Antihelminthic drugs for humans with a wide spectrum of action

Antihelminthic drugs allow you to quickly get rid of parasites that have settled in the body. When used correctly, modern medicines are relatively safe for humans. Due to the wide spectrum of action, the same agent can affect different types of helminths.

The principle and mechanism of action of antihelminthic drugs

The main principle of action of an anthelmintic agent is to deprive the parasite of important vital functions and expel it from the body. Each drug has a specific type of effect on helminths.

Once in the intestines, it infects the body of the worm in one of the following ways:

• Causes neuromuscular blockade of the parasite. The body of the worm is paralyzed, which is why it is not able to attach to the intestinal wall and is excreted due to intestinal peristalsis.
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• It inhibits the formation of tubulin, a protein that is part of the cellular structures of the intestinal canal of the worm.
• Violates the utilization of glucose by the cells of the parasite. Since glucose is involved in the synthesis of ATP, the helminth is deprived of its main source of energy, weakens and dies.
• It has a complex effect: it paralyzes the muscles of the worm and at the same time disrupts the processes of its cellular metabolism.

As a result, helminths become inactive or completely die, and then, together with feces, are excreted from the intestines.

Compositions of broad-spectrum anthelminthic drugs for humans

Antihelminthic drugs for humans with a wide spectrum of action contain active ingredients that are effective against helminths of various types.

The following substances are used as active components of modern anthelmintic drugs:

• levamisole (Decaris);
• mebendazole (Vermox, Wormin);
• albendazole (Nemozole, Vormil);
• piperazine adepat (piperazine);
• pyrantel pamoat (Pirantel, Helmintox).

Indications for use

Antihelminthic drugs of a wide spectrum of action are used to treat various types of helminthiases - diseases dangerous to humans caused by infection with parasitic worms. Among them, nematodes and cestodoses are distinguished.

Roundworms are the causative agents of nematodes.

The most common ones are:

• pinworms (enterobiasis);
• roundworm (ascariasis);
• whipworm (trichocephalosis).

Less common:

• intestinal acne (strongyloidosis);
• hookworms (hookworms);
• toxocara canis (toxocariasis);
• trichinella (trichinosis);
• gnatostomy (gnatostomosis).

Pinworms are parasites in the large intestine. The whipworm also lives there. When the worm gets to its favorite place - the cecum - appendicitis develops.

Roundworms at different stages of their development can settle not only in the intestines. Their larvae are found in the liver, brain, lungs, heart and even in the nasopharynx.

Infection with intestinal acne is dangerous for people with reduced immunity. The disease manifests itself as loose, watery stools, skin rashes, and abdominal pain.

Toxocars affect the intestines. Migrating throughout the body in larval form, they form granulomas in various organs. Most often, the lungs are affected - then a person develops a painful cough and eyes.

Trichinosis is manifested by edema on the face, skin rash, fever, and muscle pain. In advanced cases, damage to the central nervous system (CNS) is possible. Lumps under the skin and dermatitis are a clear sign of infection with gnatostomas. Hookworms live in the duodenum, feed on blood.

The infected person suffers from:

• iron deficiency anemia;
• weakness;
• weight loss;
• diarrhea.

A variety of worms, common in the countries of the American continent, causes non-kotorosis, in which diarrhea and allergic reactions become the leading symptom.

Cestodoses cause tapeworms:

• pork tapeworm, tapeworm (teniasis);
• echinococcus, or canine tapeworm (echinococcosis);
• wide tapeworm (diphyllobothriasis).

With teniasis, the upper part of the small intestine is affected. Its digestive functions are impaired; cholecystitis, pancreatitis develop. Of particular danger is cysticercosis, in which tapeworm larvae settle in human tissues, including the brain.

Echinococcosis is characterized by the formation of larval cysts - large bubbles filled with liquid. Cysts are predominantly localized in the lungs and liver. Sexually mature helminths live in the intestines.

Adults of the broad tapeworm settle in the small intestine, which causes dyspeptic disorders and anemia. Some drugs destroy not only helminths, but also intestinal parasites of the protozoan genus - lamblia.

The versatility of anthelmintics of this group makes them indispensable in the treatment of mixed invasions, when several types of parasites infect the human body at once.

Contraindications

There are general contraindications that apply to most anthelmintic drugs.

These include:

• pregnancy and lactation;
• intolerance to the components of the drug;
• severe liver disease.

Each drug has its own additional restrictions for use, which are indicated in the instructions.

Side effects

Antihelminthic drugs for humans with a wide spectrum of action show good therapeutic activity, but its downside is some side effects.

In most cases, they are expressed by disorders of the gastrointestinal tract: diarrhea, nausea, vomiting, pain in the epigastric region. There is a temporary increase in "liver" enzymes, hematopoiesis functions suffer, and allergic reactions develop.

With massive infection, when a large number of worms die, toxicosis is possible. If the parasite that is in the brain dies (for example, in the treatment of neurocysticercosis), inflammatory reactions develop: intracranial pressure increases, convulsions appear.

There are disorders of the nervous system: headache, weakness, palpitations.

Overdose

When taking large doses of the drug or with long-term treatment, the toxic effect of the anthelmintic agent on the body increases. The development of hepatitis is possible, the content of neutrophils in the blood decreases.

To reduce the severity of the consequences, you must stop taking the medication. If the drug is in the stomach, induce vomiting or gastric lavage; take enterosorbents (activated carbon).

Precautions and special instructions

To avoid complications in anthelmintic therapy, you must strictly follow the instructions supplied by the manufacturer to the medicine. It indicates what exactly needs to be considered when taking the drug.

For example, mebendazole preparations (Vermox and Wormin) reduce the need for glucose in patients with diabetes mellitus.

Means based on levamisole (Decaris) cannot be used simultaneously with drugs that affect hematopoiesis. Drinking alcohol during the day before and after taking the medication should be discontinued due to the risk of severe intoxication, which is called a disulfiram-like reaction.

Most drugs can cause dizziness, so be careful when driving.

Drug instructions often indicate that lipophilic substances increase the toxicity of the drug. This means that when fatty foods are taken, the flow of active substances into the bloodstream of the drug increases, and its bioavailability increases. For example, albendazole is hardly absorbed by the intestinal walls. However, when you eat food rich in fat, its absorption is increased by 5 times, which increases the number of side effects.

The best antihelminthic drugs, instructions and prices

Anthelmintic drugs for humans with a wide spectrum of action cope with most common helminthiases and mixed invasions. The best of them differ not only in efficiency, but also in the absence of serious consequences for the body - they are prescribed for children and pregnant women.

Nemozole

Indian drug; produced by the pharmaceutical company Ipka Laboratories Limited. The active ingredient is albendazole. There are 3 dosage forms: tablets, suspension and chewable tablets for people with difficulty swallowing. The tablets contain 400 mg of albenadozole; in suspension - 100 mg per 5 ml of the drug.

The drug is harmful to most round and tapeworms. Among individuals sensitive to albendazole: pinworms, roundworms, whipworms, hookworms and intestinal acne. Nemozole acts on the larvae of the pork tapeworm and echinococcus. The tool is used in the treatment of the ocular form of toxocariasis. The drug copes with lamblia.

Nemozol acts on the parasitic organism in several directions at once:

• disrupts the absorption of glucose by them;
• affects his intestines;
• damages the muscles of the helminth, depriving it of the ability to move freely.

Albendazole inhibits the ability of the larva to reproduce by interfering with the laying process. Used in the treatment of nematodes, cestodes and giardiasis. The tablet is taken with meals. For most nematodes, one tablet is sufficient. When a person weighs less than 60 kg, the reception is divided by 2 times. If pinworms are the culprits of the invasion, the course is repeated after 2 weeks.

With strongyloidosis, ankylostomiasis, toxocariasis and mixed invasions, an increase in the daily dose by 2 times and the duration of the course up to 3 days is required. The daily dose should not exceed 800 mg. In addition to the general contraindications for anthelmintics, Nemozol is not prescribed for people with pathologies of the retina of the eyes.

Tablets are allowed from 3 years; suspension - from 1 year. Side effects: disorders of digestion and liver function, skin rash, increased blood pressure, dizziness. If the treatment is prolonged, hair loss is possible, which disappears after the end of the treatment. Albendazole is teratogenic: it negatively affects the development of the fetus. Women need to avoid conception while they are being treated and for another 1 month after the last dose of the medication.

Piperazine

The drug based on piperazine adipate is produced in Russia. It has a single form of release - 0.5 g tablets. Once in the intestines, piperazine paralyzes the helminth, and it leaves the host's body without resistance. The drug is absorbed into the bloodstream and excreted by the kidneys. Despite this, it is relatively low in toxicity. Since Piperazine does not kill nematodes, there is no danger of toxic decomposition products entering the bloodstream.

Main purposes: infection with pinworms and roundworms. The drug is taken one hour before meals, twice a day. With ascariasis, the course is 2 days; with enterobiasis - 5 days. To get rid of pinworms, repeat the course in a week. For mechanical washing out of worms during a week break, enemas are made with plain water at night.

The drug is contraindicated in severe kidney disease and organic lesions of the central nervous system.

Pirantel

Active ingredient: pyrantel pamoate. The drug exists in the form of tablets and suspension, which can be offered to children from 6 months of age. Like piperazine adipate, pyrantel paralyzes the parasite. But, unlike Piperazine, it is almost not absorbed from the gastrointestinal tract. Acts on pinworms, roundworms, whipworms and hookworms.

With enterobiasis, the medicine is taken once, after breakfast. The remedy paralyzes adult helminths, but does not work on their larvae, therefore, a repeated course of administration is required. With ankylostomiasis and mixed lesions with helminths, the agent is taken for 3 days. The dose depends on the patient's weight. For example, a person with an average weight (75 kg) will need 3 tables. 250 mg each. Detailed age-specific dosages are indicated in the instructions for the drug.

The drug should not be taken with myasthenia gravis and liver failure. This is one of the few anthelmintic drugs approved for use in pregnant women. The analogue of Pirantel is the French drug Helmintox.

Vermox

The drug is manufactured by the pharmaceutical company Gedeon Richter at a plant in Romania. The active ingredient is mebendazole. Release form: tablets 100 mg; 6 pieces per pack.

It is disastrous for:

• hookworm;
• intestinal acne;
• trichinella;
• gnathost.

It can be used for mixed helminthic invasions. The drug is especially effective against pinworms, whipworms and roundworms. They are used in the fight against pork tapeworm and echinococcus, when surgical removal of cysts is impossible. Treatment in this case may take 2 years.

The agent works exclusively in the intestine, practically not being absorbed by its walls and not entering the bloodstream. The drug causes a glucose deficiency in the tissues of the helminth. The regimen depends on the type of worm. To get rid of pinworms, 1 tablet is enough, provided that the course is repeated in 2-4 weeks. With ascariasis, teniasis and mixed helminthiasis, you will need 6 tablets, that is, the entire package: 1 tablet is taken twice a day in a three-day course. Trichinosis is treated for 2 weeks.

General contraindications for anthelmintic drugs are also true for Vermox. The drug should not be taken for Crohn's disease and ulcerative colitis. People with lactose intolerance should consider its presence in the tablet shell. 3 years is the minimum age from which the drug can be taken. An analogue of the drug: Vormin (India).

Decaris

Hungarian remedy based on levamisole. Manufacturer: Gedeon Richter. Available in tablets. There are 2 options for packaging: 2 tablets of 50 mg and 1 tablet of 150 mg. Mechanism of action: paralyzes the muscles of the helminth and disrupts metabolic processes in its body. After taking the drug, the parasite is removed from the body in a day.

The range of indications is not so wide: infection with roundworms and hookworms. The drug does not act on pinworms, that is, it is useless for enterobiasis. Take once, in the evening, after dinner. Drink with a little water. An adult will need 150 mg. For a child - from 25 to 150 mg, depending on age and body weight. After 1-2 weeks, the course is repeated.

Contraindicated during breastfeeding and under the age of 3 years for 50 mg tablets and up to 18 years for 150 mg. A history of drug agranulocytosis is also a contraindication. The use of the drug in pregnant women is possible.

Nourished

The drug from the Indian pharmaceutical company Mili Healthcare is produced in the form of chewable tablets based on albendazole. The drug is not included in the State Register of Medicines, therefore, it cannot be found on the free market in Russia. However, the drug is on Ukrainian pharmacy shelves, from where some sites offer its delivery.

Antihelminthic drugs for humans of a wide spectrum of action based on albendazole are active against protozoa (lamblia), round and tapeworms. They infect not only adults, but also their larvae, eggs and cysts. The same character of therapeutic action is inherent in Vormil. The drug is approved from 2 years old. An analogue available in the Russian Federation is Nemozol chewable tablets.

Helmintox

A drug of French origin based on pyrantel. The manufacturing company is Innotera Shuzi. Like the drug "Pirantel", it is available in tablets and suspensions with a fruit flavor. The content of the active substance in 1 tablet is 125 or 250 mg; in suspension - 125 mg per dose (2.5 ml).

Pills are allowed from 6 years old. The dosage of the suspension for children under 6 years of age is calculated based on their weight. The indications indicated by the manufacturer in the instructions: infection with pinworms, hookworms and roundworms. The list of drug-sensitive organisms lacks the whipworms that Pirantel has. The medicine is contraindicated in the same cases as Pirantel.

Albendazole

Drugs with the name "Albendazole" are produced by pharmaceutical companies:

• "Gedeon-Richter" (Hungary) in the form of a suspension;
• "Obolenskoe" (RF) in the form of tablets containing 400 mg of albendazole;
• "Edwands Pharma" (RF) 200 mg tablets.

Suspension is allowed for children from 1 year old, tablets - from 3 years old. Indications and contraindications are similar to those given to Nemozol - a drug with the same active ingredient. The suspension should not be taken by people with fructose intolerance.

Currently, only analogues of drugs for the active substance are available in Russian pharmacies.

Comparison of the effectiveness of drugs

In terms of effectiveness, the breadth of the spectrum of action and the variety of dosage forms, Nemozol surpasses all other anthelmintics from the list. However, it is also the most toxic drug.

Decaris and Piperazine are the most limited according to the indications. The latter is preferable to use in the treatment of enterobiasis (pinworms), when Nemozol, given its toxicity, turns out to be too "heavy artillery" for this disease.

It is important that the drug has the form that can be given to young children. In this aspect, Pirantel compares favorably: its suspension is suitable for children from 6 months. Since this remedy is allowed to be taken by pregnant women, it can be considered quite safe.

Comparative table of dosage forms, safety and prices:

Name	Active ingredient	Release form	Is it possible for Pregnant	Price in rubles for 1 tablet
Nemozole	Albendazole	Tablets, chewable tablets, suspension	No	RUB 400
Piperazine	Piperazine adipate	Pills	No	RUB 1.5
Pirantel	Pirantel	Tablets and suspension	Yes	RUB 7
Vermox	Mebendazole	Pills	No	RUB 15
Decaris	Levamisole	Pills	Yes	RUB 31 (50 mg), 72 rubles. (150 mg)
Nourished	Albendazole	Chewable tablets	No	RUB 500
Helmintox	Pirantel	Tablets and suspension	Yes	RUB 27
Albendazole-Alium (Obolenskoe)	Albendazole	Pills	No	—

Despite the versatility of broad-spectrum anthelminthic drugs, different dosages and modes of administration are required in the treatment of various helminthiases with one or another agent. They are also different for an adult and a child. When starting treatment, you need to clearly understand what treatment regimen is needed.

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