Question 1

Should praziquantel be taken with food?

Accepted Answer

Yes — taking praziquantel with a high-carbohydrate, moderate-fat meal increases bioavailability by 2–3-fold compared with the fasting state. Food also helps reduce nausea, which is the most common side effect. Avoid grapefruit juice, which excessively increases bioavailability.

Question 2

Can praziquantel be used in pregnancy?

Accepted Answer

WHO considers praziquantel safe during pregnancy and lactation for the treatment of schistosomiasis, based on large-scale safety data from mass drug administration programmes. The benefit of treating schistosomiasis (preventing anaemia, poor birth outcomes, and organ damage) generally outweighs theoretical concerns.

Question 3

What causes treatment failure after praziquantel?

Accepted Answer

Possible reasons: incorrect dose for the species (a common error — using 40 mg/kg for S. japonicum, which requires 60 mg/kg), incomplete dosing schedule, reinfection in endemic areas, or rarely true drug resistance (emerging in some S. mansoni foci in Africa).