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Anthelminthic therapies

Peter F Weller, MD, MACP
Section Editor
Karin Leder, MBBS, FRACP, PhD, MPH, DTMH
Deputy Editor
Elinor L Baron, MD, DTMH


Helminths are multicellular parasites with complex life cycles within and outside of human hosts. The mechanisms of action for many anthelminthic agents remain incompletely understood.

Anthelminthic drugs are used for treatment of symptomatic disease and for mass drug treatment programs in regions with high prevalence of infection and disease [1,2]. In some endemic areas, deworming strategies have been associated with health benefits including improvements in hemoglobin levels, growth and physical fitness, cognitive performance, and nutritional status [3,4]. (See "Mass drug administration for control of parasitic infections".)

In the United States, some agents are available through the Centers for Disease Control and Prevention Drug Service (telephone 1-404-639-3670).

An overview of anthelminthic therapies will be presented here. Therapeutic and more detailed considerations for specific helminth infections are discussed separately. (See related topics.)


Ivermectin is a semisynthetic derivative of avermectin, which is derived from the soil mold Streptomyces avermitilis. Ivermectin opens glutamate-sensitive chloride channel currents in helminths, and this may be its mechanism of action [5].

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Literature review current through: Nov 2017. | This topic last updated: May 26, 2017.
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  1. Drugs for Parasitic Infections, 3rd Ed, The Medical Letter, New Rochelle, NY 2013.
  2. World Health Organizaton. Preventive chemotherapy in human helminthiasis: Coordinated use of anthelminthic drugs in control interventions: A manual for health professionals and programme managers. WHO, Geneva 2006. http://apps.who.int/iris/bitstream/10665/43545/1/9241547103_eng.pdf (Accessed on May 31, 2017).
  3. Ojha SC, Jaide C, Jinawath N, et al. Geohelminths: public health significance. J Infect Dev Ctries 2014; 8:5.
  4. Taylor-Robinson DC, Maayan N, Soares-Weiser K, et al. Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin and school performance. Cochrane Database Syst Rev 2012; 11:CD000371.
  5. Fox LM. Ivermectin: uses and impact 20 years on. Curr Opin Infect Dis 2006; 19:588.
  6. Naquira C, Jimenez G, Guerra JG, et al. Ivermectin for human strongyloidiasis and other intestinal helminths. Am J Trop Med Hyg 1989; 40:304.
  7. Lacey E. Mode of action of benzimidazoles. Parasitol Today 1990; 6:112.
  8. Davies HD, Sakuls P, Keystone JS. Creeping eruption. A review of clinical presentation and management of 60 cases presenting to a tropical disease unit. Arch Dermatol 1993; 129:588.
  9. Bhatia V, Sarin SK. Hepatic visceral larva migrans: evolution of the lesion, diagnosis, and role of high-dose albendazole therapy. Am J Gastroenterol 1994; 89:624.
  10. Kraivichian P, Kulkumthorn M, Yingyourd P, et al. Albendazole for the treatment of human gnathostomiasis. Trans R Soc Trop Med Hyg 1992; 86:418.
  11. Cross JH, Basaca-Sevilla V. Albendazole in the treatment of intestinal capillariasis. Southeast Asian J Trop Med Public Health 1987; 18:507.
  12. Liu YH, Wang XG, Gao P, Qian MX. Experimental and clinical trial of albendazole in the treatment of Clonorchiasis sinensis. Chin Med J (Engl) 1991; 104:27.
  13. Oostburg BF. The sixth case of lagochilascariasis minor in Surinam. Trop Geogr Med 1992; 44:154.
  14. Andrews JR, Ainsworth R, Abernethy D. Trichinella pseudospiralis in humans: description of a case and its treatment. Trans R Soc Trop Med Hyg 1994; 88:200.
  15. Krepel HP, Haring T, Baeta S, Polderman AM. Treatment of mixed Oesophagostomum and hookworm infection: effect of albendazole, pyrantel pamoate, levamisole and thiabendazole. Trans R Soc Trop Med Hyg 1993; 87:87.
  16. Lange H, Eggers R, Bircher J. Increased systemic availability of albendazole when taken with a fatty meal. Eur J Clin Pharmacol 1988; 34:315.
  17. Nahmias J, Goldsmith R, Soibelman M, el-On J. Three- to 7-year follow-up after albendazole treatment of 68 patients with cystic echinococcosis (hydatid disease). Ann Trop Med Parasitol 1994; 88:295.
  18. Millán JC, Mull R, Freise S, et al. The efficacy and tolerability of triclabendazole in Cuban patients with latent and chronic Fasciola hepatica infection. Am J Trop Med Hyg 2000; 63:264.
  19. Graham CS, Brodie SB, Weller PF. Imported Fasciola hepatica infection in the United States and treatment with triclabendazole. Clin Infect Dis 2001; 33:1.
  20. Lecaillon JB, Godbillon J, Campestrini J, et al. Effect of food on the bioavailability of triclabendazole in patients with fascioliasis. Br J Clin Pharmacol 1998; 45:601.
  21. Grove DI. Treatment of strongyloidiasis with thiabendazole: an analysis of toxicity and effectiveness. Trans R Soc Trop Med Hyg 1982; 76:114.
  22. Keiser PB, Reynolds SM, Awadzi K, et al. Bacterial endosymbionts of Onchocerca volvulus in the pathogenesis of posttreatment reactions. J Infect Dis 2002; 185:805.
  23. Cross HF, Haarbrink M, Egerton G, et al. Severe reactions to filarial chemotherapy and release of Wolbachia endosymbionts into blood. Lancet 2001; 358:1873.
  24. Nitazoxanide (Alinia)--a new anti-protozoal agent. Med Lett Drugs Ther 2003; 45:29.
  25. Zumaquero-Ríos JL, Sarracent-Pérez J, Rojas-García R, et al. Fascioliasis and intestinal parasitoses affecting schoolchildren in Atlixco, Puebla State, Mexico: epidemiology and treatment with nitazoxanide. PLoS Negl Trop Dis 2013; 7:e2553.