What is the recommended oral pyrantel pamoate dose for children aged 2 years and older, including weight‑based calculation, maximum dose, and repeat dosing interval?

Pyrantel Pamoate Dosing in Children

For children aged 2 years and older, administer pyrantel pamoate as a single oral dose of 11 mg/kg (5 mg/lb) of body weight, with a maximum dose of 1 gram, and repeat the dose after 2 weeks if pinworm reinfection is suspected. 1

Weight-Based Calculation

• The FDA-approved dose is 11 mg/kg (or 5 mg/lb) of body weight given as a single oral dose 1
• This translates to approximately 5 mg of pyrantel base per pound of body weight 1
• The medication should be given as a single dose only—do not repeat unless directed by a physician 1

Maximum Dose

• The maximum single dose is 1 gram (1000 mg), regardless of body weight 1
• This cap prevents excessive dosing in heavier children and adolescents 1

Repeat Dosing Interval

• Pyrantel pamoate is administered as a single-dose treatment 1
• Do not repeat the dose unless specifically directed by a physician 1
• For pinworm infections, if symptoms persist or worms are still present after the initial treatment, consult a physician before retreating 1
• When one household member has pinworms, the entire household should be treated simultaneously unless otherwise advised, to prevent reinfection 1

Administration Instructions

• Pyrantel pamoate can be taken any time of day, with or without meals 1
• It may be taken alone or mixed with milk or fruit juice 1
• Shake the suspension well before use 1
• A laxative is not necessary before, during, or after medication 1

Efficacy by Parasite Type

• For Ascaris (roundworm) infections, pyrantel pamoate at 10-20 mg/kg demonstrates cure rates of 93-97% 2, 3
• For hookworm infections, the drug shows moderate efficacy with cure rates of 53-73% at standard dosing 2
• Pyrantel pamoate has minimal to no efficacy against Trichuris (whipworm), with cure rates similar to placebo 2, 3

Common Pitfalls to Avoid

• Do not use in children under 2 years of age—pyrantel pamoate is only FDA-approved for children 2 years and older 1
• Do not exceed 1 gram as a single dose, even if weight-based calculation suggests a higher amount 1
• Do not routinely repeat dosing without physician guidance, as this is a single-dose regimen 1
• If worms other than pinworms are identified before or after treatment, consult a physician rather than self-treating with additional doses 1
• Remember that pyrantel pamoate works primarily in the gastrointestinal tract with very limited systemic absorption, which is why it is effective against intestinal parasites but requires proper dosing for efficacy 4