Clinical Overview of Fasciolopsis

Key points

  • Fasciolopsis infections are treatable with medication.
  • Treatment is safe and effective.

Treatment and recovery

Drug

Dosage

Directions

Praziquantel*

Adults and children: 75 mg/kg orally in three divided doses for one day.

Take with liquids during a meal.

*Oral praziquantel is available for human use in the United States. Not FDA approved for this indication.

Care precautions

Praziquantel

Treatment in Pregnancy

Praziquantel is a pregnancy category B drug. There are no adequate and well-controlled studies in pregnant women. However, the available evidence suggests no difference in adverse birth outcomes in the children of women who were accidentally treated with praziquantel during mass drug administration (MDA) campaigns compared with those who were not. In MDA campaigns for which the World Health Organization (WHO) has determined that the benefit of treatment outweighs the risk, WHO encourages the use of praziquantel in any stage of pregnancy. For individual patients in clinical settings, healthcare providers should consider the risk of treatment in infected pregnant women with the risk of disease progression in the absence of treatment.

Pregnancy Category B: Either animal-reproduction studies have not demonstrated a fetal risk plus there are no controlled studies in pregnant women, or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the first trimester (and there is no evidence of a risk in later trimesters).

Treatment During Lactation

Praziquantel is excreted in low concentrations in breast milk. According to WHO guidelines for MDA campaigns, the use of praziquantel during lactation is encouraged. For individual patients in clinical settings, healthcare providers should consider the risk of treatment in infected breastfeeding women with the risk of disease progression in the absence of treatment.

Treatment in Pediatric Patients

The safety of praziquantel in children aged less than 4 years has not been established. WHO now recommends treating children at least 2 years of age with praziquantel during MDA campaigns for schistosomiasis control, citing evidence that praziquantel is safe in this age group. For individual patients in clinical settings, healthcare providers should consider the risk of treatment in children younger than 4 years old with the risk of disease progression in the absence of treatment.