Dosing & Uses
Dosage Forms & Strengths
tablet
- 250mg
Fascioliasis
Indicated for treatment of fascioliasis
10 mg/kg PO x2 doses administered 12 hr apart
Tablets are scored and divisible into two equal halves of 125 mg
If dosage cannot be adjusted exactly, round dose upwards
Dosage Modifications
Renal or hepatic impairment: Not studied
Dosage Forms & Strengths
tablet
- 250mg
Fascioliasis
Indicated for treatment of fascioliasis in patients ≥6 years
<6 years: Safety and efficacy not established
≥6 years
- 10 mg/kg PO x2 doses administered 12 hr apart
- Tablets are scored and divisible into two equal halves of 125 mg
- If dosage cannot be adjusted exactly, round dose upwards
Dosage Modifications
Renal or hepatic impairment: Not studied
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (1)
- mavacamten
triclabendazole will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Contraindicated. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction.
Serious - Use Alternative (21)
- amisulpride
amisulpride and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- bedaquiline
bedaquiline and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- chloroquine
chloroquine and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- crizotinib
crizotinib and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
triclabendazole and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- eribulin
eribulin and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- isoflurane
isoflurane and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
oxaliplatin and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
triclabendazole and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
sevoflurane and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
siponimod and triclabendazole both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (123)
- albuterol
albuterol and triclabendazole both increase QTc interval. Use Caution/Monitor.
- alfuzosin
alfuzosin and triclabendazole both increase QTc interval. Use Caution/Monitor.
- ambrisentan
triclabendazole will increase the level or effect of ambrisentan by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- amiodarone
triclabendazole and amiodarone both increase QTc interval. Use Caution/Monitor.
triclabendazole will increase the level or effect of amiodarone by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. - anagrelide
triclabendazole and anagrelide both increase QTc interval. Use Caution/Monitor.
- apomorphine
apomorphine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- arformoterol
arformoterol and triclabendazole both increase QTc interval. Use Caution/Monitor.
- aripiprazole
aripiprazole and triclabendazole both increase QTc interval. Use Caution/Monitor.
- arsenic trioxide
triclabendazole and arsenic trioxide both increase QTc interval. Use Caution/Monitor.
- artemether
triclabendazole and artemether both increase QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
triclabendazole and artemether/lumefantrine both increase QTc interval. Use Caution/Monitor.
- asenapine
triclabendazole and asenapine both increase QTc interval. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and triclabendazole both increase QTc interval. Use Caution/Monitor.
- atomoxetine
atomoxetine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- bortezomib
triclabendazole will increase the level or effect of bortezomib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- carisoprodol
triclabendazole will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- citalopram
triclabendazole and citalopram both increase QTc interval. Use Caution/Monitor.
triclabendazole will increase the level or effect of citalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. - clobazam
triclabendazole will increase the level or effect of clobazam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- clofazimine
triclabendazole and clofazimine both increase QTc interval. Use Caution/Monitor.
- clomipramine
triclabendazole will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- clozapine
clozapine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- dasatinib
dasatinib and triclabendazole both increase QTc interval. Use Caution/Monitor.
- degarelix
degarelix and triclabendazole both increase QTc interval. Use Caution/Monitor.
- deutetrabenazine
triclabendazole and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dexlansoprazole
triclabendazole will increase the level or effect of dexlansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- diazepam
triclabendazole will increase the level or effect of diazepam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- diazepam intranasal
triclabendazole will increase the level or effect of diazepam intranasal by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may decrease rate of diazepam elimination, thereby increasing adverse reactions to diazepam.
- disopyramide
triclabendazole and disopyramide both increase QTc interval. Use Caution/Monitor.
- dofetilide
triclabendazole and dofetilide both increase QTc interval. Use Caution/Monitor.
- dolasetron
dolasetron and triclabendazole both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and triclabendazole both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and triclabendazole both increase QTc interval. Use Caution/Monitor.
- dronedarone
triclabendazole and dronedarone both increase QTc interval. Use Caution/Monitor.
- efavirenz
efavirenz and triclabendazole both increase QTc interval. Use Caution/Monitor.
- eliglustat
triclabendazole and eliglustat both increase QTc interval. Use Caution/Monitor.
- encorafenib
triclabendazole and encorafenib both increase QTc interval. Use Caution/Monitor.
- escitalopram
triclabendazole will increase the level or effect of escitalopram by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- esomeprazole
triclabendazole will increase the level or effect of esomeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- etravirine
triclabendazole will increase the level or effect of etravirine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- fingolimod
fingolimod and triclabendazole both increase QTc interval. Use Caution/Monitor.
- flibanserin
triclabendazole will increase the level or effect of flibanserin by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- fluoxetine
triclabendazole and fluoxetine both increase QTc interval. Use Caution/Monitor.
- fosphenytoin
triclabendazole will increase the level or effect of fosphenytoin by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- fostemsavir
triclabendazole and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gemifloxacin
gemifloxacin and triclabendazole both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and triclabendazole both increase QTc interval. Use Caution/Monitor.
- granisetron
triclabendazole and granisetron both increase QTc interval. Use Caution/Monitor.
- haloperidol
triclabendazole and haloperidol both increase QTc interval. Use Caution/Monitor.
- histrelin
triclabendazole and histrelin both increase QTc interval. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- ibutilide
triclabendazole and ibutilide both increase QTc interval. Use Caution/Monitor.
- ifosfamide
triclabendazole will increase the level or effect of ifosfamide by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- iloperidone
triclabendazole and iloperidone both increase QTc interval. Use Caution/Monitor.
- imipramine
triclabendazole will increase the level or effect of imipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- indacaterol, inhaled
triclabendazole and indacaterol, inhaled both increase QTc interval. Use Caution/Monitor.
- inotuzumab
triclabendazole and inotuzumab both increase QTc interval. Use Caution/Monitor.
- itraconazole
itraconazole and triclabendazole both increase QTc interval. Use Caution/Monitor.
- lansoprazole
triclabendazole will increase the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- lapatinib
triclabendazole and lapatinib both increase QTc interval. Use Caution/Monitor.
- lenvatinib
triclabendazole and lenvatinib both increase QTc interval. Use Caution/Monitor.
- leuprolide
triclabendazole and leuprolide both increase QTc interval. Use Caution/Monitor.
- levofloxacin
triclabendazole and levofloxacin both increase QTc interval. Use Caution/Monitor.
- lithium
lithium and triclabendazole both increase QTc interval. Use Caution/Monitor.
- lofexidine
triclabendazole and lofexidine both increase QTc interval. Use Caution/Monitor.
- lopinavir
triclabendazole and lopinavir both increase QTc interval. Use Caution/Monitor.
- lumefantrine
triclabendazole and lumefantrine both increase QTc interval. Use Caution/Monitor.
- methadone
triclabendazole and methadone both increase QTc interval. Use Caution/Monitor.
- methsuximide
triclabendazole will increase the level or effect of methsuximide by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- mifepristone
triclabendazole and mifepristone both increase QTc interval. Use Caution/Monitor.
- mirtazapine
mirtazapine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- modafinil
triclabendazole will increase the level or effect of modafinil by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- moxifloxacin
triclabendazole and moxifloxacin both increase QTc interval. Use Caution/Monitor.
- nelfinavir
triclabendazole will increase the level or effect of nelfinavir by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- nilotinib
triclabendazole and nilotinib both increase QTc interval. Use Caution/Monitor.
- ofloxacin
triclabendazole and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
triclabendazole and olanzapine both increase QTc interval. Use Caution/Monitor.
- omeprazole
triclabendazole will increase the level or effect of omeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- ondansetron
triclabendazole and ondansetron both increase QTc interval. Use Caution/Monitor.
- osilodrostat
osilodrostat and triclabendazole both increase QTc interval. Use Caution/Monitor.
- osimertinib
triclabendazole and osimertinib both increase QTc interval. Use Caution/Monitor.
- ospemifene
triclabendazole will increase the level or effect of ospemifene by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- paliperidone
triclabendazole and paliperidone both increase QTc interval. Use Caution/Monitor.
- panobinostat
triclabendazole and panobinostat both increase QTc interval. Use Caution/Monitor.
- pantoprazole
triclabendazole will increase the level or effect of pantoprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- pasireotide
triclabendazole and pasireotide both increase QTc interval. Use Caution/Monitor.
- pazopanib
triclabendazole and pazopanib both increase QTc interval. Use Caution/Monitor.
- pentamidine
triclabendazole and pentamidine both increase QTc interval. Use Caution/Monitor.
triclabendazole will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. - phenobarbital
triclabendazole will increase the level or effect of phenobarbital by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- phenytoin
triclabendazole will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- pimavanserin
triclabendazole and pimavanserin both increase QTc interval. Use Caution/Monitor.
- pimozide
triclabendazole and pimozide both increase QTc interval. Use Caution/Monitor.
- primaquine
triclabendazole and primaquine both increase QTc interval. Use Caution/Monitor.
- procainamide
triclabendazole and procainamide both increase QTc interval. Use Caution/Monitor.
- progesterone micronized
triclabendazole will increase the level or effect of progesterone micronized by affecting hepatic enzyme CYP2B6 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- propafenone
triclabendazole and propafenone both increase QTc interval. Use Caution/Monitor.
- quetiapine
triclabendazole and quetiapine both increase QTc interval. Use Caution/Monitor.
- quinidine
triclabendazole and quinidine both increase QTc interval. Use Caution/Monitor.
- quinine
triclabendazole and quinine both increase QTc interval. Use Caution/Monitor.
- rabeprazole
triclabendazole will increase the level or effect of rabeprazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- ranolazine
triclabendazole and ranolazine both increase QTc interval. Use Caution/Monitor.
- ribociclib
triclabendazole and ribociclib both increase QTc interval. Use Caution/Monitor.
- risperidone
triclabendazole and risperidone both increase QTc interval. Use Caution/Monitor.
- romidepsin
triclabendazole and romidepsin both increase QTc interval. Use Caution/Monitor.
- saquinavir
triclabendazole and saquinavir both increase QTc interval. Use Caution/Monitor.
- sertraline
triclabendazole will increase the level or effect of sertraline by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
sertraline and triclabendazole both increase QTc interval. Use Caution/Monitor. - solifenacin
solifenacin and triclabendazole both increase QTc interval. Use Caution/Monitor.
- sorafenib
triclabendazole and sorafenib both increase QTc interval. Use Caution/Monitor.
- sotalol
triclabendazole and sotalol both increase QTc interval. Use Caution/Monitor.
- stiripentol
triclabendazole will increase the level or effect of stiripentol by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- sunitinib
triclabendazole and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
tacrolimus and triclabendazole both increase QTc interval. Use Caution/Monitor.
- tetrabenazine
triclabendazole and tetrabenazine both increase QTc interval. Use Caution/Monitor.
- thioridazine
triclabendazole and thioridazine both increase QTc interval. Use Caution/Monitor.
- tofacitinib
triclabendazole will increase the level or effect of tofacitinib by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- toremifene
triclabendazole and toremifene both increase QTc interval. Use Caution/Monitor.
- trazodone
triclabendazole and trazodone both increase QTc interval. Use Caution/Monitor.
- trimipramine
triclabendazole will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- triptorelin
triclabendazole and triptorelin both increase QTc interval. Use Caution/Monitor.
- vandetanib
triclabendazole and vandetanib both increase QTc interval. Use Caution/Monitor.
- vemurafenib
triclabendazole and vemurafenib both increase QTc interval. Use Caution/Monitor.
- voriconazole
triclabendazole and voriconazole both increase QTc interval. Use Caution/Monitor.
triclabendazole will increase the level or effect of voriconazole by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. - vorinostat
vorinostat and triclabendazole both increase QTc interval. Use Caution/Monitor.
- ziprasidone
triclabendazole and ziprasidone both increase QTc interval. Use Caution/Monitor.
Minor (0)
Adverse Effects
>10%
10 mg/kg total
- Abdominal pain (56%)
- Hyperhidrosis (23%)
20 mg/kg total in 2 divided doses
- Abdominal pain (93%)
- Hyperhidrosis (25%)
- Nausea (18%)
- Decreased appetite (18%)
- Headache (14%)
- Urticaria (11%)
1-10% (10 mg/kg total)
Vertigo (9%)
Nausea (8%)
Urticaria (7%)
Vomiting (6%)
Headache (6%)
Dyspnea (5%)
Pruritus (4%)
Asthenia (4%)
Musculoskeletal chest pain (4%)
Cough (4%)
Decreased appetite (3%)
Chest pain (3%)
Pyrexia (2%)
Jaundice (2%)
Chest discomfort (2%)
1-10% (20 mg/kg total in 2 divided doses)
Vomiting (7%)
Diarrhea (7%)
Elevated bilirubin (6.8%)
Elevated AST (4.5%)
Elevated ALP (4.2%)
Pruritus (4%)
Musculoskeletal chest pain (4%)
Elevated ALT (3%)
Postmarketing Reports
Resistance to triclabendazole reported
Warnings
Contraindications
Hypersensitivity to triclabendazole and/or to other benzimidazole derivatives or to any of the excipients
Cautions
Prolongs QTc interval; magnitude of QTc prolongation can increase with increasing treatment duration; monitor electrocardiogram (ECG) in patients with a history of prolongation of QTc interval or a history of symptoms compatible with a long QT interval or with electrolyte imbalance like hypokalemia, or in patients with hepatic impairment; if signs of cardiac arrhythmia occur during treatment, stop treatment and monitor ECG
Drug interactions overview
- In vitro data suggest coadministration of triclabendazole and CYP2C19 substrates may increase plasma concentrations of CYP2C19 substrates; potential elevated concentrations of CYP2C19 substrates is expected to be transient based on the short elimination half-life and short treatment duration of triclabendazole
- Monitor ECG when used in patients who receive drugs that are known to prolong the QTc interval, or patients taking CYP1A2 inhibitors; if signs of cardiac arrhythmia occur during treatment, stop treatment and monitor ECG
Pregnancy & Lactation
Pregnancy
There are no available data on use in pregnant women to inform a drug- associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Lactation
There are no data on presence in human milk, effects on the breastfed infant, or effects on milk production
Published animal data indicate that triclabendazole is detected in goat milk when administered as a single dose to one lactating animal
When a drug is present in animal milk, it is likely that the drug will be present in human milk
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Mechanism of action is not fully elucidated
Studies in vitro and/or in infected animals suggest that triclabendazole and its active metabolites (sulfoxide and sulfone) are absorbed by the tegument of the immature and mature worms of Fasciola hepatica and Fasciola gigantica, leading to a decrease of the resting membrane potential, inhibition of tubulin function as well as protein and enzyme synthesis
Absorption
Peak plasma concentration: 1.16 micromol/L (triclabendazole); 38.6 micromol/L (sulfoxide); 2.29 micromol/L (sulfone)
Peak plasma time: 3-4 hr AUC: 5.72 micromol⋅hr/L (triclabendazole); 386 micromol⋅hr/L (sulfoxide); 30.5 micromol⋅hr/L (sulfone)
Metabolism
Primarily metabolized by CYP1A2 (~64%) into its active sulfoxide metabolite and to a lesser extent by CYP2C9, CYP2C19, CYP2D6, CYP3A, and FMO
Sulfoxide metabolite is further metabolized primarily by CYP2C9 to the active sulfone metabolite and to a lesser extent by CYP1A1, CYP1A2, CYP1B1, CYP2C19, CYP2D6, and CYP3A4
Elimination
Half-life: 8 hr (triclabendazole); 14 hr (sulfoxide); 11 hr (sulfone)
No excretion data on humans
Excretion (in animals): Feces (90% [sulfoxide and sulfone metabolite]); urine (<10%)
Administration
Oral Administration
Administer with food
Swallow tablet (whole or divided in half) with water
Alternatively, may be crushed and mixed with applesauce (stable up to 4 hr)
Storage
Tablets: Store in original container at <30°C (86°F)
Images
Formulary
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