Levamisole

CLINICAL USE

Treatment of roundworm (Ascaris lumbricoides)

DOSE IN NORMAL RENAL FUNCTION

120–150 mg as a single dose

PHARMACOKINETICS

Molecular weight :204.3

%Protein binding :19–26

%Excreted unchanged in urine : 5

Volume of distribution (L/kg) :100–120 litres

half-life – normal/ESRD (hrs) :3–4 (16 for metabolites)

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in normal renal function

HD :Unknown dialysability. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Alcohol: may produce a disulfiram-like reactionPhenytoin: increased levels of phenytoin have been reportedWarfarin: enhanced INR

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Available on a named patient basis from IDISAvoid in patients with pre-existing blood disordersHas been successfully used to treat relapsing nephrotic syndrome in children at a dose of 2.5mg/kg/alternate day. (Al-Saran K, Mirza K, Al-Ghanam G, et al. Experience with levamisole in frequently relapsing, steroid-dependent nephritic syndrome. Pediatr Nephrol. 2006 Feb; 21(2): 201–5)Has also been used in haemodialysis patients to enhance response to Hepatitis B vaccine. (Kayatas M. Levamisole treatment enhances protective antibody response to hepatitis B vaccine in hemodialysis patients.

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