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Prazinec

Prazinec (praziquantel 600 mg, Sun Pharma) — WHO essential medicine for schistosomiasis, intestinal and liver flukes, and most cestodes. Standard 40 mg/kg single dose for schistosomiasis.

Medisinsk vurdert av Morgan Ellis — Farmasøytisk forsker · 8 års erfaring  · Sist gjennomgått: mai 2026

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Quick Answer — What is Prazinec?

Prazinec is praziquantel 600 mg fra Sun Pharma. Praziquantel is the WHO Essential Medicine for schistosomiasis, intestinal flukes, liver flukes, and most cestodes including neurocysticercosis. Standard adult dose for schistosomiasis: 40 mg/kg as a single dose; for tapeworm: 5–10 mg/kg single dose; for neurocysticercosis: 50 mg/kg/day in 3 divided doses for 14–30 days under specialist supervision.

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What is Prazinec?

Prazinec is praziquantel 600 mg from Sun Pharma. Praziquantel is one of the most important drugs in tropical medicine — the global standard for schistosomiasis (which affects roughly 240 million people worldwide), and the agent of choice for most cestode and trematode infections. WHO mass-drug-administration programmes have used praziquantel to treat over a billion people since the 1990s.

Mekanisme for virkning

Praziquantel increases calcium permeability across the parasite tegument (outer covering), causing rapid sustained muscle contraction. This paralyses the worm and exposes its surface antigens to host immune attack — a one-two punch of pharmacological paralysis followed by immune-mediated killing. The mechanism explains why praziquantel works so well in immunocompetent patients and is somewhat less effective in heavily immunosuppressed hosts.

Oral bioavailability is good (~80%) but first-pass hepatic metabolism is heavy — only about 25% reaches systemic circulation as active drug. Plasma half-life is 1–1.5 hours.

Prazinec indications and dose

IndikasjonDoseSchedule
Schistosomiasis (S. mansoni, S. haematobium, S. japonicum)40 mg/kgSingle dose (S. japonicum: 60 mg/kg)
Intestinal tapeworm (Taenia saginata, T. solium)5–10 mg/kgSingle dose
Hymenolepis nana25 mg/kgSingle dose, repeat at 1 week
Liver flukes (Clonorchis, Opisthorchis)25 mg/kg TIDFor 1 day (75 mg/kg total)
Lung fluke (Paragonimus)25 mg/kg TIDFor 2 days
Neurocysticercosis (specialist)50 mg/kg/day in 3 dosesFor 14–30 days WITH steroid cover

Take with water or a soft drink during or shortly after a meal. Tablets have a bitter taste — do not chew. Children > 4 years: same weight-based dosing applies.

Neurocysticercosis is a specialist diagnosis. Praziquantel for CNS cysticercosis must be given with concurrent corticosteroid (typically dexamethasone) to suppress the inflammatory response to dying cysts — otherwise raised intracranial pressure can be catastrophic. Imaging (MRI brain) is mandatory before treatment. Do not self-treat suspected neurocysticercosis.

Bivirkninger

  • Vanlig: abdominal discomfort, nausea, malaise, headache, dizziness, drowsiness — usually within first 24 hours, often related to dying parasites rather than the drug
  • Mindre vanlige: urticaria, fever, transient eosinophilia rebound
  • Sjeldne: bradycardia, transient transaminase rise
  • Neurocysticercosis-specific: headache, seizures, raised intracranial pressure as cysts die — the reason for steroid cover

Legemiddelinteraksjoner

  • Strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, phenobarbital) — reduce praziquantel levels significantly; avoid combination or use alternative
  • Sterke CYP3A4-hemmere (ketoconazole, ritonavir, cimetidine) — raise levels; reduce dose if combination unavoidable
  • Dexamethasone — reduces praziquantel levels by ~50%, but the combination is still required for neurocysticercosis (clinical effect retained)
  • Chloroquine — reduces praziquantel levels modestly
  • Grapefruktjuice — raises levels; avoid during treatment
Graviditet og amming. Albendazol og mebendazol anbefales IKKE i første trimester (data om teratogenitet fra dyreforsøk). Bruk er akseptabelt i 2./3. trimester ved moderat til tung ormebyrde. Data om ivermectin under graviditet er begrenset, men tilfredsstillende i WHOs massebehandlingsprogrammer; unngå i første trimester der alternativer finnes. Praziquantel og pyrantel er kompatible med graviditet.

Kontraindikasjoner

  • Hypersensitivity to praziquantel
  • Ocular cysticercosis — treatment can destroy the eye; specialist surgical assessment first
  • Children < 4 years — safety not established
  • Severe hepatic impairment

Oppbevaring

Store Prazinec below 30°C in the original blister, protect from light and moisture.

Hvorfor bestille fra MedsBase

Prazinec is supplied from a WHO-GMP-sertifisert produsent, diskré pakket og sendt over hele verden. Hver bestilling er dekket av vår Reshipment Assurance Policy — du tar aldri kostnaden for en tapt pakke.

Vanlige spørsmål

How quickly does Prazinec work?

Schistosomes and most flukes are paralysed within hours. Egg shedding stops over the following 1–2 weeks. For schistosomiasis, urine or stool testing at 4–6 weeks confirms cure.

Why take Prazinec with food?

Food increases bioavailability roughly 2-fold. For most indications this is helpful. Do not chew — the bitter taste is intense.

Will I see worms in my stool after?

For tapeworm, expect partial passage of fragmented proglottids over the days following the dose — the worm is partly digested by host enzymes after praziquantel has done its job. For schistosomiasis the eggs are microscopic; you won’t see worms.

Is Prazinec safe in pregnancy?

WHO endorses praziquantel use in pregnancy where infection is symptomatic or the worm burden is significant. The first trimester is preferred to be avoided where alternatives exist. Consult a clinician for individualised guidance.

Can children take Prazinec?

Yes from age 4 with the same weight-based dosing as adults. WHO mass-drug-administration programmes routinely treat school-age children for schistosomiasis with single-dose praziquantel.

What if I have neurocysticercosis?

Treatment requires neurology supervision. MRI imaging, concurrent dexamethasone, and (for ocular involvement) ophthalmology assessment are mandatory. Self-treatment can be catastrophic — the brain inflammation from dying cysts can cause raised intracranial pressure.

Does praziquantel treat ascaris or pinworm?

No. Praziquantel covers cestodes (tapeworms) and trematodes (flukes including schistosoma). For nematodes (ascaris, pinworm, hookworm, whipworm) use albendazole or mebendazole.

Can I drink alcohol after the dose?

Avoid alcohol on the day of treatment — it amplifies the dizziness and drowsiness common in the first 24 hours.

Why might Prazinec fail?

Most common reasons: under-dosing (especially in heavy patients), reinfection from continued exposure (re-entering schistosomiasis-endemic water bodies), or co-administration with strong CYP3A4 inducers (rifampicin, anticonvulsants) that reduce drug levels.

Should I retest after treatment?

For schistosomiasis, retest with urine or stool at 4–6 weeks. For intestinal tapeworm, retest at 1 and 3 months. For neurocysticercosis, repeat MRI at 3–6 months under specialist guidance.

Andre antiparasittære legemidler

Medisinsk ansvarsfraskrivelse. Denne siden er kun til informasjonsformål og erstatter ikke profesjonell medisinsk rådgivning. Snakk med en kvalifisert lege før du starter med noen antihelmintisk behandling, spesielt hvis du er gravid eller ammer, har nedsatt immunforsvar, skal behandle et barn under 2 år, eller hvis symptomene vedvarer etter en behandlingsperiode. Eosinofili, vekttap, vedvarende magesmerter eller reiserelaterte symptomer krever klinisk vurdering. Alvorlige parasittiske sykdommer (neurocysticerkose, strongyloides hyperinfeksjon, schistosomiasis med organskade) håndteres av spesialister.

Flere alternativer i behandling av orm

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