triclabendazole

Contraindicated in:

Hypersensitivity to triclabendazole and/or to other benzimidazole derivatives.

Use Cautiously in:

QT interval prolongation or concurrent use of QT interval prolonging medications;
Electrolyte abnormalities (especially hypokalemia and hypomagnesemia);
Hepatic impairment;
OB: Safety not established in pregnancy;
Lactation: Use while breastfeeding only if potential maternal benefit justifies potential risk to infant;
Pedi: Children <6 yr (safety and efficacy not established).

Adv. Reactions/Side Effects ⬆ ⬇

CV: chest pain, QT interval prolongation

Derm: ↑sweating, urticaria, pruritus

EENT: vertigo

GI: ↑liver enzymes, abdominal pain, nausea, diarrhea, jaundice, vomiting

Metab: ↓appetite

Neuro: headache

Resp: cough, dyspnea

Misc: fever

Interactions ⬆ ⬇

Drug-drug:

QT interval prolonging medications may ↑ risk of QT interval prolongation and torsades de pointes.
CYP1A2 inhibitors may ↑ levels and the risk of QT interval prolongation.
May ↑ levels and risk of toxicity of CYP2C9 substrates.

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇

PO (Adults and Children ≥6 yr): 10 mg/kg every 12 hr for a total of 2 doses.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Inhibits tubulin function as well as protein and enzyme synthesis, resulting in inhibition of motility and disruption of cell structure.

Therapeutic effects:

Death of affected larval form of susceptible parasites.

Spectrum:

Fasciola hepatica (liver fluke).
Fasciola gigantica.

Classifications ⬆ ⬇

Therapeutic Classification: anthelmintics

Pharmacokinetics ⬆ ⬇

Absorption: Absorption ↑ with food.

Distribution: Not widely distributed to tissues.

Protein Binding: Triclabendazole: 96.7%; Sulfoxide metabolite: 98.4%; Sulfone metabolite: 98.8%.

Metabolism/Excretion: Primarily metabolized by CYP1A2 isoenzyme into sulfoxide metabolite (active), which is then primarily metabolized by CYP2C9 isoenzyme into sulfone metabolite (active). Excretion information not available for humans.

Half-Life: Triclabendazole: 8 hr; Sulfoxide metabolite: 14 hr; Sulfone metabolite: 11 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	3–4 hr	12 hr

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Advise to take as directed. If missed dose, take as soon as remembered. Do not take two doses at the same time. Emphasize the importance of follow-up testing to confirm eradication of the infection.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Advise patient to report severe side effects such as persistent abdominal pain, yellowing of skin/eyes, or allergic reactions.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇