Piperazine
Contraindicated
Textbook
Antagonistic effect, reducing efficacy.
Should not be used concomitantly.
Source: Harrison 22e · p1751
Drug reference
pyrantel pamoate
Tetrahydropyrimidine analogue · Anthelmintic
Tetrahydropyrimidine analogueAnthelmintic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
1 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactions
- PiperazineContraindicatedTextbookHarrison 22e · p1751
Mechanism
Pyrantel pamoate is a depolarizing neuromuscular blocking agent. It opens nonselective cation channels and induces persistent activation of nicotinic acetylcholine receptors, specifically the L type, leading to spastic paralysis of the worm. It also inhibits cholinesterases.
Indications
ascariasisenterobiasishookworm infections caused by A. duodenale and N. americanusmixed infections with T. trichiurapinworm infectionsPin worm (Enterobius)Roundworm (Ascaris)Hookworm (Ancylostoma, Necator)
Dosing
- Adult
- Ascaris, Ancylostoma and Enterobius: single dose of 10 mg/kg. Necator and for Strongyloides: a 3 day course has been suggested.
Pharmacokinetics
Bioavailability
Only 10–15% of an oral dose is absorbed.
Metabolism
Poorly absorbed from the GI tract.
Excretion
Less than 15% excreted in urine as parent drug and metabolites; major proportion recovered in feces.
Contraindications
- Safety in pregnant women not established
- Safety in children below 2 years not established
Side effects
Common
transient GI symptomsheadachedizzinessrashfeverG.i. symptoms (occasional)
Drug interactions
Related guidelines
Other Tetrahydropyrimidine analogue drugs
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Sources: KD Tripathi 7e, Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team