Section 15 · Monograph
Praziquantel
Reviewed Nov 2026FDA label
BiltricideAnthelmintic
- Forms
- Tab: 600mg
- Dose
- Neurocysticercosis with multiple viable cysts: 50mg/kg/day divided three times daily x14 days, combined with albendazole
- MOA
- Increases parasite calcium permeability, causing tetanic paralysis
Indications
- Schistosomiasis and liver fluke infectionsFDA-labeled
Off-Label Uses
- Neurocysticercosis (combined with albendazole)Off-label
Mechanism of Action
- Increases membrane permeability to calcium in the parasite, causing tetanic contraction, paralysis and tegument damage
Full Dosing
Adult / usual
- Neurocysticercosis with multiple viable cysts (off-label): 50mg/kg/day divided three times daily for 14 days with albendazole
- Take with meals; do not chew tablets
- Corticosteroids and antiseizure drugs are given alongside
Contraindications
- Ocular cysticercosis (inflammation from dying parasites may cause irreversible eye damage)
- Concomitant rifampin or other strong CYP inducers
- Hypersensitivity to praziquantel
Drug Interactions
- Rifampin, carbamazepine, phenytoin, phenobarbital and dexamethasone lower levels
- Cimetidine and azole antifungals raise levels
Adverse Effects
- Dizziness, headache, drowsiness
- Abdominal discomfort and nausea
- Seizures and neurologic worsening from dying cysts
- Urticaria
Monitoring Parameters
- Fundoscopic exam before therapy
- Seizure control and neurologic status
- Imaging response
Pregnancy & Lactation
- Limited data; used when benefit justifies risk
- Avoid breastfeeding on treatment day and for 72 hours after