PINWORM INFECTION
IS EXTREMELY CONTAGIOUS1,2

Eggs can survive on toys, doorknobs, faucets, and furniture for up to 3 weeks1,3

Pinworm eggs are sticky and resilient. They cling to fomites such as toys, doorknobs, faucets, furniture, towels, and bedding for up to 3 weeks. Since pinworm eggs can survive indoors for up to 3 weeks and are easily transmitted to other household members, pinworm infections tend to spread within infected families.1,3

According to the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) Red Book, prevalence can reach up to 50% in families with an infected child.1,3

Household objects that act as fomites for pinworm eggs include1,3:

Pinworm is easily spread to shared surfaces like door knobs.

Highly infective pinworm eggs can survive on fomites for 3 weeks and are easily transmitted through contact with shared objects.1,3


Pinworm transmission to the entire household

Transmission to other members of a household occurs easily when contact is made with contaminated household objects such as bed linens, clothing, carpeting, toys, towels, and toilet seats. Following contact, the sticky eggs are unknowingly ingested via hand to mouth, spreading the infection to another household member. Self-infection or reinfection usually results from perianal scratching and transporting of infective pinworm eggs on the fingertips or under the fingernails to the mouth.1,3


Why breaking the cycle can be difficult

  • One female pinworm can lay up to 10,000 highly infective eggs on the perianal folds of the infected person1
  • While important, personal hygiene and housecleaning alone are unlikely to stop an outbreak4; likewise, drug therapy should accompany appropriate household sterilization
  • Eggs can become airborne, inhaled, and swallowed by other household members5

Advice to caregivers1

  • Infected people should shower in the morning to remove infective pinworm eggs
  • Frequently changing the underclothes, bedclothes, and bedding of an infected person may decrease egg contamination
  • Parents and caregivers should be cautioned not to shake out bed linens, blankets, and towels during an outbreak
  • Specific hygiene measures such as avoiding scratching of the perianal area, practicing good hygiene, and keeping fingernails short may decrease the risk of continued transmission

IMPORTANT SAFETY INFORMATION

Contraindication: EMVERM is contraindicated in persons with a known hypersensitivity to the drug or its excipients (mebendazole, microcrystalline cellulose, corn starch, anhydrous lactose, sodium starch glycolate, magnesium stearate, stearic acid, sodium lauryl sulfate, sodium saccharin, and FD&C Yellow #6).

Warnings and Precautions:

  • Risk of Convulsions: Convulsions in infants below the age of 1 year have been reported.

  • Hematologic Effects: Neutropenia and agranulocytosis have been reported in patients receiving mebendazole at higher doses and for prolonged duration. Monitor blood counts in these patients.

  • Metronidazole and Serious Skin Reactions: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) have been reported with the concomitant use of mebendazole and metronidazole. Avoid concomitant use of mebendazole and metronidazole.

Adverse Reactions Reported in Mebendazole-treated Subjects from 39 Clinical Trials*: anorexia, abdominal pain, diarrhea, flatulence, nausea, vomiting, rash.

Adverse Reactions Identified During Postmarketing Experience with Mebendazole*: agranulocytosis, neutropenia, hypersensitivity including anaphylactic reactions, convulsions, dizziness, hepatitis, abnormal liver tests, glomerulonephritis, Stevens-Johnson syndrome/toxic epidermal necrolysis, exanthema, angioedema, urticaria, alopecia.

*Includes mebendazole formulations, dosages and treatment duration other than EMVERM 100 mg chewable tablet.

Drug Interactions: Concomitant use of EMVERM and metronidazole should be avoided.

Pregnancy: The available published literature on mebendazole use in pregnant women has not reported a clear association between mebendazole and a potential risk of major birth defects or miscarriages. There are risks to the mother and fetus associated with untreated helminthic infection during pregnancy.

Untreated soil transmitted helminth infections in pregnancy are associated with adverse outcomes including maternal iron deficiency anemia, low birth weight, neonatal and maternal death.

Lactation: Limited data from case reports demonstrate that a small amount of mebendazole is present in human milk following oral administration. There are no reports of effects on the breastfed infant, and the limited reports on the effects on milk production are inconsistent. The limited clinical data during lactation precludes a clear determination of the risk of EMVERM to a breastfed infant; therefore, developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for EMVERM and any potential adverse effects on the breastfed infant from EMVERM or from the underlying maternal condition.

Pediatric Use: The safety and effectiveness of EMVERM 100 mg chewable tablet has not been established in pediatric patients less than two years of age. Convulsions have been reported with mebendazole use in children less than one year of age.

Geriatric Use: Clinical studies of mebendazole did not include sufficient numbers of subjects aged 65 and older to determine whether they respond differently from younger subjects.

Overdosage: In patients treated at dosages substantially higher than recommended or for prolonged periods of time, the following adverse reactions have been reported: alopecia, reversible transaminase elevations, hepatitis, agranulocytosis, neutropenia, and glomerulonephritis.

Symptoms and signs of overdose: In the event of accidental overdose, gastrointestinal signs/symptoms may occur.

Treatment of overdose: There is no specific antidote.

Patient Counseling: Healthcare professionals should advise the patient to read the FDA-approved patient labeling (Patient Information) Advise patients that:

  • Taking EMVERM and metronidazole together may cause serious skin reactions and should be avoided.

  • EMVERM can be taken with or without food.

INDICATION

EMVERM® is indicated for the treatment of patients two years of age and older with gastrointestinal infections caused by Ancylostoma duodenale (hookworm), Ascaris lumbricoides (roundworm), Enterobius vermicularis (pinworm), Necator americanus (hookworm), and Trichuris trichiura (whipworm).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. To report SUSPECTED ADVERSE REACTIONS contact Impax Laboratories, Inc. at 1-877-994-6729.

Please click here for Full Prescribing Information.

References:
1. Committee on Infectious Diseases, American Academy of Pediatrics. Red Book: 2015 Report of the Committee on Infectious Diseases. 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015:621-622, 934. 2. Kucik CJ, Martin GL, Sortor, BV. Common intestinal parasites. Am Fam Physician. 2004;69(5):1161-1168. 3. Epidemiology & risk factors. Centers for Disease Control and Prevention website. http://www.cdc.gov/parasites/pinworm/epi.html. Updated January 10, 2013. Accessed March 30, 2017. 4. Maguire JH. Intestinal nematodes (roundworms). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:3199-3207.e2. 5. Biology. Centers for Disease Control and Prevention website. http://www.cdc.gov/parasites/pinworm/biology.html. Reviewed January 10, 2013. Accessed March 30, 2017.

IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

Contraindication: EMVERM is contraindicated in persons with a known hypersensitivity to the drug or its excipients (mebendazole, microcrystalline cellulose, corn starch, anhydrous lactose, sodium starch glycolate, magnesium stearate, stearic acid, sodium lauryl sulfate, sodium saccharin, and FD&C Yellow #6).

Warnings and Precautions:

  • Risk of Convulsions: Convulsions in infants below the age of 1 year have been reported.

  • Hematologic Effects: Neutropenia and agranulocytosis have been reported in patients receiving mebendazole at higher doses and for prolonged duration. Monitor blood counts in these patients.

  • Metronidazole and Serious Skin Reactions: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) have been reported with the concomitant use of mebendazole and metronidazole. Avoid concomitant use of mebendazole and metronidazole.

Adverse Reactions Reported in Mebendazole-treated Subjects from 39 Clinical Trials*: anorexia, abdominal pain, diarrhea, flatulence, nausea, vomiting, rash.

Adverse Reactions Identified During Postmarketing Experience with Mebendazole*: agranulocytosis, neutropenia, hypersensitivity including anaphylactic reactions, convulsions, dizziness, hepatitis, abnormal liver tests, glomerulonephritis, Stevens-Johnson syndrome/toxic epidermal necrolysis, exanthema, angioedema, urticaria, alopecia.

*Includes mebendazole formulations, dosages and treatment duration other than EMVERM 100 mg chewable tablet.

Drug Interactions: Concomitant use of EMVERM and metronidazole should be avoided.

Pregnancy: The available published literature on mebendazole use in pregnant women has not reported a clear association between mebendazole and a potential risk of major birth defects or miscarriages. There are risks to the mother and fetus associated with untreated helminthic infection during pregnancy.

Untreated soil transmitted helminth infections in pregnancy are associated with adverse outcomes including maternal iron deficiency anemia, low birth weight, neonatal and maternal death.

Lactation: Limited data from case reports demonstrate that a small amount of mebendazole is present in human milk following oral administration. There are no reports of effects on the breastfed infant, and the limited reports on the effects on milk production are inconsistent. The limited clinical data during lactation precludes a clear determination of the risk of EMVERM to a breastfed infant; therefore, developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for EMVERM and any potential adverse effects on the breastfed infant from EMVERM or from the underlying maternal condition.

Pediatric Use: The safety and effectiveness of EMVERM 100 mg chewable tablet has not been established in pediatric patients less than two years of age. Convulsions have been reported with mebendazole use in children less than one year of age.

Geriatric Use: Clinical studies of mebendazole did not include sufficient numbers of subjects aged 65 and older to determine whether they respond differently from younger subjects.

Overdosage: In patients treated at dosages substantially higher than recommended or for prolonged periods of time, the following adverse reactions have been reported: alopecia, reversible transaminase elevations, hepatitis, agranulocytosis, neutropenia, and glomerulonephritis.

Symptoms and signs of overdose: In the event of accidental overdose, gastrointestinal signs/symptoms may occur.

Treatment of overdose: There is no specific antidote.

Patient Counseling: Healthcare professionals should advise the patient to read the FDA-approved patient labeling (Patient Information) Advise patients that:

  • Taking EMVERM and metronidazole together may cause serious skin reactions and should be avoided.

  • EMVERM can be taken with or without food.

INDICATION

EMVERM® is indicated for the treatment of patients two years of age and older with gastrointestinal infections caused by Ancylostoma duodenale (hookworm), Ascaris lumbricoides (roundworm), Enterobius vermicularis (pinworm), Necator americanus (hookworm), and Trichuris trichiura (whipworm).

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. To report SUSPECTED ADVERSE REACTIONS contact Impax Laboratories, Inc. at 1-877-994-6729.

Please click here for Full Prescribing Information.