Version July 2025
Dosage guidance:
Dosing: Dose is expressed as pyrantel base.
Ascariasis (Ascaris lumbricoides) (roundworm): Limited data available: Children and Adolescents: Oral: 11 mg/kg once daily for 3 days; maximum dose: 1,000 mg/dose (Ref).
Hookworms (Ancylostoma duodenale and Necator americanus ): Limited data available: Children and Adolescents: Oral: 11 mg/kg once daily for 3 days; maximum dose: 1,000 mg/dose (Ref).
Moniliformis: Very limited data available: Children and Adolescents: Oral: 11 mg/kg/dose every 2 weeks for 3 doses (Ref).
Pinworm (Enterobius vermicularis ): Note: It is recommended to treat the entire household to prevent reinfection (Ref).
Children and Adolescents: Limited data available in ages <2 years:
Weight-directed dosing: Oral: 11 mg/kg administered as a single dose; maximum dose: 1,000 mg/dose; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
Fixed dosing:
11 to 16 kg: Oral: 125 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
17 to 28 kg: Oral: 250 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
29 to 39 kg: Oral: 375 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
40 to 50 kg: Oral: 500 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
51 to 62 kg: Oral: 625 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
63 to 73 kg: Oral: 750 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
74 to 84 kg: Oral: 875 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
>84 kg: Oral: 1,000 mg once; repeat dose in 2 weeks to eliminate possible reinfection (Ref).
Trichostrongylosis (Trichostrongylus spp): Limited data available: Children and Adolescents: Oral: 11 mg/kg as a single dose; maximum dose: 1,000 mg/dose (Ref).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling; use with caution.
(For additional information see "Pyrantel pamoate: Drug information")
Dosage guidance:
Dosing: Dose is expressed as pyrantel base.
Ascariasis (Ascaris lumbricoides) (roundworm) (alternative agent) (off-label use): Oral: 11 mg/kg (maximum: 1 g/dose) as a single dose (Ref).
Hookworm infection (Ancylostoma duodenale or Necator americanus) (off-label use): Oral: 11 mg/kg (maximum: 1 g/dose) once daily for 3 days (Ref).
Pinworm infection (Enterobiasis):
Weight-directed dosing: Oral: 11 mg/kg (maximum: 1 g/dose) as a single dose (Ref); repeat dose in 2 weeks to prevent reinfection (Ref).
Fixed dosing:
≥40 to 50 kg: Oral: 500 mg as a single dose (Ref); repeat dose in 2 weeks to eliminate possible reinfection (Ref).
51 to 62 kg: Oral: 625 mg as a single dose (Ref); repeat dose in 2 weeks to eliminate possible reinfection (Ref).
63 to 73 kg: Oral: 750 mg as a single dose (Ref); repeat dose in 2 weeks to eliminate possible reinfection (Ref).
74 to 84 kg: Oral: 875 mg as a single dose (Ref); repeat dose in 2 weeks to eliminate possible reinfection (Ref).
>84 kg: Oral: 1 g as a single dose (Ref); repeat dose in 2 weeks to eliminate possible reinfection (Ref).
Trichostrongylosis (Trichostrongylus spp.) (off-label use): Oral: 11 mg/kg (maximum: 1 g/dose) as a single dose (Ref).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling; use with caution.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Central nervous system: Dizziness, headache
Gastrointestinal: Abdominal cramps, diarrhea, nausea, vomiting
Disease-related concerns:
• Hepatic impairment: Use with caution in patients with hepatic impairment.
Dosage form specific issues:
• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity ("gasping syndrome") in neonates; the "gasping syndrome" consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer's labeling.
• Phenylalanine: Chewable tablets may contain phenylalanine.
Other warnings/precautions:
• Household contacts: Since pinworm infections are easily spread to others, treat all family members in close contact with the patient.
• Self-medication (OTC use): When used for self-medication, patients should be instructed to contact health care provider if symptoms or pinworm infection persists after treatment or if any worms other than pinworms are present before or after treatment. Patients should not repeat dose unless directed to do so by their health care provider.
Some dosage forms may contain propylene glycol; in neonates, large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Suspension, Oral [strength expressed as base]:
Pin-Away: 50 mg/mL (60 mL) [sugar free; contains methylparaben, polysorbate 80, propylene glycol, propylparaben, sodium benzoate]
Reeses Pinworm Medicine: 50 mg/mL (30 mL) [contains saccharin sodium, sodium benzoate]
Yes
Chewable (Pin-X Oral)
720.5 mg (12): $13.44
Suspension (Pin-X Oral)
50 mg/mL (30 mL): $8.61
Disclaimer: The pricing data provide a representative AWP and/or AAWP price from a single manufacturer of the brand and/or generic product, respectively. The pricing data should be used for benchmarking purposes only, and as such should not be used to set or adjudicate any prices for reimbursement or purchasing functions. Pricing data is updated monthly.
Pyrantel base 50 mg is equivalent to pyrantel pamoate 144 mg.
Oral: May be administered without regard to meals. The use of a laxative is not required prior to, during, or after use.
Chewable tablets: Chew thoroughly. May be administered alone or with milk or fruit juice.
Oral suspension: Shake suspension well before use. May be taken alone or mixed with milk or fruit juice.
Oral: May be administered without regard to meals. The use of a laxative is not required prior to, during, or after use.
Chewable tablets: Chew thoroughly. May be administered alone or with milk or fruit juice.
Suspension: Shake well before use. May be administered alone or mixed with milk or fruit juice.
Store at 15°C to 30°C (59°F to 86°F).
Treatment of pinworms (Enterobius vermicularis) (OTC products: FDA approved in ages ≥2 years weighing ≥11 kg and adults); has also been used for the treatment of ascariasis (Ascaris lumbricoides), hookworms (Ancylostoma duodenale and Necator americanus), Trichostrongylus spp, and Moniliformis moniliformis.
Substrate of CYP2D6 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program
There are no known significant interactions.
Chewable tablets may contain phenylalanine.
Pyrantel pamoate has minimal systemic absorption. Systemic absorption would be required in order for pyrantel pamoate to cross the placenta and reach the fetus.
Monitor stool for presence of eggs, worms, and occult blood.
Causes the release of acetylcholine and inhibits cholinesterase; acts as a depolarizing neuromuscular blocker, paralyzing the helminths.
Absorption: Oral: Poor.
Metabolism: Partially hepatic.
Time to peak, serum: 1 to 3 hours.
Excretion: Feces (>50% as unchanged drug); urine (≤7% as unchanged drug and metabolites).
