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piperazine

Anthelmintic

Anthelmintic
CDSCO approved
EXCRETION
not curated
INTERACTIONS
5 major
incl. contraindicated
PREGNANCY
not curated
Top interactionssee all 6
  • Pyrantel PamoateContraindicatedTextbookHarrison 22e · p1751
  • BupropionSevereDatabaseDDInter
  • IohexolSevereDatabaseDDInter
  • IopamidolSevereDatabaseDDInter

Mechanism

Causes hyperpolarization of Ascaris muscle by a GABA agonistic action. Opening of Cl¯ channels causes relaxation and depresses responsiveness to contractile action of ACh, leading to flaccid paralysis and expulsion of live worms.

Indications

Ascaris (Roundworm)Enterobius (Pin worm)Intestinal obstruction due to roundwormsPregnancy (safe to use)

Dosing

Adult
Roundworm: 4 g once a day for 2 consecutive days. Pin worm: 50 mg/kg (max. 2 g) once a day for 7 days OR 75 mg/kg (max. 4 g) single dose, repeated after 3 weeks.
Pediatric
Roundworm: 0.75 g/year of age (max. 4 g).

Pharmacokinetics

Bioavailability
A considerable fraction of the oral dose is absorbed.
Metabolism
Partly metabolized in liver.
Excretion
Excreted in urine.

Contraindications

  • Renal insufficiency
  • Epileptics

Side effects

Common
NauseaVomitingAbdominal discomfortUrticaria
Serious
  • Dizziness (at high doses)
  • Excitement (at high doses)
  • Convulsions (toxic doses)
  • Respiratory failure (toxic doses)

Drug interactions

Pyrantel Pamoate
Contraindicated
Textbook

Antagonistic effect, reducing efficacy.

Should not be used concomitantly.

Source: Harrison 22e · p1751

Bupropion
Severe
Database

Drug interaction classified as: metabolism

Source: DDInter

Iohexol
Severe
Database

Clinical effect not specified

Source: DDInter

Iopamidol
Severe
Database

Clinical effect not specified

Source: DDInter

Tramadol
Severe
Database

Clinical effect not specified

Source: DDInter

Pyrantel
Moderate
Textbook

Reduced efficacy of pyrantel against worms.

Avoid concomitant use.

Source: KDT 7e · p852

6 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Unclassified drugs

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Sources: KD Tripathi 7e·Verified: 2026-05-10 · House clinical team