Niclosamide works by inhibiting oxidative phosphorylation in helminthes, and is essentially lethal to tapeworms on contact. The worms are then passed through the digestive tract and passed through the stool, although they are usually destroyed by the intestine and no longer recognizable.

Niclosamide is available through prescription only and is administered orally through a chewable tablet. No special instructions or diet is needed to for the dosage, which can be taken on an empty stomach. It is recommended, though, to take the tablet after a light meal like breakfast, to prevent any nausea or stomach discomfort. For patients with beef tapeworm, a one-tablet dose of 2 grams will clear up the infection. For those suffering with dwarf tapeworms, the 2-gram tablets must be taken once a day for a full seven days even if symptoms begin to fade. Sometimes, a second dosage cycle is recommended in these patients to make sure the parasite is eliminated and does not return. The drug should be stored in a cool, dry place away from direct sunlight.

Common side effects include abdominal pain, anorexia, and diarrhea. These common side effects will usually pass on their own and require no medical follow-up. More rare side effects include dizziness, rash, drowsiness, and itching. If experiencing prolonged episodes of rare side effects, it is usually best to see a doctor.

In worms, levamisole acts as a nictonic receptor agonist and eliminates them by causing muscle paralysis. This paralysis leads to the worm’s eventual death. Less understood is how levamisole works to strengthen the immune system. For this reason, it is still being studied concerning its use with certain cancers.

Levamisole is available by prescription only and is administered orally via a 50 milligram tablet. The dosage differs for each patient and depends on a patient’s age and weight, as well as the strength of the drug. No matter the dosage, each tablet should be taken with a full glass of water. If a dose is missed, it is important that the patient contact his or her doctor before taking the assigned dose; “double-dosing” is not recommended. Currently scientists and medical researchers are testing the efficacy of combining levamisole with mebendazole in order to lessen resistance to a one-drug treatment.

Side effects of Levamisole include allergic reactions, nausea, diarrhea, and rash. Vomiting shortly after taking the drug may occur, but it is best to consult a doctor to make sure an additional does is not needed. Rare, but also reported, symptoms include difficulty breathing, muscle weakness, seizures, and speech disturbances. Because Levamisole can lower the immune system’s capacity to fight off infection, it is advised that patients taking the drug avoid large gatherings and people that show cold or flu symptoms.

Suramin works by blocking various growth processes within the worms. Specifically, the drug blocks insulin growth, epidermal growth, and platelet-derived growth, which limits cell production and migration. When this happens, the worms become immobile and eventually die.

Suramin can be administered only in a hospital with nurse or doctor supervision and is given by one weekly intravenous injection of one gram for a total of six weeks. Maintaining a regular dosage and doctor visit it important when taking the drug so that a physician can monitor the progression of the cure as well as any side effects. Dosage will be different for each patient and will depend on the strength of the drug as well as body weight. Suramin is not available in the United States or Canada.

Suramin may have the potential to cause serious side effects, and it is always best for physicians to be made aware of a patient’s complete medical history. Nausea and vomiting occur as the most frequent side effects, but the majority of patients will also experience a rash that appears within the first few days of treatment. Some patients report feeling a crawling sensation in the skin when given the drug. Suramin may cause some symptoms that are essentially harmless, such as cloudy urine, but still arise panic in some patients. Extreme side effects, such as kidney damage, convulsions, and unusual bleeding or swelling, may occur, but are rare. Although Suramin has not been studied in pregnant women, it has caused birth defects in animals.

Albendazole works by destroying the intestinal cells of the worm. The drug prohibits the development of microtubules, which are important for glucose uptake during the larval and adult worm stages. Without this glucose, the worms’ energy stores are depleted and it eventually dies.

Albendazole is available through prescription only and the dosage depends on the type of helminth diagnosed. When curing hydatid disease, patients weighing more than 60 kilograms should take a 400 milligram dose twice a day via a tablet, with meals. For patients that weigh less than 60 kilograms, a 15 milligram in divided doses is given twice a day. The drug is administered in three 28 day cycles with a 14 day drug-free interval in between. When treating neurocysticerosis, an infection caused by pork tapeworms, the same doses are given, but the treatment interval is only eight to thirty days. If a dose is missed, it is recommended that patients contact their doctor, but continue to take the doses as directed, and not “double-dose.” The drug should always be stored in an air-tight container at room temperature or in the refrigerator.

Side effects when using albendazole may include dizziness, heachache, vomiting, fever, nausea, and temporary hair loss. In very rare instances the drug may cause sore throat, seizures, vision problems, jaundice, mood changes, and allergic reactions. It is recommended that when taking albendazole for hookworms, iron supplements be taken to prevent anemia; however, it’s usually best to take guidance from a physician.