Levamisole: Uses, Dosage, and Side Effects for Humans

Summary of Key Points

Levamisole is a medication primarily used to treat parasitic infections such as ascariasis, hookworm, and strongyloidiasis. It works by stimulating the immune system and paralyzing parasites, allowing the body to eliminate them. Levamisole is also sometimes used off-label for other conditions. It’s essential to follow your healthcare provider’s instructions for dosing and administration. If you have any concerns, you can consult one of our telemedicine providers for personalized advice.

Names of Medication

US Brand Name: No longer available in the U.S.

Generic Name: Levamisole

The generic name is the official medical name of the active ingredient in the medication. It is listed in parentheses.

Pharmacologic Category

Levamisole belongs to two main categories:

1. Anthelmintic: Used to treat parasitic worm infections.
2. Immunomodulator: Used to modify the immune system.

Levamisole Dosage

Levamisole is used to treat various parasitic infections in adults. The dosage depends on the specific condition being treated. Always consult your healthcare provider before adjusting your dose. Our telemedicine providers are available to help you manage your treatment plan.

1. Ascariasis (Roundworm infection): 150 mg as a single dose. No further treatment is typically needed unless reinfection occurs.
2. Strongyloidiasis (Threadworm infection): 150 mg once daily for 3 days. Treatment may be repeated if necessary.
3. Hookworm infection: 150 mg as a single dose. Follow-up may be required depending on the severity of the infection.
4. Ancylostomiasis (Hookworm infection): 150 mg as a single dose. Repeat treatment may be necessary in some cases.
5. Trichuriasis (Whipworm infection): 150 mg as a single dose. Retreatment may be considered if symptoms persist.
6. Schistosomiasis: 150 mg once daily for 3 days. Additional treatment may be required based on the severity of the infection.
7. Filariasis: 150 mg once daily for 3 days. Retreatment may be necessary depending on the response to therapy.
8. Echinococcosis (Hydatid disease): 150 mg once daily for 3 days. Further treatment may be needed based on the infection’s severity.
9. Toxocariasis (Visceral larva migrans): 150 mg once daily for 3 days. Retreatment may be necessary in some cases.
10. Giardiasis: 150 mg once daily for 3 days. Follow-up may be required to ensure the infection is fully cleared.

Dosage Forms and Strengths

Levamisole is available in the following forms:

1. Tablet: 50 mg, 150 mg

Administration Instructions for Levamisole

Levamisole should be taken by mouth with a full glass of water. It can be taken with or without food, but taking it with food may help reduce stomach upset. Be sure to follow the dosing schedule provided by your healthcare provider. If you miss a dose, take it as soon as you remember, but do not double up on doses. If you have any questions about how to take your medication, consult one of our telemedicine providers.

Levamisole Side Effects and Adverse Reactions

Like all medications, Levamisole can cause side effects. While not everyone experiences them, it’s important to be aware of potential reactions. If you experience any severe or persistent side effects, contact a healthcare provider immediately. Our telemedicine team is available to help you manage any concerns.

Common Levamisole Side Effects

1. Nausea: Feeling sick to your stomach, which may improve if you take the medication with food.
2. Vomiting: Some patients may experience vomiting, especially if the medication is taken on an empty stomach.
3. Diarrhea: Loose or watery stools can occur but are usually mild and temporary.

Less Common Side Effects

1. Fatigue: Feeling unusually tired or weak.
2. Headache: Mild to moderate headaches may occur but are typically short-lived.

Rare but Serious Side Effects

1. Agranulocytosis: A severe decrease in white blood cells, which can increase the risk of infection. Seek medical attention if you experience fever, sore throat, or signs of infection.
2. Liver toxicity: In rare cases, Levamisole can affect liver function. Symptoms may include yellowing of the skin or eyes (jaundice), dark urine, or severe fatigue.

Contraindications for Levamisole

A contraindication is a specific situation or condition where a medication should not be used because it may be harmful to the patient. If you have any of the conditions listed below, Levamisole may not be safe for you. Always talk to your healthcare provider before starting any new medication, and you can consult with one of our providers through telemedicine for personalized advice.

Conditions Where Levamisole Should Be Avoided

1. Hypersensitivity to Levamisole: If you have had an allergic reaction to Levamisole in the past, you should not take this medication. Allergic reactions can include symptoms like rash, itching, swelling, or difficulty breathing.
2. Severe Liver or Kidney Disease: Levamisole is processed by the liver and kidneys. If these organs are not functioning properly, the medication may build up in your body, leading to toxicity or harmful side effects.
3. Blood Disorders: Levamisole can affect your white blood cell count, so it is contraindicated in patients with pre-existing blood disorders like agranulocytosis or neutropenia, as it may worsen these conditions.
4. Autoimmune Diseases: Levamisole has immune-modulating properties, meaning it can affect how your immune system works. If you have an autoimmune condition like lupus or rheumatoid arthritis, Levamisole may exacerbate your symptoms.

Drug to Drug Interactions

Levamisole can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Levamisole:

1. Warfarin (Coumadin): Levamisole may enhance warfarin’s blood-thinning effects, increasing the risk of bleeding.
2. Phenytoin (Dilantin): Levamisole can raise phenytoin levels in the blood, potentially leading to toxicity.
3. Fluorouracil (Adrucil): When combined with Levamisole, this chemotherapy drug may increase the risk of severe side effects, including low blood cell counts and gastrointestinal issues.
4. Alcohol: Consuming alcohol while taking Levamisole may heighten the risk of liver damage and other side effects.

Levamisole in Pregnancy

Is it Safe to Take Levamisole When Pregnant?

Levamisole is not recommended during pregnancy. Animal studies suggest potential harm to the fetus, and there is limited data on its safety in pregnant women. If you are pregnant or planning to become pregnant, discuss alternative treatments with your healthcare provider. You can also consult one of our telemedicine providers to explore safer options for your condition.

Levamisole While Breastfeeding

Is it Safe to Take Levamisole While Breastfeeding?

There is limited information on whether Levamisole passes into breast milk or its effects on a breastfeeding infant. Due to the potential for serious side effects in the nursing baby, it is generally advised to avoid Levamisole while breastfeeding. Speak with your healthcare provider about alternative treatments, or consult one of our telemedicine providers for personalized advice.

Estimated Cost of Levamisole

The estimated cost of a 30-day supply of Levamisole without insurance, using a GoodRX coupon, ranges from $50 to $70. Prices may vary depending on the pharmacy and location. Check with your pharmacy or use a GoodRX coupon for the most accurate pricing.

Possible Alternatives to Levamisole

If Levamisole is not suitable for you, alternative treatments and lifestyle changes may help manage the conditions it treats. Always discuss any changes to your treatment plan with your healthcare provider, and feel free to consult one of our telemedicine providers for guidance.

1. Ascariasis: Alternatives include albendazole (Albenza) or mebendazole (Vermox). Maintaining good hygiene and avoiding contaminated food and water can help prevent reinfection.
2. Strongyloidiasis: Ivermectin (Stromectol) is often the first-line treatment. Preventive measures include wearing shoes in areas where the infection is common and avoiding contact with contaminated soil.
3. Hookworm Infection: Albendazole (Albenza) or mebendazole (Vermox) are commonly used. Improving sanitation and wearing protective footwear can reduce the risk of infection.
4. Ancylostomiasis: Similar to hookworm infection, albendazole or mebendazole are effective treatments. Public health measures like improving sanitation can help prevent the spread of the disease.
5. Trichuriasis: Mebendazole or albendazole are the preferred treatments. Practicing good hygiene and avoiding contaminated food and water can help prevent reinfection.
6. Schistosomiasis: Praziquantel (Biltricide) is the standard treatment. Avoiding contact with contaminated freshwater sources can help prevent schistosomiasis.
7. Filariasis: Diethylcarbamazine (DEC) is the primary treatment. Preventive measures include using mosquito nets and insect repellent in areas where the disease is common.
8. Echinococcosis: Albendazole is often used to treat this condition. In some cases, surgery may be required to remove cysts. Preventive measures include avoiding contact with infected animals and practicing good hygiene.
9. Toxocariasis: Albendazole or mebendazole are effective treatments. Preventing infection involves avoiding contact with contaminated soil and practicing good hygiene, especially around pets.
10. Giardiasis: Metronidazole (Flagyl) or tinidazole (Tindamax) are common treatments. Boiling water or using water filters can help prevent infection, especially when traveling to areas with poor sanitation.

Recent Updates on Levamisole Research

Recent studies have explored Levamisole’s potential in treating autoimmune diseases and certain cancers due to its immune-modulating effects. However, these uses are still under investigation, and Levamisole is not currently approved for these conditions. Additionally, research has highlighted the risks associated with Levamisole-contaminated cocaine, which has been linked to serious side effects like skin necrosis and immune system suppression. If you have concerns about Levamisole or its potential uses, consult one of our telemedicine providers for the latest information and personalized advice.

James Kingsley

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