Praziquantel: Effective Treatment for Tapeworm Infections

Praziquantel is the drug of choice for most intestinal tapeworm (cestode) infections.

Mechanism

Causes rapid vacuolization and disintegration of the tegument, exposing antigens → immune attack. Induces spastic paralysis → detachment from intestinal wall.

Indications & Dosing

Infection	Species	Dose
Taeniasis	T. solium (pork), T. saginata (beef), T. asiatica	5–10 mg/kg single dose
Neurocysticercosis	T. solium larvae in CNS	50 mg/kg/day × 15 days (with steroids)
Hymenolepiasis	H. nana, H. diminuta	25 mg/kg single dose (repeat in 2 wks)
Diphyllobothriasis	D. latum (fish tapeworm)	10–25 mg/kg single dose

Safety

• Well-tolerated; side effects: dizziness, headache, abdominal pain, nausea (often from dying parasites).
• Contraindicated in ocular cysticercosis (risk of inflammatory vision loss).
• Pregnancy: Category B; used if benefit > risk.