triclabendazole (Rx)

Brand and Other Names:Egaten
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and triclabendazole

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            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 (16)

            • 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.

            • 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 (120)

            • 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.

            • 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. Modify Therapy/Monitor Closely. For patients requiring deutetrabenazine doses >24 mg/day and are taking other drugs known to prolong QTc, assess the QTc interval before and after increasing the dose of deutetrabenazine or other medications known to prolong QTc.

            • 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.

            • 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.

            • ziprasidone

              triclabendazole and ziprasidone both increase QTc interval. Use Caution/Monitor.

            Minor (0)

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              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

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              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
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              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.

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              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%)

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              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)

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              Images

              No images available for this drug.
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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.