of human cestodiasis caused by Diphyllobothrium pacificum, with no ova found in stool examinations at 30,60, and 90 days after treatment 7.