Pyrantel for Pinworms

[shayna]

Hello!

I am 38 weeks pregnant and it seems my 2 year old has brought home a case of pinworms! My pediatrician is uncomfortable authorizing Pyrantel since it is technically category C-- but I think that the alternative (having a newborn most likely acquiring the infestation is no good either)- I was thinking that if I take it now (fetus is fully formed) and right after delivery before my milk is in (which is when the next dose will be due), I can minimize the baby's exposure... what do you say, Dr. Hale?

[admin]

Shayna, Pin-x (Pyrantel) is not expected to increase the risk of congenital anomalies due to poor absorption. The drug is not well absorbed from the intestinal tract; therefore the fetus should have little if any exposure to the drug. There were no well-controlled human studies for pyrantel located. The World Health Organization does recommend treatment for helminth infections after the first trimester of pregnancy. In summary, there were no human studies located for pyrantel but the drug is not expected to increase the risk of congenital anomalies due to poor absorption. The majority of the literature recommends delaying treatment at least until after the first trimester of pregnancy unless the benefit to the mother outweighs the risk to the fetus. Sandra Lovato R.N. InfantRisk Center 806-352-2519

[shayna]

Thank you, Samdra. And what is the recommendation with Pyrantel and breastfeeding? Since I am due in about 10 days and the med needs to be repeated after 2 weeks, chances are good that I will have given birth by the time I am due for the second dose. I was thinking that if it works for me to do it within 3 days postpartum, that will be good timing since after that meds seem to move more readily into the milk. true?

[admin]

Shayna,

Pin-x (pyrantel) is rated an L3-no data-probably compatible. No data on transfer of pyrantel in human milk are available, but due to minimal oral absorption, and low plasma levels, it is unlikely that breastmilk levels would be clinically relevant. Peak plasma levels are generally less than 0.05 to 0.13 µg/mL and occur prior to 3 hours. Reported side effects are few and minimal. I suggest taking this right after you breastfeed and waiting about 3 hours to feed again.

Sandra Lovato