OXAMNIQUINE
(ox-am'ni-kwin)
Vansil
Classifications: antiinfective; anthelmintic
Prototype: Mebendazole
Pregnancy Category: C

Availability

250 mg capsules

Actions

Hydroquinone derivative prepared in the presence of Aspergillus sclerotium. Mechanism of action not fully explained, but it appears that drug-induced strong contractions and paralysis of worm musculature leads to immobilization of their suckers and dislodgment from their usual residence in mesenteric veins to the liver.

Therapeutic Effects

Dislodgment of schistosomes begins about 2 d after single oral dose; movement is not complete until 6 d after treatment with the drug. After treatment, surviving unpaired females return to mesenteric vessels; however, oviposition (egg laying) seems to stop in 24–48 h after drug treatment, reducing egg load and removing principal cause of pathology associated with schistosomal infection.

Uses

All stages of Schistosoma mansoni infection, including acute and chronic phases with hepatosplenic involvement.

Contraindications

Safe use during pregnancy (category C), lactation, or in children is not established.

Cautious Use

History of convulsant disorders.

Route & Dosage

Schistosomiasis
Adult: PO 12–15 mg/kg as single dose
Child: PO <30 kg, 10 mg/kg times 2 doses at 2–8 h intervals

Administration

Oral

Give on an empty stomach, if possible.
Administer with food if necessary to reduce GI distress and improve tolerance.
Store product in tightly closed container at controlled room temperature less than 30° C (86° F).

Adverse Effects (1%)

CNS: Transitory dizziness, drowsiness, headache; persistent fever (in patients being treated in Egypt); EEG abnormalities, convulsions (rare). GI: Anorexia, nausea, vomiting, abdominal pain, elevated liver enzyme concentrations. Hematologic: Increased erythrocyte sedimentation rate, reticulocyte count, and increased or decreased leukocyte count. Skin: Urticaria. Urogenital: Red-orange urine.

Interactions

Food: Rate and extent of absorption are decreased by food.

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Peak: 1–3 h. Metabolism: Extensively metabolized in GI mucosa. Elimination: Excreted in urine. Half-Life: 1–2.5 h.

Nursing Implications

Assessment & Drug Effects

Supervise ambulation and use other safety precautions because >30% of patients experience dizziness or drowsiness.
If patient has a history of seizures, the possibility of seizures is increased because of drug action (occurs within hours of drug administration).

Patient & Family Education

Use caution while driving or performing other tasks requiring alertness because drug can cause dizziness or drowsiness.
Be aware that drug may change the normal urine color to a harmless orange-red.
Do not breast feed while taking this drug without consulting physician.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug