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Pyrantel pamoate is an OTC depolarizing anthelmintic that paralyzes pinworms so they pass in stool.
Dose 11 mg/kg base (max 1 g) as a single treatment; repeat in 14 days.
Safe for children 2 years and older; younger children require clinician guidance.
Household treatment and hygiene are essential to prevent reinfection.
Side effects are usually mild (nausea, cramps).
OTC in many regions but clinicians should confirm diagnosis and plan repeat dosing.
Pyrantel pamoate is a first-line anthelmintic for luminal nematodes in pediatrics, especially pinworm. Success hinges on repeat dosing and hygiene reinforcement.
Use pyrantel for uncomplicated Enterobius infestations and, when other agents are unavailable, for ascariasis or hookworm with clinician monitoring.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Enterobiasis (pinworm) | Children and adolescents | Yes | Dose 11 mg/kg (max 1 g) once and repeat after 14 days to eradicate newly hatched larvae; treat household contacts simultaneously and emphasize strict hand hygiene to prevent reinfection. |
| Ascariasis | Children | Yes | Use when albendazole is unavailable or contraindicated; administer 11 mg/kg once daily for 3 days and repeat stool O&P 2–3 weeks later to confirm clearance. |
| Hookworm infection | Children | No | Less effective than benzimidazoles; consider when preferred agents cannot be given, deliver 11 mg/kg daily for 3 days, and monitor hemoglobin/iron status for persistent anemia. |
FDA-approved primary uses with Level A evidence
Quick selection guides and diagnostic pearls
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How to explain treatment to families
Pyrantel pamoate is generally well tolerated for pinworm therapy; most adverse effects are mild and transient gastrointestinal symptoms.
Common reactions include abdominal cramping, nausea, and headache as the worms are expelled. Educate families about expected stool changes and when to call for care.
Nausea
Common • mild
Abdominal cramps or diarrhea
Common • mild
Headache
Uncommon • mild
Dizziness
Rare • mild
Rash
Rare • moderate
Organized by affected organ systems
How to discuss side effects with families
Management protocols and monitoring
Common concerns and practical guidance
Administration guidance for pyrantel pamoate.
Shake the suspension well. Measure doses by weight (11 mg/kg base) with the dosing cup or syringe. For chewables, chew completely before swallowing.
Treat all household members at the same time to reduce reinfection. Repeat the dose in 2 weeks unless your clinician advises otherwise.
Emergency contact: Seek care for difficulty breathing, swelling of the face, severe rash, or worsening abdominal pain.
Combine pyrantel with handwashing and household cleaning to keep pinworms from coming back.
Different formulations and concentrations
Safe preparation and measuring techniques
Tailored approaches for different ages
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Expert pearls and evidence-based tips
Pyrantel pamoate stays within the intestinal lumen and paralyzes susceptible nematodes by acting as a depolarizing neuromuscular blocker.
The drug functions as a nicotinic acetylcholine receptor agonist at the parasite neuromuscular junction. Sustained depolarization produces spastic paralysis so worms lose their grip on the mucosa and are expelled with peristalsis. Human neuromuscular junctions are spared because pyrantel is poorly absorbed and has much lower affinity for mammalian receptors.
Simple explanations and helpful analogies
Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Pyrantel pamoate therapy succeeds when medication, hygiene, and household coordination all align. These pearls help busy clinics deliver reliable pinworm eradication plans.
Focus on repeat dosing, whole-household treatment, and relentless hygiene reinforcement to prevent reinfection.
Record the exact 11 mg/kg (base) dose and volume on the prescription label so parents do not estimate from OTC charts.
Book a reminder call, portal message, or calendar invite for the household 14 days after the first dose to eradicate new…
Dose all close contacts on the same day, including asymptomatic siblings and caregivers, to break the reinfection cycle.
Daily morning showers, short fingernails, and hot-water laundering of bedding/clothing for several days markedly reduce …
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Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Pyrantel Pamoate (base) and monitor your child's response to treatment.
Yes. Clinicians usually recommend treating the entire household and close caregivers at the same time to prevent reinfection and egg cycling on shared surfaces.
Eggs can survive the first dose. A second dose 14 days later kills worms that hatch after the initial treatment before they mature and lay new eggs.
Infants should only receive pyrantel under clinician supervision to ensure precise dosing and monitoring for side effects such as abdominal cramps.
No. It can be taken with or without food; taking it with a small snack may reduce stomach upset. Encourage plenty of fluids to flush expelled worms.