Medicated

The Best Dewormer for You and Your Family


written by HaVy Ngo, PharmD - Aug 30, 2021

Photo Credit: by Karsten Winegeart, Unsplash.com
Photo Credit: by Karsten Winegeart, Unsplash.com

What are intestinal worms?

Intestinal worms or parasitic worms are one of the main types of intestinal parasites. Their distinct shapes classify them:

- Flatworms, including flukes and tapeworms

- Roundworms, including pinworms and hookworms

The most common cause of intestinal worm infection is eating undercooked meat from animals such as pigs, cows, or even fish. Besides consuming undercooked meat and seafood, other causes of intestinal worms are:

- Consumption of contaminated water or soil

- Coming in contact with contaminated feces

- Poor sanitation, poor hygiene

After being consumed, the parasites travel to the intestine, where they grow and reproduce. Symptoms appear when the worm increase in number while getting bigger.

How to you that you have intestinal worms?

Being able to recognize symptoms of intestinal worms early will allow you to seek medical consultation from your primary care physician early and start treatment as soon as possible. Common symptoms of intestinal worms are described as below:

- Abdominal pain

- Diarrhea, nausea, vomiting

- Gas, bloating

- Fatigue

- Abdominal pain

- Unexplained weight loss

Untreated intestinal worm infection can lead to severe, life-threatening symptoms. Please seek medical care immediately if you experience any of the below symptoms:

- Bloody stool

- Pus in the stool

- Extremely fatigue and dehydration

- Fever, generalized malaise

If the infection is mild and you have a robust immune system, it may resolve itself sometimes. However, depending on the symptoms and the type of worm, oral medication may be indicated.

Deworming medications

One of the highly demanded dewormer products that our pharmacy offers is Combantrin. The generic name of Combantrin is pyrantel pamoate. This drug's other common brand names are Pin-Away, Pinworm Medicine, Antiminth, Pin-X, Ascarel, and Pinworm cablets. Combantrin is indicated for treating different types of intestinal parasites, including pinworms, roundworms, and other types of intestinal worms, as determined by your doctor. Combantrin works by paralyzing the worms; they are then passed in the stool. This medication is available in two dosage forms: oral tablets of 125 mg and oral suspension of 50mg/mL. The oral suspension is ideal to be used in kids or those who have a problem swallowing.

Combantrin has been tested in children of the age of two and older, where the effective doses have not shown any problems or different side effects compared to adults. Please talk to your doctor or pharmacist about other medication you are currently taking, as drug interaction may occur, leading to the decreased effectiveness of Combantrin or the current medication. Also, it is essential to consult with your doctor if you have existing liver disease. Do not take this medication if you are pregnant.

What is the proper way to take Combantrin?

What is the appropriate dose?

It is important to know that Combantrin is dosed per weight. The general recommended dose is 1 tablet (125 mg) per 25 lbs. (11 kg) of body weight. If you are using the oral suspension, this dose of 125 mg is equivalent to ½ teaspoonful (2.5 mL) per 25 lbs. (11 kg). Please carefully follow all dosing instructions. If your doctor recommends a different dosing regimen, please follow your doctor’s recommendation.

Combantrin can be taken with or without food, and it is acceptable to take it with water, milk, or juice. It is a single-dose treatment of pinworms and roundworms. However, for the pinworm treatment, since it is highly contagious, all household members need to be treated for the infection at the same time. Often, all household members may have to be treated again in 2 to 3 weeks to clear up the infection completely. Please consult your doctor or pharmacist if you have any questions regarding dosing and the number of treatments.

How to measure the oral suspension?

For oral suspension, an oral syringe or measuring spoon are the best way to measure oral suspension. A regular household spoon may not deliver the most accurate dose. Remember to shake the solution well before using.

What about storage?

In order to ensure the integrity of this medication, please follow the following instructions regarding storage:

- Store away from direct heat and light

- Make sure the oral suspension dosage from is not frozen

- Keep out of reach of children

- Do not use if the medication is outdated; discard any outdated medication

Precautions while being on Combantrin

Dizziness, drowsiness are common side effects of this medication. If this is the first time you take this medication, make sure you are not driving or operating heavy machinery. Let your doctor or pharmacist know if these symptoms are severe or unbearable. This medication's other common side effects include stomach pain, nausea, vomiting, diarrhea, or headache. If those symptoms persist and do not improve, please contact your doctor, or seek medical care immediately.

Other precautions if you are taking Combantrin for pinworms:

Though Combantrin is a very effective treatment for different types of intestinal worms, pinworms may return in some patients after the first round of treatment. The following tips are good practices to prevent reinfection:

- Avoid scratching the area around the buttocks.

- Keep fingernails short; make sure to wash your hands with soap and water thoroughly throughout the day, especially before eating and after using the toilet.

- Tight underpants should be worn day and night; make sure to change them daily.

- Clean and sanitize the toilet seat.

- Bedroom floor should be cleaned by vacuuming or damp mopping daily for several days after treatment. Avoid dry mopping to reduce stirred-up dust.

- Ensure to wash all bedding and clothing items after treatment. Avoid shaking bedding items.

Prevention of intestinal worms

Once the infection is clear, to prevent future infection, please practice good body and hand hygiene. Always wash hands with soap and water after using the toilet and before preparing, eating foods. In addition to hand hygiene, practice good food practice is also essential to prevent reinfection:

- Avoid raw food, including meat and fish

- Thoroughly cook meat and seafood before eating

- Raw fruits and vegetables should be washed thoroughly, peeled, or cooked

If you are visiting developing countries, basic sanitation and handwashing are extremely helpful. Also, make sure to drink water that is bottled or boiled.

Combantrin 125 mg is available at our pharmacy for $30.99 per 12 tablets; 30 mL oral suspension (50mg/mL) bottle is available for $34.99. Combantrin is an over-the-counter medication, thus, it would not require a prescription from your doctor. Please reach out to your doctor or pharmacist if you have any other questions or concerns.

Reference:

https://www.cdc.gov/parasites/index.html

https://www.drugs.com/cons/combantrin.html

https://www.healthline.com/health/intestinal-worms#prevention

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