Levamisole

Levamisole, sold under the trade name Ergamisol among others, is a medication used to treat parasitic worm infections. Specifically it is used for ascariasis and hookworm infections. It is taken by mouth. Levamisole, sold under the trade name Ergamisol among others, is a medication used to treat parasitic worm infections. Specifically it is used for ascariasis and hookworm infections. It is taken by mouth. Side effects may include abdominal pain, vomiting, headache, and dizziness. Use is not recommended during breastfeeding or the third trimester of pregnancy. Serious side effects may include an increased risk of infection. It belongs to the antihelmintic class of medications. Levamisole was discovered in 1966. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about US$0.18 to US$0.33 for a course of treatment. It is not commercially available in the United States. Levamisole is also used as a dewormer for livestock. Levamisole was originally used as an anthelmintic to treat worm infestations in both humans and animals. Levamisole works as a nicotinic acetylcholine receptor agonist that causes continued stimulation of the parasitic worm muscles, leading to paralysis. In countries that still permit the use of levamisole, the recommended dose for anthelmintic therapy is a single dose, with a repeated dose 7 days later if needed for a severe hookworm infection. Most current commercial preparations are intended for veterinary use as a dewormer in cattle, pigs, and sheep. However, levamisole has also recently gained prominence among aquarists as an effective treatment for Camallanus roundworm infestations in freshwater tropical fish. After being pulled from the market in the U.S. and Canada in 1999 and 2003, respectively, levamisole has been tested in combination with fluorouracil to treat colon cancer. Evidence from clinical trials support its addition to fluorouracil therapy to benefit patients with colon cancer. In some of the leukemic cell line studies, both levamisole and tetramisole showed similar effect. Levamisole has been used to treat a variety of dermatologic conditions, including skin infections, leprosy, warts, lichen planus, and aphthous ulcers. An interesting adverse side effect these reviewers reported in passing was 'neurologic excitement'. Later papers, from the Janssen group and others, indicate levamisole and its enantiomer, dexamisole, have some mood-elevating or antidepressant properties, although this was never a marketed use of the drug. One of the more serious side effects of levamisole is agranulocytosis, or the depletion of the white blood cells. In particular, neutrophils appear to be affected the most. This occurs in 0.08–5% of the studied populations. There have also been reports of levamisole induced necrosis syndrome in which erythematous painful papules can appear almost anywhere on skin. It has been used as an adulterant in cocaine resulting in serious side effects.