Piperazine

Indications
 Oral
Ascariasis
Adult: As hydrate: 4.5 g as a single dose repeated once after 14 days. Alternatively, may be given as a preparation with senna in a single dose of 4 g of the phosphate, repeat dose mthly for up to 3 mth if needed; same dosage regimen may also be used to prevent ascariasis.
Child: As a single dose, repeated once after 14 days. <1 yr: 120 mg/kg (only upon medical advice), 1-3 yr: 1.5 g, 4-5 yr: 2.25 g, 6-8 yr: 3 g, 9-12 yr: 3.75 g. Alternatively, may be given as a preparation with senna in a single dose of 4 g of the phosphate, repeat dose mthly for up to 3 mth if needed; same dosage regimen may also be used to prevent ascariasis.
Oral
Enterobiasis
Adult: As hydrate: 2.25 g once daily for 7 days, 2nd course may be repeated after an interval of 7 days. Alternatively, may be given as a preparation with senna in a single dose of 4 g of the phosphate, repeat dose after 14 days.
Child: <1 yr: 45-75 mg/kg (only upon medical advice), 1-3 yr: 750 mg, 4-6 yr: 1.125 g, 7-12 yr: 1.5 g, >12 yr: same as adult dose. To be taken once daily for 7 days, 2nd course may be repeated after an interval of 7 days. Alternatively, for children >6 yr: May be given as a preparation with senna in a single dose of 4 g of the phosphate; repeat dose after 14 days.
Contraindications
 Severe renal impairment, epilepsy. Pregnancy.
Warnings / Precautions
 Hepatic impairment, neurological conditions, mild to moderate renal impairment. Lactation.
Adverse Reactions
 Nausea, vomiting, colic, abdominal pain, diarrhoea, urticaria, skin rashes, headache, bronchospasm, dizziness, nystagmus, ataxia, paraesthesia, myoclonic contractions, choreiform movements, muscular incoordination (worm wobble), confusion, EEG abnormalities, blurred vision.
Potentially Fatal: Stevens-Johnson syndrome, bronchospasm and angioedema.
Drug Interactions
 Antagonism if pyrantel and piperazine are used together. Piperazine may potentiate extrapyramidal effects of chlorpromazine and other phenothiazines.
See Below for More piperazine Drug Interactions
Mechanism of Actions
 Piperazine is effective against the intestinal nematodes roundworm (Ascaris lumbricoides), pinworm and threadworm (Enterobius vermicularis). It produces a neuromuscular block resulting in muscle paralysis of the worms which are consequently dislodged and expelled in the faeces.
Absorption: Readily absorbed from the GIT (oral).
Distribution: Distributes into breast milk.
Excretion: Via urine (as metabolites).
Administration
 May be taken with or without food.
ATC Classification
 P02CB01 - piperazine ; Belongs to the class of piperazine and derivatives agents. Used as antinematodal.
Available As
  • Piperazine 2 mg
  • Piperazine Citrate 4000 mg
  • Piperazine Adipate 450 mg
  • Piperazine 5 mg
  • Piperazine Citrate 500 mg
  • Piperazine Hexahydrate 500 mg
  • Piperazine Citrate 750 mg
  • Piperazine 750 mg
  • Piperazine Citrate 771.42 mg
  • Piperazine 80 mg

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