Piperazine


Generic Medicine Info
Indications and Dosage
Oral
Enterobiasis
Adult: As piperazine hydrate: 2,000-2,250 mg daily given as a single or in divided doses for 7 days. May repeat course after 1-week interval in severe infections.
Child: As piperazine hydrate: 1-2 years 375 mg; 2-4 years 750 mg; 5-12 years 1,500 mg; >12 years Same as adult dose. All doses are given daily as a single or in divided doses for 7 days. May repeat course after 1-week interval in severe infection.

Oral
Ascariasis
Adult: As piperazine hydrate: 4,000-4,500 mg as a single dose with the evening meal. If patient is constipated, administer laxative in the morning after treatment to facilitate expulsion of worms. Dosing recommendations may vary among individual products. Refer to specific product guidelines.
Child: As piperazine hydrate: 1-2 years 1,125-1,333 mg; 3-8 years 2,250-2,666 mg; 9-12 years: 3,000 mg; >12 years Same as adult dose. All doses to be taken as a single dose with the evening meal. If patient is constipated, administer laxative in the morning after treatment to facilitate expulsion of worms. Dosing recommendations may vary among individual products. Refer to specific product guidelines.
Renal Impairment
Severe: Contraindicated.
Hepatic Impairment
Contraindicated.
Administration
May be taken with or without food.
Contraindications
History of epilepsy. Severe renal impairment. Hepatic impairment. Pregnancy.
Special Precautions
Patient with anaemia, severe malnutrition, neurological disturbances. Mild to moderate renal impairment. Children. Lactation.
Adverse Reactions
Eye disorders: Blurred vision, nystagmus, cataracts (rare).
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain.
Immune system disorders: Hypersensitivity reactions (e.g. bronchospasm, angioedema, urticaria, Stevens-Johnson syndrome).
Musculoskeletal and connective tissue disorders: Muscular incoordination and weakness.
Nervous system disorders: Ataxia, headache, dizziness, drowsiness, paraesthesia, myoclonic contractions (if renal or neurological disease exist), choreiform movements, tremor, seizure, hyporeflexia.
Psychiatric disorders: Confusion.
Monitoring Parameters
Examine stool for worms and ova.
Drug Interactions
May potentiate the adverse effects of phenothiazines (e.g. chlorpromazine). Antagonised anthelmintic effect with pyrantel pamoate.
Action
Description: Piperazine is an anthelmintic effective against Ascaris lumbricoides (roundworm) and Enterobius vermicularis (threadworm/pinworm). It blocks the effect of acetylcholine at the neuromuscular junction which causes flaccid paralysis to roundworms, which are then dislodged by the movement of the gut and expelled in the faeces. Its mode of action against threadworm is not fully elucidated.
Pharmacokinetics:
Absorption: Readily absorbed from the gastrointestinal tract.
Distribution: Enters breast milk.
Excretion: Via urine (partly as metabolites).
Chemical Structure

Chemical Structure Image
Piperazine

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 4837, Piperazine. https://pubchem.ncbi.nlm.nih.gov/compound/Piperazine. Accessed July 26, 2021.

Storage
Storage recommendations may vary among individual products. Refer to specific product guidelines.
MIMS Class
Anthelmintics
ATC Classification
P02CB01 - piperazine ; Belongs to the class of piperazine and derivatives agents. Used as antinematodal.
References
Anon. Piperazine (Briggs Drugs in Pregnancy and Lactation). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/07/2021.

Anon. Piperazine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 12/07/2021.

Ascalix Syrup 4 g/30 mL (Wallace Manufacturing Chemists Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 12/07/2021.

Ascalix Syrup 750 mg/5 mL (Wallace Manufacturing Chemists Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 12/07/2021.

Buckingham R (ed). Piperazine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/07/2021.

Preston CL (ed). Piperazine + Chlorpromazine. Stockley’s Drug Interactions [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 12/07/2021.

Disclaimer: This information is independently developed by MIMS based on Piperazine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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