Piperazine Citrate
Indications: Ascariasis; Enterobiasis
DESCRIPTION:
Each white, compressed tablet for oral use contains 275.75 mg. piperazine citrate anhydrous equivalent to 250 mg. piperazine hexahydrate. Piperazine citrate is a white, crystalline powder, having no more than a slight odor. It is soluble in water; insoluble in alcohol and in ether.
CLINICAL PHARMACOLOGY:
Piperazine is readily absorbed from the gastrointestinal tract, partially degraded in vivo, and the remainder excreted (at individually varying rates) in the urine. Its antihelminitic mechanism of action (best studied in Ascaris) appears to be paralysis of worm muscle, thus permitting worm expulsion by normal intestinal peristalsis. There is wide range between effective therapeutic and clinically toxic doses of piperazine.
INDICATIONS AND USAGE:
Treatment of intestinal--Ascariasis, (due to Ascaris lumbricoides, "Roundworms"); and,
Enterobiasis (due to Enterobius (Oxyuris) vermicularis, "pinworms").
CONTRAINDICATIONS:
Impaired renal function. Convulsive disorders (e.g., marked predisposition to grand mal epilepsy). History of hypersensitivity reactions to piperazine or its salts.
WARNINGS:
Because of potential neurotoxicity of this drug, especially in children, prolonged or repeated treatment in excess of that recommended should be avoided.
USAGE IN PREGNANCY: The safety of this drug for use during pregnancy has not been established.
PRECAUTIONS:
If CNS, gastrointestinal, or hypersensitivity reactions occur, the drug should be discontinued. In patients with severe malnutrition, anemia, or hepatic diseases, appropriate caution should be exercised.
ADVERSE REACTIONS:
The following, usually due to excessive dosage, have been reported: GASTROINTESTINAL--nausea, vomiting, abdominal cramps, and diarrhea.
CENTRAL NERVOUS SYSTEM--headache, vertigo, ataxia, tremors, choreiform movement, muscular weakness, hyporeflexia, paresthesia, blurring of vision, paralytic strabismus, convulsions, EEG abnormalities, sense of detachment, and memory defect.
HYPERSENSITIVITY--urticaria, erythema multiforme, purpura, fever, and arthralgia.
DOSAGE AND ADMINISTRATION:
General--Doses are usually taken before breakfast. No prior fasting, laxatives, enemas, or special diets are needed. To prevent re-infestation, the practice of personal and environmental hygiene should be recommended. The therapeutic programs given below usually provide complete deinfestation. In the event of resistant or re-infestation, the appropriate treatment program may be repeated, following a 7-day rest period.
FOR ASCARIASIS (Roundworm Infestation):
Adults--a single daily dose of 3.5 Gm. (hexahydrate equivalent) for 2 consecutive days.
Children--75 mg. (hexahydrate equivalent)/Kg. of body weight/day for 2 consecutive days, with a maximum daily dose of 3.5 Gm.
FOR ENTEROBIASIS (Pinworm Infestation):
Adults and Children--65 mg. (hexahydrate equivalent)/Kg. of body weight/day with a maximum daily dose of 2.5 Gm., for 7 consecutive days.