Biltricid tablets instructions for use. What worms does Biltricid treat? The best prevention can only be

Active substance

Praziquantel (praziquantel)

Release form, composition and packaging

Film-coated tablets white or almost white with a slight orange tint, oblong, biconvex, engraved with "BAYER" on one side and "LG" on the other; 3 dividing marks are applied on both sides of the tablet.

Excipients: corn starch, microcrystalline cellulose, sodium lauryl sulfate, magnesium stearate, hypromellose, macrogol 4000, titanium dioxide.

6 pcs. - dark glass bottles (1) - packs of cardboard.

pharmachologic effect

Pharmacokinetics

Suction

Following oral administration, praziquantel is rapidly and completely absorbed. The maximum concentration in is reached within 1-2 hours. The half-life of the drug unchanged is 1-2.5 hours, together with metabolites - 4 hours.

To achieve a therapeutic effect, it is necessary to maintain a plasma concentration of the drug equal to 0.19 mg / l for 4-6 (maximum up to 10) hours.

Distribution

Penetrates through the BBB. The concentration in the cerebrospinal fluid is 10-20% of its concentration in the blood plasma. Penetrates into breast milk at a concentration of 20-25% of the concentration in the blood serum.

Metabolism

It is metabolized during the "first pass" through the liver. The main metabolites are hydroxylated degradation products of praziquantel.

breeding

It is excreted mainly by the kidneys. More than 80% of the dose is excreted within 4 days, with 90% of this amount within 24 hours.

Pharmacokinetics in special clinical situations

Indications

• treatment of infections caused by various types of schistosomes (Schistosoma haematobium, Schistosoma mansoni, Schistosoma intercalatum, Schistosoma japonicum, Schistosoma mekongi);
• treatment of infections caused by liver flukes (Clonorchis sinensis, Opistorchis viverrini) and lung flukes (including Paragonimus westermani).

Contraindications

• cysticercosis of the eye;
• combined use with rifampicin;
• children under 4 years of age (safety and efficacy have not been established);
• hypersensitivity to the components of the drug.

Carefully the drug should be used for decompensated liver failure, hepatolienal schistosomiasis, and rhythm disturbances.

Dosage

The tablet should be taken orally as a whole, without chewing, with a small amount of liquid before or during a meal. If it is recommended to take 1 time / day, then the tablet should be taken in the evening. With repeated use of the drug during the day, it is recommended to observe the interval between doses of at least 4 hours and no more than 6 hours.

Doses of Biltricid are set strictly individually and depend on the type of pathogen.

The drug is prescribed adults and children over 4 years old.

At infections caused by Schistosoma haematobium: 40 mg/kg of body weight once. Duration of treatment - 1 day.

At infections caused by Schistosoma mansoni and Schistosoma intercalatum: 40 mg/kg 1 time/day or 20 mg/kg 2 times/day. Duration of treatment - 1 day.

At infections caused by Schistosoma japonicum, Schistosoma mekongi: 60 mg/kg 1 time/day or 30 mg/kg 2 times/day. Duration of treatment - 1 day.

At infections caused by Clonorchis sinensis, Opisthorchis viverrini: 25 mg/kg 3 times/day for 1-3 days.

At infections caused by Paragonimus westermani and other species: 25 mg/kg 3 times/day for 2-3 days.

Side effects

From the digestive system:> 10% - nausea, vomiting; >1% and<10% - отсутствие аппетита; <0.01% - диарея с примесью крови.

From the side of the central nervous system:> 10% - headache, dizziness; >1% and<10% - головокружение, сонливость; < 0.01% - судороги.

From the body as a whole:>1% and<10% - астения, лихорадка.

From the musculoskeletal system:>1% and<10% - миалгия.

From the side of the cardiovascular system:> 10% - arrhythmia.

Allergic reactions:>1% and<10% - крапивница; <0.01% - генерализованные аллергические реакции, включая полисерозит.

Overdose

Data on an overdose of the drug Biltricid are not provided.

drug interaction

With simultaneous use with drugs that induce cytochrome P450 liver enzymes, for example, with anticonvulsants, the concentration of praziquantel in the blood plasma may decrease, and when combined with drugs that inhibit these enzymes, for example, with cimetidine, it may increase.

Chloroquine reduces the concentration of praziquantel in the blood plasma.

special instructions

In decompensated liver failure and hepatolienal schistosomiasis, Biltricide should be used with caution due to the risk of its longer presence in elevated concentrations in the vascular bed, including collateral vessels. Such patients may be hospitalized for treatment.

In cases of cardiac arrhythmias and while taking digitalis preparations, treatment with Biltricid should be carried out under the supervision of a physician.

Patients who live or have lived in areas endemic for cysticercosis and trematodosis are recommended to be treated in a hospital.

Pediatric use

The safety of the drug in children under 4 years old not installed.

Influence on the ability to drive vehicles and control mechanisms

When using Biltricide, you should refrain from driving a car / moving mechanisms on the day / days of taking the drug and for the next 24 hours.

Pregnancy and lactation

For impaired renal function

Since the drug has a predominantly renal route of excretion, in case of renal failure, there may be a slowdown in its excretion.

For impaired liver function

With decompensated liver failure, the metabolism of the drug in the liver is reduced, which is accompanied by an elongation of T 1/2 and an increase in the concentration of praziquantel in the blood.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

List B. The drug should be stored out of the reach of children, dry, dark place at a temperature not exceeding 30°C. Shelf life - 5 years.

In a pharmacy, the drug "Biltricid" can be purchased in the form of oblong, biconvex white tablets, sometimes with a slight yellowish or orange tint. Tablets are placed in dark glass bottles of 6 pieces. The main active ingredient of the drug is praziquantel - each tablet contains about 600 mg of this substance. As for the auxiliary components, the drug contains magnesium stearate, macrogol 4000, microcrystalline cellulose, hypromellose, corn starch, and povidone.

Indications for admission

This medicine is indicated in the treatment of helminthic diseases, such as, for example, opisthorchiasis. Treatment with "Biltricid" helps with infection of the human body with different types of schistosomes. Indications for therapy are diseases caused by liver and some other types of helminths.

The drug "Biltricid": instructions for use

In no case should you use the medicine arbitrarily. Only a doctor after a thorough diagnosis can prescribe treatment with the drug "Biltricid". The instructions for use contain only general recommendations.

The tablet should be swallowed without chewing with a small amount of water. It is recommended to take the drug before or during a meal. If the medicine needs to be drunk once a day, then it is best to do it in the evening.

Description of contraindications and side effects

For many patients with helminthiases, doctors prescribe the drug "Biltricid". Its analogues, by the way, are more toxic. Despite the fact that the drug acts on the body sparingly, there are still some limitations. In particular, it is not prescribed for children under four years of age, as well as for women in the first trimester of pregnancy. Contraindications include cysticercosis of the eye, allergy to the constituent components of the drug. Therapy should not be combined with rifampicin. The drug is used with caution in the presence of cardiac arrhythmias, decompensated form of liver failure, hepatolienal schistosomiasis.

The drug "Biltricid": analogues

This medicine is quite popular in modern medical practice. On the other hand, not all patients are suitable for the drug "Biltricid". Analogues of this tool, of course, exist. For example, in some cases, doctors prescribe medications such as Medamin, Levamisole, Helmintox. In the fight against helminths, such means as Nemozol, Zentel, Dekaris, Mebendazole and some others can also be used. In any case, you need to remember that only the attending physician can prescribe an analogue.

Biltricide is a praziquantel-based drug manufactured (and developed) by the pharmaceutical company Bayer AG. Although there are almost two dozen trade names for praziquantel abroad, only Biltricide is sold in the post-Soviet space, so it will not be possible to purchase a cheaper analogue of this drug.

Since praziquantel is included in the list of vital drugs approved by the government of the Russian Federation, it can be purchased at almost every pharmacy. Officially, the drug is dispensed by prescription, however, due to the fact that Biltricide is not included in the list of drugs subject to subject-quantitative accounting, it is usually sold without a prescription. A bottle with six 600-milligram tablets costs about 300 rubles.

Indications for taking Biltricide

Praziquantel has an anti-cestodial and anti-trematodous effect, i.e. able to destroy flatworms from the class of cestodes (tapeworms) and trematodes (digenetic flukes).

According to the instructions, the full list of helminthiases that can be treated with praziquantel includes:

• cysticercosis (helminths-causative agents - larvae of pork tapeworm);
• taeniasis (pork tapeworms);
• teniarinhoz (bovine tapeworm);
• hymenolepiasis (dwarf tapeworms);
• diphyllobothriasis (wide ribbons);
• schistosomiasis (schistosomes);
• fasciolopsidosis (fasciolopsis);
• fascioliasis (liver and giant flukes);
• opisthorchiasis (Siberian flukes);
• clonorchiasis (Chinese flukes);
• metagonimosis (metagonims);
• paragonimiasis (lung flukes).

However, according to the experience of doctors around the world, praziquantel can also be used to treat the following helminthiasis:

• dicroceliosis (lanceolate flukes);
• nanophyetosis (nanofietus);
• dipilidiosis (cucumber chains);
• sparganosis (larvae of Spirometra erinaceieuropaei).

Infection for the most part of them occurs only through the use of poorly processed meat of mammals or fish. Given the growth of medical literacy of the population, such cases are becoming less and less, and drug prophylaxis is not required here - only “targeted” treatment of diagnosed helminthiasis.

Nevertheless, cestodoses and trematodes have common characteristic symptoms, the presence of which may be the reason for testing or even immediate treatment.

Typical symptoms of a tapeworm infection include:

As for liver flukes, it is impossible to diagnose their infection at home.

Dosage and regimen of treatment with Biltricid

Treatment with Biltricide for dicroceliosis and dipilidiosis has not been developed, but the likelihood of getting sick with these helminthiases is extremely small.

Praziquantel is considered a very toxic drug that negatively affects the human liver. For this reason, it is usually not used:

• with liver diseases;
• in the first trimester of pregnancy;
• under the age of 4 years.

A correctly calculated single dose of Biltricide, sufficient to remove the tapeworm, as a rule, does not cause serious "side effects". However, the large doses required for the treatment of trematodosis often provoke the following side effects:

• lethargy;
• disorientation;
• migraine;
• drowsiness;
• itching and skin rash;
• severe sweating;
• nausea;
• vomit;
• stomach ache;
• diarrhea with blood;
• increased activity of liver enzymes.

Due to the toxicity of Biltricide, it is highly undesirable to use it without the consent of a doctor because of the possible consequences for the liver. Moreover, large worms from the class of tapeworms are perfectly excreted by folk remedies, so even when a doctor prescribes Biltricid, it is worth trying the following folk anthelmintics first:

In the absence of time for the preparation of folk remedies, they can be replaced with ready-made multicomponent preparations from antiparasitic plants.

"Biltricid" is by far the most popular of all praziquantel-based anthelmintic drugs. It is produced by the German pharmaceutical company Baer Pharm. The medicine is produced in the form of tablets of six pieces in each vial. The substance praziquantel has an extremely wide range of effects, it is used to treat most common infestations by tapeworms and flukes.

The effectiveness of the drug

Due to its main component praziquantel, the drug "Biltricid" is very effective in the treatment of many helminthiases, for example, such as:

• Opisthorchiasis caused by the Siberian fluke.
• Clonorchiasis caused by the Chinese fluke.
• Fascioliasis, the causative agent is the giant and liver fluke.
• Paragonimosa is a lung fluke.
• Fasciolopsidosis.
• Diphyllobothriasis - metagonims and wide ribbons.
• Teniosis that occurs when pork tapeworm enters the body.
• Teniarinhoz - bovine tapeworm.
• Hymenolepiasis, the causative agent is pygmy tapeworm.
• Cysticercosis, when tapeworm larvae are found.

double action

Contraindications for admission

If we compare "Biltricid" with "Chloxil", which was used to treat opisthorchiasis until the beginning of the twenty-first century, then the new remedy should be called a safer anthelmintic than the previous one. Among its general contraindications, the instructions give only individual intolerance, as well as cysticercosis of the eyes, when the larvae of the tapeworm settle in the eyes. In this case, praziquantel cannot be used because of the danger of damage to the visual organ in the areas of death of the larvae.

During pregnancy

According to its effect on the fetus, the Bayer anthelmintic drug "Biltricid" belongs to category "B", that is, animal tests have established the complete safety of this drug for future offspring, however, the drug has not been tested on pregnant women. This indicates that the drug, as well as its analogues, can be used in the second and third trimesters of pregnancy if the possible harm from helminths is more dangerous than the consequences of taking the drug. Against the background of opisthorchiasis, you can wait until the end of pregnancy, but in some situations, such helminthiasis threatens the development of cancer or cirrhosis of the liver, and therefore requires urgent treatment.

When breastfeeding

Praziquantel passes into breast milk in large quantities. Given this factor, it is advisable for women to refuse breastfeeding on the day of the appropriate treatment, and in addition, for the next few days. Reviews of the home use of "Biltricid" will be considered at the end of the article.

drug interaction

In the event that opisthorchiasis is not the only human disease, and the patient regularly uses other drugs, it is important to make sure that Biltricid does not affect the effectiveness of other medicines. The bioavailability of this medicinal product is reduced or completely eliminated by components such as:

• Anti-tuberculosis antibiotic "Rifampicin".
• Immunosuppressant Chloroquine.
• Glucocorticosteroid Dexamethasone.
• Antiepileptic drugs in the form of "Carbamazepine", "Phenobarbital" and "Phenytoin".

In addition, the instructions for use in relation to "Biltricid" include two more restrictions on the use of the drug, namely the age of up to four years and liver disease. The first limitation stems from the lack of research and experience with praziquantel in young children, as ninety percent of those infected are at least ten years of age or older. In a situation of intensive invasion, it is permissible to treat children with Biltricid. The second limitation is due to the fact that the presented drug is able to partially destroy liver cells. But in this case, doctors explain that we are talking about liver diseases that are not associated with helminthic invasions, since against the background of opisthorchiasis, the liver is more or less sick in almost all patients.

Reviews of patients about the use of "Biltricid" are of interest to many.

Method of dosing and treatment regimen

A single dose in the treatment of opisthorchiasis, as a rule, is forty milligrams per kilogram of weight. Tablets are swallowed without chewing. It is advisable to seize the medicine with one hundred grams of bread and drink two hundred milligrams of milk or jelly and tea.

Patients can treat opisthorchiasis at home, but in some situations it is important to take the drug under the supervision of a doctor and in a hospital. Thus, it is recommended to treat opisthorchiasis in a hospital for patients:

• In the presence of an acute stage of opisthorchiasis.
• Patients suffering from neuropsychological ailments.
• With violations of the functions of organs that were affected by helminths.

Diet

It is important to approach the treatment of opisthorchiasis in a comprehensive manner, that is, in addition to taking the drug from Bayer "Biltricid", as well as other anti-opisthorchiasis drugs, the functions of the hepatobiliary system, namely the gallbladder, liver and gastrointestinal tract, should be restored. The chance to cure opisthorchiasis from the first time increases if, during the period of preparation for therapy, the patient follows a therapeutic diet, which involves:

• Limited fat intake - no more than ninety grams per day, but subject to normal intake of proteins and carbohydrates.
• Daily calorie content should be no more than two and a half thousand kcal.
• It is required to exclude products that are characterized by an abundance of essential oils, including cholesterol, purines and oxalic acid.
• It is important to increase the amount of fiber as well as fluids in your daily diet.
• Excessive consumption of cold foods should be avoided.

Such a diet will help restore the liver and improve bile secretion, as a result of which helminths will be removed after taking the medicine. This is confirmed by the "Biltricid" instructions for use and reviews.

Patients suffering from a chronic form of the disease should be treated for concomitant diseases of opisthorchiasis, such as gastritis, cholecystitis, cholangitis, duodenitis, ulcers, and so on. Only after the general condition of the body has improved, it will be possible to start persecuting opisthorchis due to "Biltricid". Before using this anthelmintic, patients with an acute form of opisthorchiasis must eliminate allergic reactions, as well as intoxication and fever attacks.

Reasons for the lack of a quick effect

By no means always opisthorchiasis can be treated from the first or from the second dose of "Biltricide". The reason for this is far from the low effectiveness of the described drug, but the incredible survivability of Siberian flukes, for which experts find only two explanations. First of all, it was found that after taking a dose of the drug, the helminths hide in the gallbladder for a while, and immediately after a decrease in the concentration of the drug, they come out in order to re-fix in the liver area. In addition, relapses of the disease are associated with the process of self-infection of the body. Despite the fact that flukes are not able to reproduce inside a person, some of the larvae that enter the body are fixed in the mucous membrane, passing into a state of suspended animation. These dormant larvae awaken after the destruction of mature flukes.

Each package contains instructions for use for "Biltricid". Price and reviews will be presented below.

Biltricide- an anthelmintic agent, a derivative of pyrazinisoquinoline. It has a wide spectrum of action, which includes many trematodes and cestodes. Thus, praziquantel (the active ingredient of Biltricid) is highly active against all human pathogens of schistosomiasis, clonorchiasis, paragonimiasis, opisthorchiasis, as well as against Fasciolopsis buski, Hetorophyes heterophyes and Metagonimus yokogawai (intestinal flukes). Among trematodes, Fasciola hepatica is resistant to praziquantel; the mechanism of resistance has not been elucidated. Praziquantel is highly effective against pathogens of intestinal cestodosis: hymenolepiasis (Hymenolepsis nana), diphyllobothrium (Diphyllobothrium latum), teniarhynhosa (Taeniarhynhus saginatus), teniasis (Taenia solium), also acts on cysticerci.

Praziquantel has two main effects on susceptible helminths. In low doses, it causes an increase in muscle activity, followed by muscle contraction and spastic paralysis. At slightly higher doses, it causes damage to the tegument (the outer covering of flatworms). The mechanism of action has not been fully elucidated. It is believed that the effect of praziquantel is due to its ability to increase the permeability of membranes for calcium ions (and some other mono- and divalent cations).

Compound

Praziquantel + excipients.

Pharmacokinetics

Rapidly and completely absorbed from the gastrointestinal tract. Plasma protein binding - 80%. It is metabolized in the liver to form inactive mono- and polyhydroxylated metabolites. It is mainly excreted by the kidneys (within 4 days - 80%), mainly in the form of metabolites: 90% is excreted within 24 hours. A small amount is excreted with feces. In small quantities passes into breast milk. With impaired renal function, excretion slows down, with liver damage, the intensity of metabolism decreases, which is accompanied by a longer presence of unchanged praziquantel in the body with the creation of high concentrations.

Indications

• schistosomiasis, including intestinal schistosomiasis and genitourinary schistosomiasis;
• opisthorchiasis;
• clonorchiasis;
• paragonimiasis;
• metagonimiasis;
• fasciolopsidosis and other trematodosis caused by susceptible helminths;
• intestinal cestodiasis: hymenolepiasis, diphyllobothriasis, teniarinhoz, teniasis;
• neurocysticercosis.

Release forms

Film-coated tablets 600 mg.

There are no other dosage forms, whether capsules, drops or suspension.

Instructions for use and regimen

Inside, whole, without chewing, with a small amount of liquid, before or during a meal. If a single dose of the drug per day is recommended, then the tablet should be taken in the evening. With repeated use of the drug during the day, an interval between doses of at least 4 and no more than 6 hours is recommended.

Adults and children over 4 years old. Doses of Biltricid are selected strictly individually and depend on the type of pathogen.

Schistosoma haematobium - 40 mg/kg of body weight once. Duration of treatment - 1 day.

Schistosoma mansoni and Schistosoma intercalatum - 40 mg / kg 1 time per day or 20 mg / kg 2 times a day. Duration of treatment - 1 day.

Schistosoma japonicum, Schistosoma mekongi - 60 mg/kg 1 time per day or 30 mg/kg 2 times a day. Duration of treatment - 1 day.

Clonorchis sinensis, Opisthorchis viverrini - 25 mg/kg 3 times a day for 1-3 days.

Paragonimus westermani and other species - 25 mg/kg 3 times a day for 2-3 days.

Side effect

• headache;
• dizziness;
• drowsiness;
• myalgia;
• in the treatment of neurocysticercosis, the phenomena of meningism, impaired thinking, increased intracranial pressure, hyperthermia are possible;
• stomach ache;
• nausea;
• vomit;
• transient increase in the level of hepatic transaminases;
• fever;
• skin rashes.

Contraindications

• hypersensitivity to praziquantel;
• cysticercosis of the eye;
• 1 trimester of pregnancy;
• lactation;
• children's age up to 4 years;
• liver failure;
• liver cysticercosis.

Use during pregnancy and lactation

Biltricid is contraindicated for use in the 1st trimester of pregnancy and during lactation (breastfeeding).

In the 2nd and 3rd trimesters of pregnancy, praziquantel is used only under strict indications.

If necessary, use during lactation is recommended to interrupt breastfeeding on the day of taking praziquantel and for the next 72 hours.

Use in children

Contraindicated in children under 4 years of age. The safety of the drug in children under 4 years of age has not been established.

special instructions

With cysticercosis of the eye, Biltricid is not used because of the risk of developing eye tissue lesions in the process of death of cysticerci.

Influence on the ability to drive vehicles and control mechanisms

In the process of taking praziquantel and during the following days, it is necessary to refrain from driving vehicles and other potentially hazardous activities.

drug interaction

Dexamethasone reduces the concentration of Biltricide in the blood plasma.

Chloroquine can lead to a decrease in the concentration of praziquantel in the blood (the mechanism of this interaction is not clear).

With simultaneous use with cytochrome P450 inducers, for example, with antiepileptic drugs (phenytoin, phenobarbital and carbamazepine), dexamethasone, the concentration of praziquantel in the blood plasma may decrease, and when combined with cytochrome P450 inhibitors, for example, with cimetidine, ketoconazole, itraconazole, erythromycin, it may increase .

Simultaneous use of rifampicin (a strong inducer of cytochrome P450) with praziquantel is contraindicated.

Analogues of the drug Biltricid

The drug Biltricid has no structural analogues for the active substance. The drug contains a unique active ingredient in its composition.

Analogues by pharmacological group (antihelminthic drugs):

• Vermox;
• Wormin;
• Gelmodol VM;
• Helmintox;
• Decaris;
• mebendazole;
• Medamin;
• Nemozol;
• Nemocide;
• Tansy flowers;
• Piperazine;
• Piperazine adipate;
• Pirantel;
• Pyrantel pamoate;
• Pirvinium;
• Sanoxal;
• Telmox 100;
• Pumpkin seeds.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see the available analogues for the therapeutic effect.