Levamisole is a fast acting drug which acts on nematode nerve ganglia paralysing the worm’s musculature within seconds of contact. Unable to maintain their position, the worms are then ejected by normal peristaltic movement, usually within 24 hours of levamisole administration. Although it is certain that levamisole primarily influences the neuromuscular system of nematodes, it is possible that in some helminthes the inhibition of the fumarate reductase system contributes to the anthelmintic efficacy of levamisole. Levamisole is indicated for the treatment of infections by the following gastrointestinal worm
- Ascaris lumbricoides: Roundworm
- Necator americanus: Hookworm
- Ancylostoma duodenal: Hookworm
- E nterobius vermicularis: Pinworm
- Trichuris trichuria: Whipworm
- Strongyloides stercoralis: Threadworm
- Trichostrongylus colubriformis
Levamisole is the active laevo-isomer of tetramisole. It works by paralysing susceptible intestinal worms which are then excreted from the intestines. Levamisole also enhances cellular immune responses in humans.
The following doses of Levamisole are given as a single administration, preferably after a light meal.
- Age 1-4 year: 1 Tablets or 5 ml Syrup
- Age 5-15 year: 2 Tablets or 10 ml Syrup
- Age 16 year and over: 3 Tablets or 15 ml Syrup
In cases of severe hookworm infection it is suggested that a second standard dose be given one or seven days after the first, whichever timing is feasible.
May increase toxicity of phenytoin. Increases bioavailability of ivermectin; decreases bioavailability of albendazole. Alcohol causes disulfiram-like reaction.
There is no absolute contra-indication to the use of Levamisole
Side-effects are infrequent. They are usually mild and transient and include nausea, vomiting, abdominal pain, giddiness(dizziness) and headache. An encephalopathylike syndrome has been reported to have occurred in a few patients two or three weeks after treatment.
Although studies in animals have shown that Levamisole produces no teratogenic effects, current medical practice requires that the benefits of any drug used during pregnancy should be weighed against the possible dangers.
Effect on ability to drive or operate machinery
: There is no evidence to suggest that Levamisole , used for anthelmintic purpose, will produce sedation. Mild and transient giddiness is an infrequent side-effect of treatment. No precautions are suggested concerning the ability to drive or operate machinery.
In case of concurrent microfilaraemia transient fever may occur.
Counter possible anticholinesterase activity with e.g. atropine. Control blood pressure and respiration . Do not use sedatives.
Tablet: Store in room temperature and protect from moisture.
Syrup: Store in room temperature and protect from light.