Which medications in the drug class Anthelmintics are used in the treatment of Schistosomiasis (Bilharzia)?

Updated: Sep 20, 2018
  • Author: Shadab Hussain Ahmed, MD, AAHIVS, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Anthelmintics

Parasite biochemical pathways are sufficiently different from the human host to allow selective interference by chemotherapeutic agents in relatively small doses.

Praziquantel (Biltricide)

Praziquantel is usually well tolerated. It is used for the treatment of individual patients and for mass community treatment programs. The drug's mechanism of action is complex; it induces ultrastructural changes resulting in increased permeability to calcium ions. Calcium ions accumulate in the parasite cytosol, leading to muscle contractions and ultimate paralysis of adult worms. The worm's tegument membrane (the natural covering of the worm body) is damaged, exposing the worm to the patient's immune response, which leads to worm death. The cure rate with praziquantel is 85% or greater. In persons not cured, the egg burden is markedly decreased.

Oxamniquine (Vansil)

Oxamniquine is no longer available in the United States. Its mechanism of action is complex. The drug is metabolized into an ester by schistosomes. It damages the tegument of male schistosome worms so that the patient's immune system is able to kill the organisms. It also stops female worms from producing eggs. Oxamniquine is effective only against S mansoni. The cure rate with the drug is 60-90%.


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