title: The little we know about the pharmacokinetics and pharmacodynamics of praziquantel (racemate and R-enantiomer).
abstract: Praziquantel has been the mainstay of schistosomiasis control since 1984 and widely distributed since 2006 through 'preventive chemotherapy' programmes to school-aged children or at-risk populations. In addition, preschool-aged children are now recognized as a vulnerable population and a group for targeted treatment, but they may be difficult to dose correctly with the available product--a racemate, based on the biologically active enantiomer (R-praziquantel) and the inactive distomer (S-praziquantel), which contributes the bitter taste and doubles the size of the tablets. Hence, a paediatric formulation is required, possibly enantiomerically pure. Developing such a product and extending its use to younger children should be pharmacologically guided, but limited data exist on pharmacokinetics and pharmacokinetic/pharmacodynamic correlations for praziquantel. This article presents available data on the chemistry, pharmacokinetics and pharmacodynamics of praziquantel, as well as R-praziquantel, and points to gaps in our knowledge.
authors.affiliation: UNICEF/UNDP/World Bank/WHO Special Programme on Research & Training in Tropical Diseases (TDR), World Health Organization, 20 Avenue Appia, CH-1211, Geneva 27, Switzerland.
authors.forename: Piero
authors.initials: P
authors.lastname: Olliaro
authors.forename: Petra
authors.initials: P
authors.lastname: Delgado-Romero
authors.forename: Jennifer
authors.initials: J
authors.lastname: Keiser
mesh_terms: D000871:Anthelmintics / Q000737:chemistry / Q000493:pharmacokinetics*; D006801:Humans; D011223:Praziquantel / Q000737:chemistry / Q000493:pharmacokinetics*; D012552:Schistosomiasis / Q000188:drug therapy / Q000517:prevention & control; D013237:Stereoisomerism
chemical_list: D000871:Anthelmintics; D011223:Praziquantel
keywords: Schistosoma spp.; chemotherapy; schistosomiasis