Summary
Levamisole is a drug of choice for treatment of ascariasis. With recommended dosages, it is virtually free of side effects. Single doses of 50 to 150mg will eliminate all parasites in 90 to 100 % of ascariasis patients irrespective of worm burden. Activity against hookworms has been demonstrated for levamisole but the most effective treatment regimen has not been determined. Further drug trials are needed for better assessment of efficacy. Levamisole has little or no curative action on infections with whipworms and pinworms. It may have some activity against strongyloides but confirmatory studies are needed.
It has been shown that levamisole has significant activity against microfilariae of Wuchereria bancrofti and Brugia malayi. It is not, however, as effective as diethylcarbamazine (‘Hetrazan’), and side reactions are greater. In tolerated doses, levamisole does not have significant action on adult forms or microfilariae of Onchocerea volvulus. The drug applied topically, however, may find a place in treatment of ocular onchocerciasis.
Limited trials with levamisole for toxoplasmosis and chronic cutaneous leishmaniasis have given promising results, and further studies are indicated.
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References
Beaver, P.C.: The standardization of fecal smears for estimating egg production and worm burden. Journal of Parasitology 36: 451–456 (1950).
Blagg, W.; Schloegel, E.J.; Mansour, N.S. and Khalaf, G.I.: A new concentration technic for the demonstration of protozoa and helminth eggs in feces. American Journal of Tropical Medicine and Hygiene 4: 23–28 (1955).
Bouyer, C.: Traitement de parasitoses intestinales par le lévamisole. Bulletin de la Societé de Pathologie Exotique et de Ses Filiales 63: 255–265(1970).
Butler, P.G.: Levamisole therapy of chronic Leishmania tropica. Journal of Tropical Medicine and Hygiene 81: 221–224 (1978).
Chodera, L. and Powlowski, Z.: Tetramisole in der behandlung von ascariasis, necatoriasis und trichuriasis; in Vth International Congress of Infectious Diseases, Vienna, September, pp. 199–203 (1970).
Davis, A.: Drug Treatment in Intestinal Helminthiasis (WHO, Geneva 1973).
Duke, B.O.: Further trial of levamisole against Onchocerca volvulus. Transactions of the Royal Society of Tropical Medicine and Hygiene 69: 287–288 (1975).
Farid, Z.; Bassily, S.; Miner, W.F.; Hassan, A. and Laughlin, L.W.: Comparative single/dose treatment of hookworm and roundworm infections with levamisole and bephenium. Journal of Tropical Medicine and Hygiene 80: 107–108 (1977).
Fegies, M. and Guerrero, J.: Treatment of toxoplasmosis with levamisole. Transactions of the Royal Society of Tropical Medicine and Hygiene 71: 178–179 (1977).
Gatti, F.; Krubwa, F.; Vandepitte, J. and Thienpoint, D.: Control of intestinal nematodes in African school children by the trimestrial administration of levamisole. Annales des Societés Belges de Médecine Tropicale 52: 19–31 (1972).
Gerwel, C. and Powlowski, Z.: Mass therapy of imported cases of necatoriasis; in Vth International Congress of Infectious Diseases, Vienna, September, pp.205-206 (1970).
Hall, S.A.; Joseph, M.M.; Saggar, S.N.; Wood, C.H. and Gleisner, E.: A trial of Ketrex (the laevo-isomer of tetramisol) in the treatment of ascariasis. East African Medical Journal 47: 424–433 (1970).
Huys, J.; Van den Berghe, G.; Freyens, P. and Kayihigi, J.: Treatment of ankylostomiasis with levamisole. African Journal of Medical Sciences 5: 75–77 (1976).
Janssen, P.A.J.: The levamisole story. Progress in Drug Research 20: 347–383 (1976).
Jones, B.R.; Anderson, J. and Fuglsang, H.: Evaluation of microfilaricidal effects in the cornea from topically applied drugs in ocular onchocerciasis: trials with levamisole and mebendazole. British Journal of Ophthalmology 62: 440–444 (1978).
Lionel, N.D.; Mirando, E.H.; Nanayakkara, J.C. and Soysa, P.E.: Levamisole in treatment of ascariasis in children. British Medical Journal 4: 340–341 (1969).
Lucas, A.O. and Oduntan, S.O.: Treatment of hookworm infection and other intestinal parasites with 1 -tetramisole (Ketrex). Annals of Tropical Medicine and Parasitology 66: 391–398 (1972).
Martin, L.K. and Beaver, P.C.: Evaluation of Kato thick-smear technique for quantitative diagnosis of helminth infections. American Journal of Tropical Medicine and Hygiene 17: 382–391 (1968).
Merlin, M.; Carme, B.; Kaeuffer, H. and Laigret, J.: Activité du lévamisole (Solaskil) dans la filariose lymphatique à Wuchereria bancrofti (variété Pacifica). Bulletin de la Societé de Pathologie Exotique et des Ses Filiales 69: 257–265 (1976).
Miller, M.J.; Farahmandian, I.; Arfaa, F.; Katz, N.; Winsor, E. and Bennett, E.: An evaluation of levamisole for treatment of ascariasis. Southern Medical Journal 71: 137–140 (1978).
Moreau, J.P.; Radanielina, R. and Barbier, D.: Activité du lévamisole dans la filariose de Bancroft. Medicina Tropical 35: 51–55 (1975).
Narasimham, M.V.; Roychaudhuri, S.P.; Das, M. and Rao, C.K.: Levamisole and mebendazole in the treatment of bancroftian infection. Southeast Asian Journal of Tropical Medicine and Public Health 9: 571–575 (1978).
O’Holohan, D.R. and Zaman, V.: Treatment of Brugia malayi infection with levamisole. Journal of Tropical Medicine and Hygiene 77: 113–115 (1974).
Saugrain, J. and Delavat, A.: Bilan de l’action anthelminthique de l’isomère levogyre du tetramisole en Polynesie francaise. Bulletin de la Societé de Pathologie Exotique des Ses Filiales 63: 507 (1970).
Stoll, N. and Hausheer, W.C.: Concerning two options in dilution egg counting: small drop and displacement. American Journal of Hygiene 6: 134–135 (1926).
Thienpoint, D.; Brugmans, J.; Abadi, K. and Tanamal, S.: Tetramisole in the treatment of nematode infections. American Journal of Tropical Medicine and Hygiene 18: 520–525 (1969).
Vakil, B.J.; Dalai, N.J.; Gangrade, R.R. and Bhise, K.B.: Clinical trial with L-tetramisole in roundworm and hookworm infections. Transactions of the Royal Society of Tropical Medicine and Hygiene 66: 250–254 (1972).
Whitlock, H.V.: Some modifications of the McMaster helminth egg-counting technique and apparatus. Journal of the Council for Scientific and Industrial Research, Australia 21: 177–180 (1948).
World Health Organization: Expert Committee on control of ascariasis; World Health Organization Technical Report Series No. 379, p.40 (1967).
Zaman, V. and Lal, M.: Treatment of Wuchereria bancrofti with levamisole. Transactions of the Royal Society of Tropical Medicine and Hygiene 67: 610 (1973).
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Miller, M.J. Use of Levamisole in Parasitic Infections. Drugs 20, 122–130 (1980). https://doi.org/10.2165/00003495-198020020-00005
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DOI: https://doi.org/10.2165/00003495-198020020-00005