Praziquantel Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 18, 2023.

Applies to praziquantel: oral tablet.

Serious side effects of Praziquantel

Along with its needed effects, praziquantel may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking praziquantel:

Incidence not known

• Black, tarry stools
• blistering, peeling, or loosening of the skin
• bloody diarrhea
• blurred or loss of vision
• chest pain or discomfort
• chills
• cough
• dark urine
• diarrhea
• difficulty swallowing
• difficulty with moving
• disturbed color perception
• dizziness
• double vision
• fainting
• fast, slow, or irregular heartbeat
• fever
• general feeling of discomfort or illness
• general tiredness and weakness
• halos around lights
• hives, itching, skin rash
• joint pain, stiffness, or swelling
• light-colored stools
• lightheadedness, dizziness, or fainting
• muscle pains, cramps, or stiffness
• nausea
• night blindness
• overbright appearance of lights
• painful or difficult urination
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• red skin lesions, often with a purple center
• red, irritated eyes
• redness of the skin
• severe abdominal or stomach pain
• seizures
• sleepiness or unusual drowsiness
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• stomach discomfort with or without nausea
• stomach pain
• sweating
• swelling of the eyelids, face, lips, hands, or feet
• swollen glands
• thickening of bronchial secretions
• tightness in the chest
• tremor
• troubled breathing
• tunnel vision
• unusual bleeding or bruising
• unusual tiredness or weakness
• upper right abdominal pain
• vomiting
• yellow eyes and skin

Other side effects of Praziquantel

Some side effects of praziquantel may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

• Change in walking and balance
• clumsiness or unsteadiness
• continuing ringing or buzzing or other unexplained noise in the ears
• dizziness or lightheadedness
• feeling of constant movement of self or surroundings
• headache
• hearing loss
• lack or loss of strength
• loss of appetite
• sensation of spinning
• weight loss

For Healthcare Professionals

Applies to praziquantel: compounding powder, oral tablet.

General

Side effects varied according to dose and duration of therapy. Side effects depended on parasite species, extent of infestation, infection duration, and parasite location in the body. Side effects occurred earlier and were more frequent and/or serious in patients with severe infestation.

Often, it was unclear if this drug, an endogenous reaction to parasites dying from the drug, or symptoms of the infestation caused the reported side effects.

Side effects included malaise, headache, dizziness, abdominal discomfort (with or without nausea), pyrexia, and urticaria; generally in order of severity. Such side effects were more frequent and/or serious in patients with heavy worm burden.

Nervous system

Very common (10% or more): Headache, dizziness

Common (1% to 10%): Vertigo, somnolence (including drowsiness)

Very rare (less than 0.01%): Seizures

Frequency not reported: Cerebral inflammatory reaction

Postmarketing reports: Convulsion, somnolence, vertigo, tinnitus, intention tremor[Ref]

The inflammatory reaction produced by antigenic substances released from dying cysts frequently involved increased intracranial pressure, seizures, severe headaches, nausea, and vomiting. In areas where Taenia solium was endemic, these reactions may occur as the result of undiagnosed cysticercosis in patients being treated for other parasitic infections. The duration of the reaction differs among patients. Delayed reactions have been reported.[Ref]

Gastrointestinal

Very common (10% or more): Gastrointestinal and abdominal pains, nausea, vomiting

Common (1% to 10%): Diarrhea

Frequency not reported: Abdominal discomfort (with or without nausea), gagging

Postmarketing reports: Abdominal pain, bloody diarrhea, vomiting[Ref]

A syndrome of severe abdominal pain and bloody diarrhea was reported less often during schistosomiasis therapy.

Gagging and vomiting have been reported due to the bitter taste of the tablets.[Ref]

Other

Very common (10% or more): Fatigue

Common (1% to 10%): Feeling unwell (asthenia, malaise), pyrexia/fever

Frequency not reported: Rise in temperature, transient edema

Postmarketing reports: Asthenia, fatigue, polyserositis, gait disturbance[Ref]

Dermatologic

A 13-year-old male developed Mazzotti reaction after treatment with ivermectin, praziquantel, and albendazole for presumptive schistosomiasis and strongyloidiasis. Six days after receiving standard empiric therapy, he developed epigastric pain, vomiting, and urticaria. This progressed in 4 hours and included fever, general myalgia, and edema of the face, lower extremities, and penis accompanied by urticaria of the arms, legs, and trunk. He was diagnosed with a Mazzotti reaction and treated with methylprednisolone; symptoms subsided within 12 hours.[Ref]

Very common (10% or more): Urticaria

Common (1% to 10%): Rash

Very rare (less than 0.01%): Pruritus

Frequency not reported: Mazzotti-like reaction

Postmarketing reports: Pruritus, rash, Stevens-Johnson syndrome[Ref]

Metabolic

Common (1% to 10%)/Postmarketing reports: Anorexia

Musculoskeletal

Common (1% to 10%)/Postmarketing reports: Myalgia

Frequency not reported: Musculoskeletal aches and fatigue[Ref]

Hepatic

Frequency not reported: Mild increases in liver enzymes

Postmarketing reports: Hepatitis

Cardiovascular

Very rare (less than 0.01%): Unspecified arrhythmias

Postmarketing reports: Arrhythmia (including bradycardia, ectopic rhythms, ventricular fibrillation, atrioventricular blocks)

Hypersensitivity

Postmarketing reports: Allergic reaction, generalized hypersensitivity, anaphylactic reaction

Hematologic

Postmarketing reports: Eosinophilia

Respiratory

Postmarketing reports: Pneumonitis, dyspnea, wheezing

Ocular

Postmarketing reports: Visual disturbance

References

1. Markwalder K, Hess K, Valavanis A, Witassek F. Cerebral cysticercosis: treatment with praziquantel. Report of two cases. Am J Trop Med Hyg. 1984;33:273-80.

2. Bada JL, Trevino B, Cabezos J. Convulsive seizures after treatment with praziquantel. Br Med J (Clin Res Ed). 1988;296:646.

3. Watt G, White NJ, Padre L, Ritter W, Fernando MT, Ranoa CP, Laughlin LW. Praziquantel pharmacokinetics and side effects in Schistosoma japonicum-infected patients with liver disease. J Infect Dis. 1988;157:530-5.

4. Homeida MM, Eltom IA, Sulaiman SM, Ali HM, Bennett JL. Tolerance of two brands of praziquantel. Lancet. 1989;2:391.

5. Ciferri F. Delayed CSF reaction to praziquantel. Lancet. 1988;1:642-3.

6. Flisser A, Madrazo I, Plancarte A, Schantz P, Allan J, Craig P, Sarti E. Neurological symptoms in occult neurocysticercosis after single taeniacidal dose of praziquantel. Lancet. 1993;342:748.

7. McMahon JE. Praziquantel: a new schistosomicide against Schistosoma mansoni. Arzneimittelforschung. 1981;31:592-4.

8. Leblanc R, Knowles KF, Melanson D, MacLean JD, Rouleau G, Farmer JP. Neurocysticercosis: surgical and medical management with praziquantel. Neurosurgery. 1986;18:419-27.

9. Product Information. Biltricide (praziquantel). Bayer. 2001.

10. Cerner Multum, Inc. Australian Product Information.

11. Polderman AM, Gryseels B, Gerold JL, Mpamila K, Manshande JP. Side effects of praziquantel in the treatment of Schistosoma mansoni in Maniema, Zaire. Trans R Soc Trop Med Hyg. 1984;78:752-4.

12. Watt G, Baldovino PC, Castro JT, Fernando MT, Ranoa CP. Bloody diarrhoea after praziquantel therapy. Trans R Soc Trop Med Hyg. 1986;80:345-6.

13. Stelma FF, Talla I, Sow S, Kongs A, Niang M, Polman K, Deelder AM, Gryseels B. Efficacy and side effects of praziquantel in an epidemic focus of schistosoma mansoni. Am J Trop Med Hyg. 1995;53:167-70.

14. Shorter D, Hale K, Elliott E. Mazzotti-like Reaction After Treatment with Praziquantel for Schistosomiasis. Pediatr Infect Dis J. 2006;25:1087-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer

Praziquantel is used to treat infections caused by schistosoma worms, which enter the body through skin that has come into contact with contaminated water. Schistosoma worms are found in Africa, South America, Middle Eastern countries, the Caribbean, and parts of Asia.

Praziquantel is also used to treat infection with liver flukes, caused by a type of worm found in East Asia. This worm enters the body while eating contaminated fish.

Praziquantel is for use in adults and children who are at least 1 year old.

Praziquantel may also be used for purposes not listed in this medication guide.