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This document outlines important safety information and warnings regarding the use of praziquantel (Biltricide). Please read the following details carefully and discuss any concerns with your healthcare provider.

• Sudden Severe Reaction: In rare cases, praziquantel can cause a sudden and severe illness, especially during treatment for the initial stage of a blood fluke infection (acute schistosomiasis). Symptoms such as worsening rash, fever, headache, muscle pain, stomach upset, and difficulty breathing require immediate medical attention.

• Brain and Nervous System Issues: Some parasites may affect the brain or nervous system, leading to seizures, confusion, or headaches, which could be exacerbated by praziquantel. If you have a history of seizures or these symptoms, consult with your healthcare provider to determine if praziquantel is suitable for you.

• Enhanced Side Effects with Liver Conditions: Individuals with liver problems might experience increased side effects because the liver metabolizes praziquantel. Persistent side effects like fatigue, weakness, dizziness, headaches, or abdominal discomfort should be reported to your provider immediately.

• Potential Heart Rhythm Disturbances: Praziquantel may cause irregular heart rhythms, such as bradycardia or tachycardia. If you have a history of heart rhythm disorders or experience symptoms like lightheadedness or dizziness, inform your provider, who may want to monitor your heart rhythm.

• Drug Interactions: Certain medications can interfere with the effectiveness and safety of praziquantel. Specifically, rifampin (used for tuberculosis and other infections) can reduce praziquantel's efficacy. You should cease rifampin four weeks before starting praziquantel and can resume it a day after completing the treatment. If discontinuing rifampin is not possible, alternative treatments for your condition will be necessary. Ensure your provider is aware of all medications you are taking.

Contraindications: This medication should not be used in the following situations due to serious health risks:

• Eye infections caused by flukes.
• Concurrent use of rifampin (Rifadin).

If any of these contraindications apply to you, please consult your healthcare provider before using praziquantel (Biltricide).

Common side effects:

• headache
• dizziness
• stomach discomfort
• nausea
• tiredness
• drowsiness
• itching
• joint or muscle pain
• loss of appetite
• vomiting
• sweating

Less common but important to monitor:

• difficulty keeping balance
• changes in vision
• ringing in the ears
• bloody diarrhea
• fever
• tremors
• shortness of breath

Serious side effects:

• Stevens-Johnson syndrome
• irregular heart rhythms
• seizures
• severe brain or nervous system problems
• severe allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Carbamazepine
• Dexamethasone
• Fosphenytoin
• Phenobarbital
• Phenytoin
• Rifampin

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Chloroquine
• Ketoconazole