Levamisole: Brands, Price & Uses in Bangladesh

Levamisole is an anthelmintic (antiparasitic) medicine used for the treatment of intestinal worm (helminth) infections.

Established/Approved Uses

• Ascariasis (roundworm infection caused by Ascaris lumbricoides) — this is the primary and most well-established indication for Levamisole.
• Hookworm infection (Ancylostoma duodenale and Necator americanus), particularly light to moderate infections; Levamisole is less effective against heavy hookworm burden and severe infections may need a repeat dose or an alternative anthelmintic.

Other Reported Uses (Variable Evidence)

• Infections with Enterobius vermicularis (threadworm/pinworm), Trichuris trichiura (whipworm), Strongyloides stercoralis, and Trichostrongylus species have been reported to respond to Levamisole, though efficacy against these organisms is generally lower and less consistent than against ascariasis.

Historical/Discontinued Use — Not a Current Indication

Levamisole was formerly used at low doses as an immunomodulatory adjunct to chemotherapy (fluorouracil) in colon cancer, and it has also been used in veterinary medicine. These uses have been withdrawn/discontinued in human medicine in many countries, including removal of the cancer-adjunct product from the market, because of the risk of serious agranulocytosis. Levamisole is not recommended and should not be used for these purposes; its current, marketed human use is as an anthelmintic for intestinal worm infection.

Levamisole is usually given as a single oral dose, preferably after a light meal.

For heavy or severe hookworm infection, a repeat dose of the same strength may be given one to seven days after the first dose, on a physician's advice.

Complete the course of Levamisole exactly as prescribed. Do not repeat doses or use Levamisole more frequently than advised by a physician, and do not share this medicine with others, since inappropriate or repeated dosing has been linked to serious blood-cell side effects (see Precautions and Warnings).

Stool examination may be repeated after 2–3 weeks in persistent or heavy infections to confirm clearance, on the physician's advice.

Side effects of Levamisole are generally infrequent, mild, and transient when used at the recommended single anthelmintic dose.

Common Side Effects

• Nausea, vomiting
• Abdominal pain/cramps
• Dizziness (giddiness)
• Headache
• Metallic taste
• Diarrhea

Rare but Serious Side Effects

• Agranulocytosis — a serious drop in white blood cells that increases infection risk; this is rare with standard short-course anthelmintic dosing but is a well-documented, serious risk with repeated or prolonged use (see Precautions and Warnings).
• An encephalopathy-like syndrome (confusion, altered consciousness, seizures) occurring 2–3 weeks after treatment has been reported rarely.
• Skin rash or hypersensitivity reactions.
• Transient fever, particularly in patients with concurrent microfilaraemia.

Seek prompt medical attention for fever, sore throat, unusual bruising/bleeding, mouth ulcers, or signs of infection during or after taking Levamisole, or for any severe or persistent symptoms.