Etrax40 mg/5 ml

Etrax 40 mg/5 ml is an anthelmintic (anti-worm) medicine used for the treatment of intestinal infections caused by susceptible gastrointestinal worm species, including:

• Ascaris lumbricoides (roundworm)
• Necator americanus and Ancylostoma duodenale (hookworm)
• Enterobius vermicularis (pinworm)
• Trichuris trichiura (whipworm), where susceptible
• Strongyloides stercoralis (threadworm)
• Trichostrongylus colubriformis

Etrax 40 mg/5 ml also has immunomodulatory properties and has historically been used as an adjunct in certain cancer treatment protocols in some countries; this use has become uncommon and is not the primary indication in most current markets, including Bangladesh, where it is used predominantly as an anthelmintic.

Contains Etrax 40 mg/5 ml (as Etrax 40 mg/5 ml hydrochloride) as the active ingredient, available as oral tablets (commonly 40 mg or 50 mg) and as an oral syrup (commonly 40 mg per 5 mL). Exact strengths available may vary by product.

Etrax 40 mg/5 ml is an anthelmintic medicine used to treat infections caused by various intestinal roundworms, including common roundworm, hookworm, and pinworm. It works by paralysing the worms so they can no longer maintain their position in the gut and are expelled by normal bowel movement. It is typically given as a single oral dose after a light meal.

Therapeutic Class: Anthelmintic

Etrax 40 mg/5 ml is the active laevo-isomer of tetramisole. Following oral administration, peak plasma concentration is achieved within about 1.5-2 hours. It is extensively metabolized in the liver, and its plasma elimination half-life is approximately 3-6 hours.

• Taken by mouth as a single dose, preferably after a light meal
• Syrup should be measured with an accurate dosing device
• No special preparation such as fasting or laxatives is generally required before taking this medicine

The following should be assessed by a healthcare professional before combining with Etrax 40 mg/5 ml:

• Alcohol, which can cause a disulfiram-like ("Antabuse") reaction, including flushing, nausea, and palpitations, when combined with Etrax 40 mg/5 ml
• Phenytoin, whose toxicity may be increased by Etrax 40 mg/5 ml
• Warfarin, whose anticoagulant effect may be increased by Etrax 40 mg/5 ml, though the clinical significance is uncertain
• Ivermectin, whose bioavailability may be increased by Etrax 40 mg/5 ml
• Albendazole, whose bioavailability may be decreased by Etrax 40 mg/5 ml

Common side effects

• Nausea, vomiting
• Abdominal pain
• Dizziness (giddiness)
• Headache

Side effects are generally infrequent, mild, and transient. In cases of concurrent microfilaraemia, transient fever may occur after treatment. Rarely, an encephalopathy-like syndrome has been reported to occur 2-3 weeks after treatment.

Pregnancy

Although animal studies have not shown teratogenic effects with Etrax 40 mg/5 ml, current medical practice requires that the benefits of any drug used during pregnancy be weighed against possible risks; it is generally not recommended in pregnant women unless a doctor considers it necessary.

Breastfeeding

Specific data on Etrax 40 mg/5 ml use during breastfeeding are limited; use should be guided by a healthcare professional.

• Use with caution in patients with a history of blood disorders, joint inflammation (such as rheumatoid arthritis or Sjögren syndrome), epilepsy, or liver disease, where dose adjustment may be necessary.
• Avoid alcohol around the time of taking Etrax 40 mg/5 ml, due to the risk of a disulfiram-like reaction.
• There is no evidence that Etrax 40 mg/5 ml, used for anthelmintic purposes, causes sedation; no specific precautions are generally needed regarding driving or operating machinery, though mild, transient dizziness has been reported infrequently.
• If clinical resistance to Etrax 40 mg/5 ml is suspected due to repeated treatment failure, this should be investigated and an anthelmintic from a different pharmacological class considered.

Overdose may cause symptoms of anticholinesterase-like activity. Monitoring of vital signs and supportive therapy are recommended; atropine may be used if symptoms of anticholinesterase activity develop, under medical supervision. Seek emergency medical treatment if overdose is suspected.

Store in a cool, dry place, protected from light, as directed on the product label. Keep out of reach of children.

• Hepatic impairment: Use with caution, as Etrax 40 mg/5 ml metabolism and biliary excretion may be reduced.
• Renal impairment: Use with caution in patients with severe kidney impairment.
• Elderly: No specific dose adjustment beyond standard adult dosing is generally required, though general caution applies as with any medicine.

Etrax 40 mg/5 ml is typically given as a single dose. In severe hookworm infection, a second dose may be given 1 to 7 days after the first. Repeated or frequent use over an extended period should be avoided to reduce the risk of anthelmintic resistance; suspected treatment failure should be investigated rather than simply repeating the same medicine.

Drug Class: Imidazothiazole anthelmintic (nicotinic acetylcholine receptor agonist)

Etrax 40 mg/5 ml acts on nematode (roundworm) nerve ganglia, causing depolarizing neuromuscular paralysis of the worm's musculature within seconds of contact. Unable to maintain their position in the intestine, the paralysed worms are then expelled from the body by normal peristaltic (bowel) movement, usually within 24 hours of taking the medicine.

Etrax 40 mg/5 ml is used in children 1 year and older for intestinal worm infections, with the dose based on age as shown in the dosage table (1-4 years: 1 tablet or 1 teaspoonful; 5-15 years: 2 tablets or 2 teaspoonfuls), given as a single dose, preferably after a light meal, or as directed by the physician.