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Pyrantel comes as a capsule and a liquid to take by mouth. It usually is taken as a single dose for pinworm and roundworm infections. The dose usually is repeated after 2 weeks for pinworm infections. For hookworm infections, pyrantel usually is taken once a day for 3 days. Pyrantel may be taken with food, juice, or milk or on an empty stomach.

Shake the liquid well to mix the medication evenly. Pyrantel may be mixed with milk or fruit juice. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pyrantel exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Pyrantel pamoate acts as a depolarizing neuromuscular blocking agent, thereby causing sudden contraction, followed by paralysis, of the helminths. This has the result of causing the worm to "lose its grip" on the intestinal wall and be passed out of the system by natural process. Since Pyrantel is poorly absorbed by the host's intestine, the host is unaffected by the small dosage of medication used. Spastic (tetanic) paralyzing agents, in particular pyrantel pamoate, may induce complete intestinal obstruction in a heavy worm load.[8] This obstruction is usually in the form of a worm impaction and happens when a very small, but heavily parasitized animal is treated and tries to pass a large number of dislodged worms at once. Worms usually pass in normal stool or with diarrhea, straining, and occasional vomiting.

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of pyrantel in the elderly with use in other age groups.

Certain drugs may interact with pyrantel pamoate including levamisole (Ripercol, Tramisol), morantel (Rumatel), and piperazine (Pipa-Tabs). Exposure to organophosphates (pesticides) while taking pyrantel pamoate should be avoided. It is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Special thanks to Professor Peter Smith for his precious advice on statisticalanalysis, and to Victoria Wright for her contribution to the field activities, aswell as the revision of the manuscript. We are grateful to the staff of theParasitology Department of the Public Health Laboratory Ivo de Carneri on PembaIsland whose dedication and enthusiasm made this study possible. We acknowledge thedonation of placebo and mebendazole by Pharmamed (Malta), and of pyrantel-oxantel byPfizer (Indonesia). This study was generously supported by the Parasitic and VectorControl, Division of Communicable Diseases, World Health Organization.

Pyrantel was initially described in 1965 by researchers from Pfizer who sought cyclic amidines with suitable pharmacokinetic properties (specifically, duration of action) for use as an anthelmintic drug. Pyrantel is mainly available in formulations for dogs and cats as the embonate salt, containing a 34.7% pyrantel base 14.

Pyrantel is available in various formulations for humans, dogs, and cats as the pamoate (US Pharmacopeia nomenclature) or embonate (European Pharmacopoeia nomenclature) salt, which contains 34.7% pyrantel base combined with pamoic acid 8. 14, 4.

By promoting the release of acetylcholine, inhibiting cholinesterase, and stimulating ganglionic neurons, pyrantel serves as a depolarizing neuromuscular blocking agent in helminths. This causes extensive depolarization of the helminth muscle membrane, resulting in tension to the helminth's muscles, leading to paralysis and release of their attachment to the host organism intestinal walls 8.

Pyrantel is administered orally.The poor solubility of the pamoate salt offers the advantage of reduced absorption from the gastrointestinal


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