Piperazine Citrate

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• Roundworms (Ascaris lumbricoides)
• Threadworms (Enterobius vermicularis) 

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Renal impairment
• Epilepsy

Cautions

• Breastfeeding
• Hepatic impairment
• Elderly
• Neurological disturbances

Forms avail. in SA and covered in this monograph: gra, syr

Infections caused by roundworms (Ascaris lumbricoides); threadworms (Enterobius vermicularis) 

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Roundworm infestation

• Oral (syr): 4-4.5g, as a single dose
• Oral (gra): 4.95g, as a single dose

Granules should be taken with a glass of water

Treatment may be repeated after 14 days if required

Threadworm infestation

• Oral (syr): 2-2.5g, dly; Treatment duration: 7 days (Manufacturer recommendation)

Treatment may be repeated after 7 days if necessary

Paed. forms avail. in SA and covered in this monograph: gra, syr

Infections caused by roundworms (Ascaris lumbricoides); threadworms (Enterobius vermicularis) 

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Roundworm infestation

Oral (syr)

• Younger than 1 year: 120mg/kg, as a single dose
• Between 1-3 years: 1.5g, as a single dose
• Between 4-5 years: 2.25g, as a single dose
• Between 6-8 years: 3g, as a single dose
• Between 9-12 years: 3.75g, as a single dose
• Older than 12 years: See adult dosage

Oral (gra)

• Younger than 1 year: Not established for use
• Between 1-6 years: 1.65g, as a single dose
• Between 7-14 years: 3.3g, as a single dose
• Older than 14 years: See adult dosage

Threadworm infestation

Oral (syr)

• Younger than 2 years: 45-75mg/kg, dly; Treatment duration: 7 days (Manufacturer recommendation)
• Between 2-3 years: 750mg, dly; Treatment duration: 7 days (Manufacturer recommendation)
• Between 4-6 years: 1.125g, dly; Treatment duration: 7 days (Manufacturer recommendation)
• Between 7-12 years: 1.5g, dly; Treatment duration: 7 days (Manufacturer recommendation)
• Older than 12 years: See adult dosage

Pregnancy

• FDA Pregnancy Category Not Rated (NR)

Breastfeeding

• Caution; no information available 

Renal Impairment

• Contraindicated

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; no information available

Central Nervous System Disorders

• Headache
• Somnolence
• Dizziness
• Nystagmus
• Ataxia
• Myoclonic contractions
• Chloreiform movements
• Seizures
• Loss of reflexes

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea
• Abdominal pain

Musculoskeletal Disorders

• Muscular incoordination
• Muscle weakness
• Tremor

Skin and Subcutaneous Tissue Disorders

• Rash
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reactions

Sensory Disorders

• Blurred vision
• Cataracts

No information available

None routine

Piperazine citrate causes paralysis of susceptible worms by binding directly and selectively to muscle membrane gamma-aminobutyric acid receptors. The worms are then easily
dislodged from their position by the movement of the gut and are expelled in the faeces.

Piperazine citrate is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Syrup (per 5ml) 500mg

• Piprine (Ranbaxy)

Syrup (per 5ml) 850mg

• Padax (Adcock)

Granules (per sachet) 1.65g

• Padax (Adcock)