Biltricide Special Precautions

Talk to the doctor before taking Biltricide.
Impaired liver function: Caution is required with certain types of liver dysfunction (severe liver failure), or if the liver and spleen are infected with blood flukes (hepatosplenic schistosomiasis). Due to reduced breakdown of the medicine in the body, the active substance remains in the blood for longer and thus the effect of the medicine is prolonged. In such cases, appropriate treatment should be administered in hospital.
Impaired kidney function: If kidney function is impaired, the excretion of praziquantel is likely to be delayed.
Heart rhythm abnormalities and digitalis-dependent heart function impairment: If suffering from an abnormal heart rhythm, the treatment should be monitored by a doctor. In the event of heart failure requiring treatment with digitalis (digitalis-dependent heart failure), therapy with Biltricide should likewise be monitored by a doctor since animal studies found the effectiveness of digitalis products to be decreased.
Schistosomiasis (bilharzia): Biltricide is not effective against migratory (immature) blood flukes (schistosomula). Consequently, it is ineffective during acute phases of blood fluke infection (acute schistosomiasis). Study data suggest that treatment with Biltricide in this acute phase of an infection cannot prevent progression to the chronic phase.
In addition, the use of Biltricide in patients with schistosomiasis may be associated with a deterioration in the clinical condition (paradoxical reactions, serum sickness, Jarisch-Herxheimer-type reactions with a sudden inflammatory immune response, probably resulting from destruction of the parasites). Such reactions mostly occur in patients receiving treatment during the acute phase of schistosomiasis. They can lead to potentially life-threatening events, such as lung dysfunction (respiratory failure), inflammation of the heart muscle (myocarditis), inflammation of the brain (encephalitis), non-inflammatory diseases of the brain (encephalopathy) and/or inflammation of the blood vessels in the brain (cerebral vasculitis).
If patients diagnosed as having schistosomiasis or fluke infection live in, or come from, an area in which infections with larvae from the pork tapeworm are common (endemic) in humans, it is advisable to administer Biltricide treatment in a hospital setting. Due to its action against the larvae of the pork tapeworm (Taenia solium), Biltricide may worsen an eye infection with such larvae (intraocular cysticercosis) or symptoms affecting the central nervous system.
Biltricide may worsen symptoms affecting the central nervous system or brain which are caused by blood flukes (schistosomiasis), lung flukes (paragonimiasis) or pork tapeworms (cysticercosis). Therefore, Biltricide should in principle not be used in patients with a history of seizures (epilepsy) or if there are any other signs of central nervous system or brain impairment, such as the nodules under the skin that are characteristic of cysticercosis.
Driving and using machines: Individuals are affected in different ways by this medicine, meaning that reactions to unexpected and sudden events may not be sufficiently rapid and specific. For this reason, the patient should remain at home, especially on starting treatment, as well as for the entire treatment period and for 24 hours after treatment has ended. This applies in particular at the start of treatment as well as in combination with alcohol. Do not drive a car or any other type of vehicle. Do not operate electrical tools or machines. Do not work without a secure foothold.
Use in Children: The safety of Biltricide in children aged under 4 years has not been established.