What is the recommended dose of pyrantel (anthelmintic) embonate for a 14-year-old?

Pyrantel Embonate Dosing for a 14-Year-Old

For a 14-year-old with pinworm or hookworm infection, administer pyrantel embonate as a single oral dose of 11 mg/kg (or 5 mg/lb) body weight, not to exceed 1 gram total dose. 1

Weight-Based Dosing Algorithm

Calculate the exact dose based on the patient's weight:

• If weight is 88-112 pounds (40-51 kg): Give 500 mg (2 teaspoonfuls of suspension) as a single dose 1
• If weight is 113-137 pounds (51-62 kg): Give 625 mg (2.5 teaspoonfuls) as a single dose 1
• If weight is 138-162 pounds (63-73 kg): Give 750 mg (3 teaspoonfuls) as a single dose 1
• If weight is 163-187 pounds (74-85 kg): Give 875 mg (3.5 teaspoonfuls) as a single dose 1
• If weight is ≥188 pounds (≥85 kg): Give 1,000 mg (4 teaspoonfuls), which is the maximum dose 1

Administration Instructions

• Give as a single dose only—do not repeat unless directed by a physician 1
• Can be taken any time of day, with or without food, milk, or fruit juice 1
• No laxative is needed before, during, or after treatment 1
• Shake suspension well before administering 1

Treatment Considerations by Helminth Type

For pinworm (Enterobius vermicularis):

• The single dose of 11 mg/kg is highly effective 1
• Treat all household members simultaneously unless otherwise advised, as pinworms spread easily within households 1

For hookworm (Ancylostoma/Necator):

• A single dose of 10 mg/kg achieves 100% cure rates for Ancylostoma duodenale 2
• For heavier hookworm infections, consider 20 mg/kg daily for 3 consecutive days, which achieves 53-73% cure rates 3
• The FDA-approved single-dose regimen (11 mg/kg) is appropriate for most cases 1

For Ascaris lumbricoides:

• Single dose of 10 mg/kg achieves 93-99% cure rates 3, 4
• The standard single-dose regimen is highly effective 1

Critical Limitations

Pyrantel is NOT effective against:

• Trichuris trichiura (whipworm)—cure rates are only 34-46%, no better than placebo 3, 5
• If whipworm is present, consider mebendazole or albendazole instead 5

Follow-Up Protocol

• If symptoms or pinworms persist after treatment, consult a physician 1
• If worms other than pinworms are identified before or after treatment, physician consultation is required 1
• Stool examination should be negative for ova by days 10-15 post-treatment if cure is achieved 2

Safety Profile

• Well-tolerated with minimal side effects 2, 6, 3
• Occasional nausea and vomiting may occur on the day of administration 2
• No liver function or renal toxicity reported in clinical trials 2
• Do not use in children under 2 years or weighing less than 25 pounds unless directed by a physician 1