The Medical Letter

Page 1 of 2 HOOKWORM infection (Ancylostoma duodenale, Necator americanus) Drug Adult dosage Pediatric dosage Drug of choice: Albendazole1,2 400 mg PO once 400 mg PO once OR Mebendazole 100 mg PO bid x 3d or 500 mg 100 mg PO bid x 3d or 500 mg once once OR Pyrantel pamoate1,3* 11 mg/kg (max. 1g) PO x 3d 11 mg/kg (max. 1g) PO x 3d * Availability problems. See table below. 1. Not FDA-approved for this indication. 2. Albendazole must be taken with food; a fatty meal increases oral bioavailability. 3. Pyrantel pamoate suspension can be mixed with milk or fruit juice.

Information provided by The Medical Letter. For a copy of the entire Drugs for Parasitic Infections article, go to: www.medicalletter.org/parasitic_cdc

MANUFACTURERS OF DRUGS USED TO TREAT PARASITIC INFECTIONS albendazole – Albenza (GlaxoSmithKline) Malarone (GlaxoSmithKline) – Albenza (GlaxoSmithKline) – albendazole atovaquone/proguanil Alinia (Romark) – nitazoxanide malathion – Ovide (Medicis) AmBisome (Gilead) – amphotericin B, liposomal mebendazole – Vermox (McNeil), others amphotericin B – Fungizone (Apothecon), others mefloquine – Lariam (Roche) amphotericin B, liposomal – AmBisome (Gilead) § meglumine antimonate – Glucantime (Aventis, Ancobon (Valeant) – flucytosine France) § Antiminth (Pfizer) – pyrantel pamoate † melarsoprol – Mel-B • Aralen (Sanofi) – chloroquine HCl and chloroquine † Mel-B – melarsoprol phosphate Mepron (GlaxoSmithKline) – atovaquone § artemether – Artenam (Arenco, Belgium) metronidazole – Flagyl (Pfizer), others § artemether/lumefantrine – Coartem, Riamet § miconazole – Monistat i.v. (Novartis) § miltefosine – Impavido (Zentaris, Germany) § Artenam (Arenco, Belgium) – artemether § Monistat i.v. – miconazole § artesunate – (Guilin No. 1 Factory, People’s NebuPent (Fujisawa) – pentamidine isethionate Republic of China) § niclosamide – Yomesan (Bayer, Germany) atovaquone – Mepron (GlaxoSmithKline) † nifurtimox – Lampit (Bayer, Germany) atovaquone/proguanil – Malarone nitazoxanide – Alinia (Romark) (GlaxoSmithKline) Nix (GlaxoSmithKline) – permethrin azithromycin – Zithromax (Pfizer), others • Nizoral (Janssen) – ketoconazole • Bactrim (Roche) – TMP/Sulfa § ornidazole – Tiberal (Roche, France) § benznidazole – Rochagan (Brazil) Ornidyl (Aventis) – eflornithine • Biaxin (Abbott) – clarithromycin (Difluoromethylornithine, DFMO) § Biltricide (Bayer) – praziquantel Ovide (Medicis) – malathion † bithionol – Bitin (Tanabe, Japan) § oxamniquine – Vansil (Pfizer) † Bitin (Tanabe, Japan) – bithionol § Paludrine (AstraZeneca, United Kingdom) – proguanil § Brolene (Aventis, Canada) – propamidine paromomycin – Humatin (Monarch); Leshcutan isethionate (Teva, Israel; topical formulation not available chloroquine HCl and chloroquine phosphate – in US) Aralen (Sanofi), others Pentam 300 (Fujisawa) – pentamidine isethionate clarithromycin – Biaxin (Abbott), others pentamidine isethionate – Pentam 300 (Fujisawa), • Cleocin (Pfizer) – clindamycin NebuPent (Fujisawa) clindamycin – Cleocin (Pfizer), others † Pentostam (GlaxoSmithKline, United Kingdom) – Coartem (Novartis) – artemether/lumefantrine sodium stibogluconate crotamiton – Eurax (Westwood-Squibb) permethrin – Nix (GlaxoSmithKline), Elimite dapsone – (Jacobus) (Allergan) § Daraprim (GlaxoSmithKline) – pyrimethamine USP § praziquantel – Biltricide (Bayer) † diethylcarbamazine citrate (DEC) – Hetrazan primaquine phosphate USP • Diflucan (Pfizer) – fluconazole § proguanil – Paludrine (AstraZeneca, United Kingdom) § diloxanide furoate – Furamide (Boots, United proguanil/atovaquone – Malarone Kingdom) (GlaxoSmithKline) doxycycline – Vibramycin (Pfizer), others § propamidine isethionate – Brolene (Aventis, eflornithine (Difluoromethylornithine, DFMO) – Canada) Ornidyl (Aventis) § pyrantel pamoate – Antiminth (Pfizer) § Egaten (Novartis) – triclabendazole pyrethrins and piperonyl butoxide – RID (Pfizer), Elimite (Allergan) – permethrin others Ergamisol (Janssen) – levamisole § pyrimethamine USP – Daraprim (GlaxoSmithKline) Eurax (Westwood-Squibb) – crotamiton Qualaquin – quinine sulfate (Mutual Pharmaceutical • Flagyl (Pfizer) – metronidazole Co/AR Scientific) § Flisint (Sanofi-Aventis, France) – fumagillin quinacrine fluconazole – Diflucan (Pfizer), others * quinidine gluconate (Eli Lilly) flucytosine – Ancobon (Valeant) § quinine dihydrochloride § fumagillin – Flisint (Sanofi-Aventis, France) quinine sulfate – Qualaquin (Mutual Pharmaceutical • Fungizone (Apothecon) – amphotericin Co/AR Scientific) § Furamide (Boots, United Kingdom) – diloxanide Riamet (Novartis) – artemether/lumefantrine furoate • RID (Pfizer) – pyrethrins and piperonyl butoxide § furazolidone – Furozone (Roberts) • Rifadin (Aventis) – rifampin § Furozone (Roberts) – furazolidone rifampin – Rifadin (Aventis), others † Germanin (Bayer, Germany) – suramin sodium § Rochagan (Brazil) – benznidazole § Glucantime (Aventis, France) – meglumine * Rovamycine (Aventis) – spiramycin antimonate † sodium stibogluconate – Pentostam † Hetrazan – diethylcarbamazine citrate (DEC) (GlaxoSmithKline, United Kingdom) Humatin (Monarch) – paromomycin * spiramycin – Rovamycine (Aventis) § Impavido (Zentaris, Germany) – miltefosine • Sporanox (Janssen-Ortho) – itraconazole iodoquinol – Yodoxin (Glenwood), others Stromectol (Merck) – ivermectin itraconazole – Sporanox (Janssen-Ortho), others sulfadiazine – (Eon) ivermectin – Stromectol (Merck) † suramin sodium – Germanin (Bayer, Germany) ketoconazole – Nizoral (Janssen), others § Tiberal (Roche, France) – ornidazole † Lampit (Bayer, Germany) – nifurtimox Tindamax (Mission) – tinidazole Lariam (Roche) – mefloquine tinidazole – Tindamax (Mission) § Leshcutan (Teva, Israel) – topical paromomycin TMP/Sulfa – Bactrim (Roche), others levamisole – Ergamisol (Janssen) § triclabendazole – Egaten (Novartis) lumefantrine/artemether – Coartem, Riamet § Vansil (Pfizer) – oxamniquine (Novartis) (continued) Page 2 of 2 • Vermox (McNeil) – mebendazole § Yomesan (Bayer, Germany) – niclosamide • Vibramycin (Pfizer) – doxycycline • Zithromax (Pfizer) – azithromycin • Yodoxin (Glenwood) – iodoquinol

* Available in the US only from the manufacturer. § Not available commercially. It may be obtained through compounding pharmacies such as Panorama Compounding Pharmacy, 6744 Balboa Blvd, Van Nuys, CA 91406 (800-247-9767) or Medical Center Pharmacy, New Haven, CT (203-688-6816). Other com- pounding pharmacies may be found through the National Association of Compounding Pharmacies (800-687-7850) or the Professional Compounding Centers of America (800-331-2498, www.pccarx.com). † Available from the CDC Drug Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333; 404-639-3670 (evenings, weekends, or holidays: 770-488-7100). • Also available generically.

Information provided by The Medical Letter. For a copy of the entire Drugs for Parasitic Infections article, go to: www.medicalletter.org/parasitic_cdc