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Levamisole

Anthelmintic · Antiparasitic, Adjuvant cancer therapy

Also known as ERGAMISOL, Levamisole hydrochloride

AnthelminticAntiparasitic, Adjuvant cancer therapy
CDSCO approved
EXCRETION
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Manufacturer advises avoid—toxicity in animal studies.
FDA category + note
Top interactionssee all 12
  • AdalimumabSevereDatabaseDDInter
  • BaricitinibSevereDatabaseDDInter
  • CertolizumabSevereDatabaseDDInter
  • CladribineSevereDatabaseDDInter

Mechanism

Levamisole was synthesized as an anthelmintic. It functions as an immunostimulant by restoring depressed immune function of B lymphocytes, T lymphocytes, monocytes, and macrophages.

Indications

Roundworm infectionsAdjuvant therapy with 5-fluorouracil after surgical resection in patients with Dukes’ stage C colon cancerAscaris lumbricoidesAscariasisAncylostomiasis (second line drug)Restores depressed T cell function (immunomodulator)

Dosing

Adult
Roundworm infections: 120–150 mg for 1 dose. If reinfection occurs, a second dose of 100 mg may be needed after 2 weeks.
Pediatric
Child 2–17 years: 100 mg for 1 dose. If reinfection occurs, a second dose may be needed after 2 weeks.
Max dose
150 mg (single dose)

Pharmacokinetics

Onset
Quickly absorbed from the GI tract; CPmax levels reached within 2 h.
Half-life
Approximately 4 h
Metabolism
Extensively metabolized in the liver.

Contraindications

  • Children under 2 years
  • Pregnancy (due to toxicity in animal studies)
  • Risk of fatal agranulocytosis

Side effects

Common
Gastrointestinal discomfortDiarrhoeaFlatulencenauseavomitingheadachedizzinessabdominal painGiddinessFatigueDrowsinessInsomnia
Serious
  • Alopecia
  • Dizziness
  • Hepatitis
  • Neutropenia
  • Seizure
  • Severe cutaneous adverse reactions (SCARs)
  • Skin reactions
  • Fatal agranulocytosis
  • agranulocytosis
  • vasculitis
  • skin necrosis
  • arthralgia

Pregnancy & lactation

Pregnancy

Manufacturer advises avoid—toxicity in animal studies.

Lactation

Amount present in milk too small to be harmful but manufacturer advises avoid.

Drug interactions

Adalimumab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Baricitinib
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Certolizumab
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Cladribine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Clozapine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Deferiprone
Severe
Database

Clinical effect not specified

Source: DDInter

Etanercept
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Fingolimod
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Golimumab
Severe
Database

Clinical effect not specified

Source: DDInter

Infliximab
Severe
Database

Clinical effect not specified

Source: DDInter

Leflunomide
Severe
Database

Clinical effect not specified

Source: DDInter

Measles Virus Vaccine Live Attenuated
Severe
Database

Clinical effect not specified

Source: DDInter

Related guidelines

Other Anthelmintic drugs

Ask House about Levamisole

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, BNF·Verified: 2026-05-10 · House clinical team