Triclabendazole is an anthelmintic medication formulated to treat infections from parasitic worms called trematodes, or flukes. Originally developed for veterinary use, it was approved for human medical use in the United States in 2019. The World Health Organization recognizes this medication as a primary treatment for certain fluke infections.
Infections Treated by Triclabendazole
Triclabendazole is the primary medication used to treat fascioliasis, an infection caused by the liver fluke Fasciola hepatica or Fasciola gigantica. Humans typically contract this parasite by consuming contaminated aquatic plants, such as wild watercress, or by drinking contaminated water. Once ingested, the immature flukes migrate from the intestines to the liver, where they mature and can cause significant damage.
The medication, sold under the brand name Egaten for human use, is also a promising treatment for paragonimiasis. This disease is caused by the lung fluke, Paragonimus, and infection usually occurs from eating raw or undercooked freshwater crabs or crayfish that harbor the parasite. The flukes travel to the lungs, where they can cause respiratory symptoms.
Dosage and Administration
The dosage of triclabendazole is determined by a healthcare professional based on the patient’s body weight. For fascioliasis, a common approach involves a single dose of 10 mg per kg of body weight. In some cases, a two-dose regimen is prescribed, with each dose taken 12 hours apart, for a total of 20 mg per kg to increase cure rates.
Triclabendazole should be taken with food, as a meal significantly enhances its absorption into the bloodstream, which is necessary for it to reach the parasites. The drug works by interfering with the internal structural components (microtubules) within the parasite’s cells. This disruption paralyzes the flukes, inhibiting their ability to absorb nutrients and ultimately causing their death.
Potential Side Effects and Precautions
Some individuals may experience side effects after taking triclabendazole, though they are generally not severe. Common reactions include abdominal pain, headache, nausea, dizziness, and sweating. Some of these symptoms, particularly abdominal pain or biliary colic (intense pain in the upper-right abdomen), may result from the dying parasites being expelled from the body rather than from the medication itself.
More serious side effects are rare but require immediate medical attention. These can include severe skin reactions like hives or rashes, or signs of liver distress such as jaundice (yellowing of the skin or eyes) and dark urine. Before starting treatment, patients should inform their doctor about their complete medical history, especially any known heart conditions like QT prolongation or pre-existing liver problems.
It is also important for patients to provide their physician with a list of all other medications they are currently taking to avoid potential drug interactions. Following the prescribed dosage and administration instructions is fundamental to the treatment’s success and safety.