UNCOVERING PINWORM
IN YOUR PRACTICE

Perianal pruritus is the hallmark symptom of pinworm infection1

  • Perianal and perineal itching are the most common symptoms of pinworm infections. Severe irritation of the anal area can lead to intense scratching and excoriation1
    • The itching is often worse at night when female pinworms are migrating out of the anus to lay eggs
    • Sleep disturbance, restlessness, and irritability are other symptoms attributed to pinworm
  • Pinworm should be suspected in young children with perianal pruritus and restless sleep2

Other, less common symptoms are1,3:

Abdominal pain Dysuria Teeth grinding
Anorexia Enuresis Weight loss


According to the Centers for Disease Control and Prevention (CDC), occasional complications in females include4:

Vulvovaginitis Pelvic granulomas Peritoneal granulomas

Diagnostic approaches

Symptoms of intense anal itching and sleep disturbance are generally strong indications of pinworm infection.

Visual identification of pinworms in the perianal region after the infected person is asleep is one possible way of diagnosing pinworm. The most common diagnostic method is called the “tape test.”3

A tape test diagnosis is made by applying clear adhesive tape to the perianal area, then examining the tape under a microscope for the presence of pinworm eggs. For the highest level of accuracy, this test should be conducted on 3 consecutive mornings.3

Pinworms infest the colon video

Courtesy of Bioresonance Therapy.

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. Meinking TL, Burkhart CN, Burkhart CG. Changing paradigms in parasitic infections: common dermatological helminthic infections and cutaneous myiasis. Clin Dermatol. 2003;21(5):407-416. 2. Kucik CJ, Martin GL, Sortor BV. Common intestinal parasites. Am Fam Physician. 2004;69(5):1161-1168. 3. 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. 4. Enterobiasis. Centers for Disease Control and Prevention website. http://www.cdc.gov/dpdx/enterobiasis/. Updated May 3, 2016. 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.