OXAMNIQUINE

• Oxamniquine is an alternative to praziquantel for the treatment of S

mansoni infections.
• It has also been used extensively for mass treatment.
• It is not effective against S haematobium or S japonicum.
 Anthelmintic Actions
• Oxamniquine is active against both mature and immature stages of S
mansoni but does not appear to be cercaricidal.
• The mechanism of action is unknown.
• Contraction and paralysis of the worms results in detachment from
terminal venules in the mesentery and transit to the liver.
• Oxamniquine has been effective in instances of praziquantel resistance.
 Clinical Uses
• safe and effective in all stages of S mansoni disease, including
advanced hepatosplenomegaly.
• results disappearance of acute symptoms and clearance of the
infection in treatment of acute (Katayama) syndrome.
• used in combination with metrifonate for mixed schistosome
infections
• Optimal dosage schedules vary for different regions of the world.
• less effective in children
• better-tolerated with food.
Pharmacokinetics
• Oxamniquine is readily absorbed orally.
• Its plasma half-life is about 2.5 hours.
• The drug is extensively metabolized to inactive metabolites and
excreted in the urine up to 75% in the first 24 hours.
• Intersubject variations in serum concentration have been noted,
which may explain some treatment failures.
 Adverse Reactions
• Central nervous system symptoms (dizziness, headache, drowsiness)
are most common.
• Nausea and vomiting, diarrhea, colic, pruritus, and urticaria also occur
Infrequently
• May cause low-grade fever, an orange to red discoloration of the
urine, proteinuria, microscopic hematuria, and a transient decrease in
leukocytes.
• Seizures have been reported rarely.
Contraindications
• Since the drug makes many patients dizzy or drowsy, it should be used
with caution in patients whose work or activity requires mental
alertness.
• should be used with caution in those with a history of epilepsy.
• contraindicated in pregnancy
 Doxycycline
• tetracyclic antibiotic agent
• has recently been shown to have significant macrofilaricidal activity
against W bancrofti
• has activity against onchocerciasis.
• Doxycycline with ivermectin has complementary therapy for the
control of onchocerciasis.
• Can reduce the transmission and occurrence of onchocercal eye
disease.