Levamisole

CLINICAL USE


Treatment of roundworm (Ascaris lumbricoides)

DOSE IN NORMAL RENAL FUNCTION

120–150 mg as a single dose

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :204.3
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :19–26
  • %Excreted unchanged in urine &nbsp &nbsp : 5

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

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

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in normal renal function
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    –

    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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