**ACRONYMS AND DEFINITIONS**

**CDC**- Center for Disease Control and Prevention recommendation**CTE**- dosing based on clinical trial(s) and/or expert opinion**PI**- Dosing from Package Insert**IDSA**- Infectious Disease Society of America recommendation

Albendazole (Albenza®)

## Dosage forms

__Tablet__- 200 mg ($$$$)

## Dosing

__Pediatric____NOTE:__Albendazole is approved in children ≥ 6 years of age. In studies, it has been used in children as young as one year at doses between 10 - 15 mg/kg/day [**PMID 15602190**,**12915835**,**9726343**]

**Ascariasis**- 400 mg given as a one time dose (CDC)**Hookworms (A. duodenale, N. americanus)**- 400 mg given as a one time dose (CDC)**Hookworms, zoonotic (A. braziliense, etc.)**- 400 mg once daily for 3 days (CDC)**Neurocysticercosis**- 15 mg/kg/day (max 800 mg/day) given in 2 divided doses for 8 - 28 days. Typically given with steroids. [based on**PMID 18495737**,**12915835**]**Pinworms (enterobiasis)**- 10 - 14 mg/kg (max 400 mg) given as a one time dose. May repeat in 2 weeks. (CTE)**Strongyloides**- 400 mg twice a day for 7 days (CDC)**Trichuriasis**- 400 mg once daily for 3 days (CDC)

__Adult__**Ascariasis**- 400 mg given as a one time dose (CDC)**Hookworms (A. duodenale, N. americanus)**- 400 mg given as a one time dose (CDC)**Hookworms, zoonotic (A. braziliense, etc.)**- 400 mg once daily for 3 - 7 days (CDC)**Neurocysticercosis**- 400 mg twice a day for 8 - 10 days. Typically given with steroids. [based on**PMID 18495737**,**14724304**]**Pinworms (enterobiasis)**- 400 mg given as a one time dose. May repeat in 2 weeks. (CTE)**Strongyloides**- 400 mg twice a day for 7 days (CDC)**Trichuriasis**- 400 mg once daily for 3 days (CDC)

## Other

- Take with food
- Tablets may be crushed or chewed
- May cause bone marrow suppression. Monitor CBC every 2 weeks while on continuous therapy.
- May cause hepatotoxicity. Monitor LFTs every 2 weeks while on continuous therapy.
__Kidney disease__- undergoes negligible kidney excretion; no dose adjustment necessary

Ivermectin | Stromectol® | Sklice® | Soolantra®

## Dosage forms

__Tablet (Stromectol®)__- 3 mg ($)

__Lotion (Sklice®)__- 0.5% ($$$$)

__Cream (Soolantra®)__- 1% ($$$$)

## Dosing

__Pediatric__**Ascariasis**- 150 - 200 mcg/kg given as a one time dose (CDC)**Hookworms, zoonotic (A. braziliense, etc.)**- 200 mcg/kg as a single dose (CDC)**Lice**- 400 mcg/kg/dose with one dose given on Day 1 and Day 8. [based on one study in patients ≥ 2 years who weigh at least 15 kg -**PMID 20220184**]**Pinworms (enterobiasis)**- 200 mcg/kg given as a one time dose and repeated in 10 days [used in some studies -**PMID 15344847**,**18452885**,**2929853**]**Scabies**- 200 mcg/kg/dose given one time and then repeated in 8 - 15 days (CTE)**Strongyloides**- 200 mcg/kg given once daily for 1 - 2 days (CDC)**Trichuriasis**- 200 mcg/kg given once daily for 3 days (CDC)

__Adult__**Ascariasis**- 150 - 200 mcg/kg given as a one time dose (CDC)**Hookworms, zoonotic (A. braziliense, etc.)**- 200 mcg/kg as a single dose (CDC)**Lice**- 400 mcg/kg/dose with one dose given on Day 1 and Day 8. [based on one study -**PMID 20220184**]**Pinworms (enterobiasis)**- 200 mcg/kg given as a one time dose and repeated in 10 days [used in some studies -**PMID 15344847**,**18452885**,**2929853**]**Scabies**- 200 mcg/kg/dose given one time and then repeated in 8 - 15 days (CTE)**Strongyloides**- 200 mcg/kg given once daily for 1 - 2 days (CDC)**Trichuriasis**- 200 mcg/kg given once daily for 3 days (CDC)

__Topical therapy (Sklice®)__**Lice**- Apply to dry hair and scalp. Leave on for 10 minutes then rinse with water. Approved for patients ≥ 6 months. (PI)

__Topical therapy (Soolantra®)__- Apply to affected areas of the face once daily. Use a pea-size amount for each area of the face (forehead, chin, nose, each cheek) that is affected. Spread as a thin layer, avoiding the eyes and lips. (PI)__Rosacea__

## Other

Dosing chart for 200 mcg/kg doses | |
---|---|

Body weight (kg) | Number of 3 mg tablets of ivermectin |

15 - 24 | 1 |

25 - 35 | 2 |

36 - 50 | 3 |

51 - 65 | 4 |

66 - 79 | 5 |

≥ 80 | 200 mcg/kg |

- When taken with food, absorption is increased two-fold. Manufacturer recommends drug be taken on an empty stomach. Some experts recommend taking with food since studies have shown higher doses are safe and may be more effective [1,2]
- Ivermectin tablets may be crushed and mixed with applesauce
__Kidney disease__- no dose adjustment necessary

Mebendazole (Emverm®)

## Dosage form

__Chewable tablet__- 100 mg ($$$$)

## Dosing

__Pediatric (> 2 years)__**Ascariasis (roundworm)**- 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)**Hookworms (A. duodenale, N. americanus)**- 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)**Pinworms (enterobiasis)**- 100 mg one time dose (PI)**Trichuriasis (whipworm)**- 100 mg twice daily for 3 days (CDC, PI)

__Adult__**Ascariasis (roundworm)**- 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC)**Hookworms (A. duodenale, N. americanus)**- 100 mg twice daily for 3 days or 500 mg given as a one time dose (CDC, PI)**Pinworms (enterobiasis)**- 100 mg one time dose (PI)**Trichuriasis (whipworm)**- 100 mg twice daily for 3 days (CDC, PI)

## Other

- The tablet may be chewed, swallowed, or crushed and mixed with food
- If the patient is not cured three weeks after treatment, a second course of treatment is advised

Praziquantel (Biltricide®)

## Dosage form

__Tablet__- 600 mg ($$$$)

## Dosing

__Pediatric____NOTE:__praziquantel is approved in children ≥ 4 years of age. In studies, it has been used in children younger than 4 years at doses of 40 mg/kg []**PMID 23236526**

**Taeniasis (Tapeworms)**- 5 - 10 mg/kg given as a one time dose (CDC)**Schistosomiasis (S. mansoni, S. haematobium, S. intercalatum)**- 40 mg/kg/day given in 2 divided doses for 1 day (CDC)**Schistosomiasis (S. japonicum, S. mekongi)**- 60 mg/kg/day given in 3 divided doses for 1 day (CDC)

__Adult__**Taeniasis (Tapeworms)**- 5 - 10 mg/kg given as a one time dose (CDC)**Schistosomiasis (S. mansoni, S. haematobium, S. intercalatum)**- 40 mg/kg/day given in 2 divided doses for 1 day (CDC)**Schistosomiasis (S. japonicum, S. mekongi)**- 60 mg/kg/day given in 3 divided doses for 1 day (CDC)

## Other

- Take with food
- Swallow tablets whole if able. Tablets have bitter taste.
- Praziquantel undergoes extensive CYP liver metabolism (
**CYP3A4**,**CYP1A2**,**CYP2C19**). Strong CYP inducers and inhibitors may affect blood levels of praziquantel. Rifampin should not be taken with praziquantel. __Kidney disease__- no dose adjustment necessary

**PRICE ($) INFO**

__Pricing legend__**$**= 0 - $50**$$**= $51 - $100**$$$**= $101 - $150**$$$$**= > $150

- Pricing based on one month of therapy at standard dosing in an adult
- Pricing based on information from GoodRX.com®
- Pricing may vary by region and availability

**BIBLIOGRAPHY**

- 1 - PMID 12362927 - Pharmacokinetic study
- 2 - PMID 20181973