BNF for Children 2011-2012

BNFC 2011–2012 5.5.2 Ascaricides 3451Mebendazole (Non-proprietary) ATablets, chewable, mebendazole 100 mg1. Mebendazole tablets can be sold to the public if supplied fororal use in the treatment of enterobiasis in children over 2years provided its container or package is labelled to show amax. single dose of 100 mg and it is supplied in a containeror package containing not more than 800 mgVermox c (Janssen) ATablets, orange, scored, chewable, mebendazole100 mg. Net price 6-tab pack = £1.36Oral suspension, mebendazole 100 mg/5 mL (banana-flavoured).Net price 30 mL = £1.595.5.2 Ascaricides(common roundworm infections)Mebendazole (section 5.5.1) is effective against Ascarislumbricoides and is generally considered to be the drugof choice.Levamisole [unlicensed] (available from ‘special-order’manufacturers or specialist importing companies, seep. 809) is an alternative when mebendazole cannot beused. It is very well tolerated; mild nausea or vomitinghas been reported in about 1% of treated patients.Piperazine may be given in a single dose, see Piperazine,above.PIPERAZINECautions epilepsyNote Packs on sale to the general public carry a warning toavoid in epilepsy, liver or kidney disease, and to seek medicaladvice in pregnancyHepatic impairment manufacturer advises avoidRenal impairment use with caution; avoid in severerenal impairment; risk of neurotoxicityPregnancy not known to be harmful but manufactureradvises avoid in first trimesterBreast-feeding present in milk—manufactureradvises avoid breast-feeding for 8 hours after dose(express and discard milk during this time)Side-effects nausea, vomiting, colic, diarrhoea, allergicreactions including urticaria, bronchospasm, andrare reports of arthralgia, fever, Stevens-Johnsonsyndrome and angioedema; rarely dizziness, muscularinco-ordination (‘worm wobble’); drowsiness, nystagmus,vertigo, blurred vision, confusion and cloniccontractions in children with neurological or renalabnormalitiesIndication and doseSee under preparation, belowWith sennosidesFor cautions, contra-indications, side-effects of sennasee section 1.6.2Pripsen c (Thornton & Ross)Oral powder, piperazine phosphate 4 g, total sennosides(calculated as sennoside B) 15.3 mg/sachet. Netprice two-dose sachet pack = £1.98. Label: 13Dose(stirred into milk or water)LEVAMISOLECautions epilepsy; juvenile idiopathic arthritis; Sjögren’ssyndromeContra-indications blood disordersHepatic impairment use with caution—dose adjustmentmay be necessaryPregnancy embryotoxic in animal studies, avoid ifpossibleBreast-feeding no information availableSide-effects nausea, vomiting, diarrhoea; dizziness,headache; on prolonged treatment taste disturbances,insomnia, convulsions, influenza-like syndrome,blood disorders, vasculitis, arthralgia, myalgia, rashLicensed use not licensedIndication and doseRoundworm (Ascaris lumbricoides). By mouthChild 1 month–18 years 2.5–3 mg/kg (max.150 mg) as a single doseHookworm. By mouthChild 1 month–18 years 2.5 mg/kg (max.150 mg) as a single dose repeated after 7 days ifsevereNephrotic syndrome (specialist supervisionsection 6.3.2). By mouthChild 1month–18 years 2.5 mg/kg (max. 150 mg)on alternate daysLevamisole (Non-proprietary) ATablets, levamisole (as hydrochloride) 50 mg Label: 4Available from ‘special-order’ manufacturers or specialistimporting companies, see p. 8095 InfectionsThreadworms. By mouthChild 3 months–1 year 1 level 2.5-mL spoonful as asingle dose in the morning, repeated after 14 daysChild 1–6 years 1 level 5-mL spoonful as a single dose inthe morning, repeated after 14 daysChild 6–18 years content of 1 sachet as a single dose (inthe morning), repeated after 14 daysRoundworms first dose as for threadworms; repeat atmonthly intervals for up to 3 months if reinfection risk5.5.3 Drugs for tapeworminfectionsTaenicidesNiclosamide [unlicensed] (available from ‘specialorder’manufacturers or specialist importing companies,see p. 809) is the most widely used drug for tapeworminfections and side-effects are limited to occasional