How Tapeworm Infection Is Treated

Treatment for a tapeworm infection will include medications that target the worm. Medications may differ based on the type of tapeworm involved, such as the beef tapeworm (Taenia saginata), pork tapeworm (Taenia solium), fish tapeworm (Diphyllobothrium latum), Asian tapeworm (Taenia asiatica), and dwarf tapeworm (Hymenolepis nana).

It’s important to take the medication as prescribed and to follow directions to avoid reinfection during and after treatment. For an infection with the pork tapeworm, if a more serious condition called cysticercosis has occurred, medications may be given to treat symptoms and in some cases surgery may be needed.

Prescriptions

Praziquantel

Biltricide (praziquantel) is one medication used to treat tapeworm infection. It is an antiparasitic drug that belongs to a class of drugs known as antihelmintics. To treat an infection with a tapeworm, one dose of praziquantel is given.

Tapeworms attach themselves to the blood vessels in the wall of the intestine. Praziquantel works to clear the infection by paralyzing the worms, who then detach from the intestinal wall and then pass through the intestine and out of the body through the anus with a bowel movement.

Praziquantel tablets should be taken whole (unless breaking a tablet is necessary for dosage), not crushed, because they have a bitter taste and will be easier to cope with if swallowed whole. They should also be taken with a meal and a full glass of water.

Allergic reactions to praziquantel are rare, but symptoms of an allergic reaction such as hives, itching, dizziness, trouble breathing, or swelling of the throat or tongue are a reason to seek medical attention right away.

Praziquantel interacts with grapefruit, so people receiving this drug shouldn’t eat grapefruit or drink grapefruit juice while taking it.

Studies of praziquantel's safety in pregnancy have been done in animals, but not in humans, and the drug is not expected to affect a fetus. However, it should only be used in pregnant women when clearly needed. Pregnant women should speak with their doctors in order to make an informed decision before using it. Praziquantel does pass into breast milk, so pausing breastfeeding for three days (72 hours) after the last dose is usually recommended.

Tell a physician about any other drugs or supplements because they may affect the effectiveness of praziquantel, including:

• Anti-seizure medications such as Carbatrol (carbamazepine, Equetro, Tegretol), Dilantin (phenytoin), Felbatol (felbamate), Mysoline (primidone), phenobarbital, Trileptal (asoxcarbazepine)
• Aralen (chloroquine)
• Azole antifungals (itraconazole, ketoconazole)
• Barbiturates such as Amytal (amobarbital), Butisol (butabarbital), Mebaral (mephobarbital), Seconal (secobarbital), or Solfoton (phenobarbital)
• Decadron (Hexadrol, dexamethasone)
• Erythrocin (erythromycin (E.E.S., EryPed, Ery-Ta)
• HIV treatments, including Sustiva (efavirenz, Atripla), Intelence (etravirine), Viramune (nevirapine), or Norvir (ritonavir, Kaletra)
• Ketozole (ketoconazole, Extina, Nizoral, Xolegal)
• Mycobutin (rifabutin) 
• Priftin (rifapentine)
• St. John's wort
• Sleep disorder medications, including Nuvigil (armodafinil) or Progivil (modafinil)
• Sporanox (itraconazole)
• Tagamet (cimetidine) 

Nitazoxanide

Alinia (nitazoxanide) is an alternative for treatment of dwarf tapeworm, but praziquantel is still the preferred treatment, though at a higher dose than for Taeniasis. Alinia is an antiprotozoal drug that may be dispensed as a tablet or as a liquid suspension. It should be taken just after having a light meal and the liquid preparation should be shaken well before dispensing.

Before taking Alinia, tell your doctor about any other diseases or conditions you have, especially diabetes, liver disease, kidney disease, HIV infection, or an immune system disease.

Any symptoms of an allergic reaction such as hives, itching, a rash, or swelling of the mouth and tongue is reason to seek medical attention right away.

The safety of Alinia in pregnancy has not been studied in humans, but animal studies do not suggest any potential risks to the fetus. Still, the drug should only be used during pregnancy when clearly needed, and pregnant women should discuss the benefits and risks with their doctors before use. It’s not known if Alinia passes into breast milk and the possible effects on a nursing baby are unknown.

Prescribing information recommends against taking Alinia while also taking Coumadin (warfarin). Tell a physician about any other drugs or supplements because they may alter the effectiveness of Alinia, including:

• Aspirin
• Bumex (bumetanide)
• Cleocin (Clindesse, clindamycin)
• Coumadin (Jantoven warfarin)
• Valproic acid
• Diabeta (Glynase, glyburide)
• Diamox Sequels (acetazolamide)
• Dilantin (Phenytek, phenytoin)
• Glucotrol (glipizide)
• Hygroton (Thalitone, chlorthalidone)
• Platinol (cisplatin)
• Prograf (Astagraf XL, tacrolimus)
• Soriatane (acitretin)
• Oncovin (Vincasar PFS, vincristine)

Treatment of Cysticercosis

Cysticercosis is a complication of infection with the pork tapeworm (T. solium). When a human ingests the eggs of the pork tapeworm, either through contaminated food, water, or from another person, the eggs can form spheres called oncospheres.

Oncospheres may travel out of the intestine and through the body. They might then take up residence in the brain, the muscles, the eyes, under the skin, or in other organs, and form cysts. These cysts may or may not require treatment.

When cysts form in the brain (causing a condition called neurocysticercosis), seizures could result. Antiparasitic medications that kill the cysts will be given, but other drugs might also be necessary. When the tapeworm cysts die upon treatment there may be inflammation that requires treatment with an anti-inflammatory such as prednisone (a corticosteroid). An anticonvulsant might be needed in order to prevent seizures. For cysts in the spinal cord or the eye, antiparasitics are not given because of a risk of inflammation that may damage tissues in those areas.

After Treatment

To ensure that the tapeworm infection has cleared, a physician will order stool tests. This test will screen for worms, eggs, or proglottids in the stool to ensure that further treatment isn’t needed or that reinfection hasn’t occurred.

It’s important to keep follow-up appointments and get all the recommended testing done.