Piperazine

Piperazine is a anthelmintic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of ascariasis caused by Ascaris lumbricoides (roundworm).
• Treatment of enterobiasis caused by Enterobius vermicularis (pinworm/threadworm).

Adult dosing depends on the type of worm infection, the exact piperazine salt and strength, body weight, and the product instructions. It is commonly given as a single dose or short course; pinworm infection may require repeat treatment and household hygiene measures to prevent reinfection. Follow the prescribing doctor’s or pharmacist’s instructions and the product label exactly.

• Common: nausea, vomiting, abdominal discomfort, diarrhoea, headache, dizziness, and tiredness.
• Less common: rash or itching.
• Serious but uncommon: confusion, tremor, poor coordination, muscle weakness, visual disturbance, or seizures, especially with overdose or in people with kidney or neurological disease.
• Seek urgent medical help for signs of allergy such as swelling of the face or throat, breathing difficulty, or severe rash.

Use caution in people with epilepsy or a history of seizures, significant kidney disease, liver disease, severe malnutrition, or neurological disorders. Do not exceed the recommended dose, and avoid repeated treatment unless advised. Treating pinworm also requires hygiene measures such as handwashing, trimming nails, washing bedding/clothes, and treating close contacts when advised. Use under a registered doctor's or pharmacist's guidance.

• Pyrantel pamoate: may have opposing actions against worms; avoid using together unless specifically instructed by a doctor.
• Medicines that lower the seizure threshold, such as some antipsychotics including phenothiazines, may increase the risk of neurological adverse effects; seek medical advice before use.
• Tell the doctor or pharmacist about all prescription medicines, over-the-counter medicines, and herbal products before taking piperazine.
• No specific food interaction is well established; take as directed on the label or by the prescriber.

• Known hypersensitivity to piperazine or any ingredient of the product.
• Uncontrolled epilepsy or significant seizure disorder, unless a specialist decides the benefit outweighs the risk.
• Severe kidney impairment or severe neurological disease, unless specifically prescribed with appropriate monitoring.

During pregnancy or breastfeeding, piperazine should be used only if a doctor confirms it is necessary and appropriate. The prescriber will consider the type of worm infection, timing of pregnancy, alternative treatments, and the health of the mother and baby.

Store the powder in a tightly closed container at room temperature, away from excess heat, moisture, and direct sunlight. Keep out of reach of children and do not use after the expiry date.