Pyrantel Pamoate Dosage
For pinworm (Enterobius vermicularis) infections, administer pyrantel pamoate as a single oral dose of 11 mg/kg (5 mg/lb) body weight, with a maximum dose of 1 gram, and this can be taken with or without food at any time of day. 1
Standard Dosing by Weight
The FDA-approved weight-based dosing schedule for pyrantel pamoate suspension is: 1
- 25-37 lbs: 125 mg (½ teaspoonful)
- 38-62 lbs: 250 mg (1 teaspoonful)
- 63-87 lbs: 375 mg (1½ teaspoonfuls)
- 88-112 lbs: 500 mg (2 teaspoonfuls)
- 113-137 lbs: 625 mg (2½ teaspoonfuls)
- 138-162 lbs: 750 mg (3 teaspoonfuls)
- 163-187 lbs: 875 mg (3½ teaspoonfuls)
- ≥188 lbs: 1,000 mg (4 teaspoonfuls, maximum dose)
Do not use in children under 25 pounds or under 2 years of age unless directed by a physician. 1
Administration Guidelines
- Single dose only: The medication should be taken as a single dose and not repeated unless directed by a physician 1
- No food restrictions: Pyrantel pamoate can be taken with or without meals, and may be taken alone or with milk or fruit juice 1
- No laxative needed: Use of a laxative is not necessary before, during, or after medication 1
- Shake well: The suspension must be shaken well before use 1
Household Treatment Considerations
When one individual in a household has pinworms, the entire household should be treated unless otherwise advised by a physician. 1 This is critical because pinworm transmission within households is extremely common due to the fecal-oral route and environmental contamination.
Alternative Dosing for Other Helminth Infections
While the FDA label specifically addresses pinworm treatment, research evidence supports alternative dosing regimens for other intestinal helminths:
- For ascariasis alone: 10 mg/kg as a single dose has shown 93-97% cure rates 2
- For hookworm infections: 20 mg/kg daily for 3 consecutive days achieves 53-73% cure rates 2
- For mixed helminth infections (Ascaris, hookworm, Trichuris): 15-20 mg/kg daily for 3 consecutive days when using oxantel-pyrantel combination 3, 4
Important Caveats
- Limited efficacy against Trichuris: Pyrantel pamoate has minimal to no effectiveness against whipworm (Trichuris trichiura), with cure rates only marginally better than placebo 2
- Follow-up required: If any worms other than pinworms are present before or after treatment, or if symptoms persist after treatment, consult a physician 1
- Well-tolerated: The medication is generally well-tolerated with minimal side effects across all age groups 3, 2, 4