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Praziquantel, marketed as Biltricide, is an anthelmintic used in humans and animals for the treatment of tapeworms and flukes. Specifically, it is effective against schistosoma, Clonorchis sinensis the fish tapeworm Diphyllobothrium latum.
It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system.[1]
Medical uses[edit]
Praziquantel is used to treat diseases in humans, mammals, and fish that are caused by infection with several types of internal/gastrointestinal, and external parasites, including:

Salmon poisoning disease
Hydatid disease caused by infection of various organs with larval stages of tapeworms of the genus Echinococcus
Cysticercosis caused by infection of the brain and/or muscles with the eggs and larvae of the pork tapeworm Taenia solium (though it has been judged less effective than albendazole in treatment of neurocysticercosis)[2]
In cats and dogs whose gastrointestinal tract is infected with the tapeworms Dipylidium caninum or Taenia taeniaeformis, respectively;[3][4] praziquantel is also often used in fixed combination with pyrantel embonate against the roundworms (ascarids): Toxocara cati and Toxascaris leonina.[3][4] Praziquantel is also effective against Echinococcus multilocularis.[3]
Schistosomiasis caused by trematodes of the genus Schistosoma.[5] As of 2005, praziquantel is the primary treatment for human schistosomiasis, for which it is usually effective in a single dose.[6]
Clonorchiasis brought on by the Chinese liver fluke Clonorchis sinensis[7]
Paragonimiasis caused by infection with lung flukes, mostly of the species Paragonimus westermani[citation needed]
Fasciolopsiasis caused by intestinal fluke Fasciolopsis buski[8]
Diplozoon paradoxum and other Trematoda infections of many fish species[9]
Side effects[edit]
The majority of side effects develop due to the release of the contents of the parasites as they are killed and the consequent host immune reaction. The heavier the parasite burden, the heavier and more frequent the side effects normally are.

Central nervous system: Frequently occurring side effects are dizziness, headache, and malaise. Drowsiness, somnolence, fatigue, and vertigo have also been seen. Almost all patients with cerebral cysticercosis experience CNS side effects related to the cell-death of the parasites (headache, worsening of pre-existing neurological problems, seizures, arachnoiditis, and meningism). These side effects may be life-threatening and can be reduced by coadministration of corticosteroids. It is strongly recommended that all patients with cerebral cysticercosis are hospitalized during treatment.
GI Tract: Approximately 90% of all patients have abdominal pain or cramps with or without nausea and vomiting. Diarrhea may develop and may be severe with colic. Sweating, fever, and sometimes bloody stools may occur together with diarrhea.
Liver: Asymptomatic and transient increases of liver enzymes (AST and ALT) are noted frequently (up to 27%). No case of symptomatic liver damage has ever been seen so far.
Sensitivity reactions: Urticaria, rash, pruritus and eosinophilia in white blood cell counts
Other locations/body as a whole: Lower back pain, myalgia, arthralgia, fever, sweating, various cardiac arrhythmias, and hypotension
Drug interactions[edit]
The antibiotic rifampicin decreases plasma concentrations of praziquantel.[10]

Carbamazepine and phenytoin are reported to reduce the bioavailability of praziquantel.[11]

Chloroquine reduces the bioavailability of praziquantel.[12]

The drug cimetidine heightens praziquantel bioavailability.[13][14]

Mechanism of action[edit]