Drug Guide
Niclosamide
Classification
Therapeutic: Anthelmintic
Pharmacological: Mitochondrial uncoupler, anthelmintic
FDA Approved Indications
- Treatment of tapeworm infections (e.g., Taenia saginata, Taenia solium, Dipylidium caninum)
Mechanism of Action
Niclosamide inhibits oxidative phosphorylation in the tapeworm mitochondria, leading to depletion of ATP and death of the parasite.
Dosage and Administration
Adult: Typically, 2 grams as a single dose, followed by a second dose after 2 weeks if necessary.
Pediatric: Dosage based on body weight; typically 30-50 mg/kg in divided doses; consult specific pediatric dosing guidelines.
Geriatric: Adjust dose if renal or hepatic impairment present, otherwise similar to adult dosing.
Renal Impairment: Use with caution; no specific dose adjustment, but monitor for adverse effects.
Hepatic Impairment: Use cautiously; no specific guidelines, as hepatic metabolism is limited, but assess hepatic function before use.
Pharmacokinetics
Absorption: Poorly absorbed from the gastrointestinal tract.
Distribution: Remains largely localized in the gastrointestinal lumen.
Metabolism: Minimal systemic absorption; some hepatic metabolism may occur.
Excretion: Primarily unchanged in feces; minimal systemic absorption means negligible renal excretion.
Half Life: Not well-defined due to minimal systemic absorption.
Contraindications
- Hypersensitivity to niclosamide or any component of the formulation.
Precautions
- Use with caution in patients with hepatic or renal impairment.
Adverse Reactions - Common
- Gastrointestinal disturbances (nausea, abdominal pain, diarrhea) (Occasional)
- Headache, dizziness (Rare)
Adverse Reactions - Serious
- Hypersensitivity reactions (rash, itching, swelling) (Very rare)
- Liver dysfunction (hepatitis, hepatitis) (Rare)
Drug-Drug Interactions
- None well-documented, but caution with other hepatotoxic drugs.
Drug-Food Interactions
- No specific interactions documented.
Drug-Herb Interactions
- Limited data; use caution with herbal products affecting hepatic function.
Nursing Implications
Assessment: Assess for signs of parasitic infection and hepatic or renal dysfunction.
Diagnoses:
- Risk for hepatic injury
- Impaired gastrointestinal function
Implementation: Administer as a single dose or as prescribed, ensuring patient adherence. Advise patients to report adverse effects.
Evaluation: Monitor for eradication of infection and adverse effects post-treatment.
Patient/Family Teaching
- Complete the full course of therapy.
- Report any adverse reactions such as rash, jaundice, or gastrointestinal symptoms.
- Maintain good hygiene to prevent reinfection.
Special Considerations
Black Box Warnings:
- None currently issued by FDA.
Genetic Factors: None known affecting drug efficacy or safety.
Lab Test Interference: Minimal systemic absorption; unlikely to interfere with laboratory tests.
Overdose Management
Signs/Symptoms: Gastrointestinal upset, nausea, vomiting.
Treatment: Supportive care; no specific antidote.
Storage and Handling
Storage: Store at room temperature, away from moisture and light.
Stability: Stable under recommended conditions.