Page 1 of 2 ENTEROBIUS vermicularis (pinworm) infection Drug Adult dosage Pediatric dosage Drug of choice:1 Mebendazole 100 mg PO once; repeat in 2wks 100 mg PO once; repeat in 2wks OR Pyrantel pamoate2* 11 mg/kg base PO once (max. 1 g); 11 mg/kg base PO once repeat in 2wks (max. 1 g); repeat in 2wks OR Albendazole3,4 400 mg PO once; repeat in 2wks 400 mg PO once; repeat in 2wks * Availability problems. See table below. 1. Since family members are usually infected, treatment of the entire household is recommended. 2. Pyrantel pamoate suspension can be mixed with milk or fruit juice. 3. Not FDA-approved for this indication. 4. Albendazole must be taken with food; a fatty meal increases oral bioavailability.

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

* 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