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Clinician’s Corner: Pinworm Treatments

Last week we discussed prescription treatment options for pinworm infestation.  We explored treatment options such as Emverm®  (mebendazole) and Albenza (albendazole).  Both products were extremely expensive costing as much as $400.00 for initial treatment, followed by a second dose in two weeks. Your Thompson Pharmacist can step in and recommend a very affordable treatment option.  Just as important as the treatment, is the second follow-up dose as well as the prevention of re-infestation.  Treatment failures are rare, and re-infestation is common.

Pyrantel pamoate- “Reese’s Pinworm Medicine”

Mechanism: It is poorly absorbed from the GI tract in humans and acts by paralyzing worms. They are unable to latch onto the intestinal mucosa, and are passed out in the stool.  At Thompson Pharmacy we carry Reese’s Pinworm Medicine for less than $15.00 one ounce bottle.

  • Pyrantel pamoate is available over the counter as a 50 mg/mL suspension. It has been over-the counter since 1986.
  • The package has detailed instructions by weight. Approved for 2 years of age and older. This dose should be repeated after 2 weeks.  Your Thompson Pharmacist can help you with the doses for all of your family members.
  • May administer with food, milk or fruit juice, at any time of day. Fasting, purgation, or special diets are not necessary for effective treatment
  • Does not reliably kill pinworm eggs. Give second dose is to prevent re-infection by adult worms that hatch from any eggs not killed by the first treatment.

PREVENTION of REINFESTATION

  • Repeated infections should be treated by the same method as the first infection.
  • Treat all household members if more than one is infected. In institutions, mass and simultaneous treatment, repeated in 2 weeks.
  • Good hand washing hygiene! Soap and water after toilet.
  • Best to not allow children to share the same bathwater, reuse or share washcloths. Showering may be preferred to avoid possible contamination of bath water.
  • Clip fingernails regularly, and avoid biting the nails and scratching around the anus.
  • Frequent changing of underclothes and bed linens first thing in the morning is a great way to prevent possible transmission of eggs in the environment and risk of reinfection. Do not shake out bed linens, the eggs can become airborne. These items should be \ carefully placed into a washer and laundered in hot water followed by a hot dryer to kill any eggs that may be there.
  • Clean shared surfaces like doorknobs, toilet seats, and furniture with a disinfectant, such as bleach
  • Pinworm eggs are spread easily and even the cleanest and most careful people can get them. Be sure to re-assure parents and caregivers.