Piperazine
Anti-parasitic
View Brand Names (3)Dose and dosage
For treatment of ascarids (Note: Because larval stages in the host’s tissues may not be affected by the drug, many clinicians recommend retreating about 2–3 weeks after the first dose):
a) 45–65 mg of base/kg PO; for pups less than 2.5 kg: 150 mg maximum. (Cornelius & Roberson 1986)
b) 110 mg/kg PO (Chiapella 1989)
c) 100 mg/kg PO; repeat in 3 weeks (Morgan 1988)
d) 20–30 mg/kg PO once (Davis 1985)
e) 110 mg/kg PO; repeat in 21 days (Kirk 1989)
f) 45–65 mg/kg (as base) PO (Roberson 1988)
For treatment of ascarids (Note: Because larval stages in the host’s tissues may not be affected by the drug, many clinicians recommend retreating about 2–3 weeks after the first dose):
a) 45–65 mg of base/kg PO; 150 mg maximum (Cornelius & Roberson 1986)
b) 110 mg/kg PO (Chiapella 1989)
c) 100 mg/kg PO; repeat in 3 weeks (Morgan 1988)
d) 20–30 mg/kg PO once (Davis 1985)
e) 110 mg/kg PO; repeat in 21 days (Kirk 1989)
f) 45–65 mg/kg (as base) PO (Roberson 1988)
a) Mice, rats, hamsters, gerbils, and rabbits: For pinworms: Piperazine citrate in drinking water at 3 grams/liter for 2 weeks. (Burke 1999)
b) Rabbits: For Pinworms: Piperazine citrate 100 mg/kg PO q24h for 2 days. Piperazine adipate: Adults: 200–500 mg/kg PO q24h for 2 days.
Young rabbits: 750 mg/kg, PO once daily for 2 days. Wash the perianal area. (Ivey & Morrisey 2000)
c) Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas: For pinworms/tapeworms using piperazine citrate: 2–5 mg/mL drinking water for 7 days, off 7 days and repeat (Adamcak & Otten 2000)
There are combination products available for use in horses that contain piperazine with increased efficacy against nematodes and other helminths. Refer to the individual products’ package insert for more information.
a) 110 mg/kg (base) PO; repeat in 3–4 weeks. Retreating at 10-week intervals for P. equorum infections in young animals is recommended.
(Roberson 1988)
b) 200 mg/kg, PO. Maximum of 80 grams in adults, 60 grams in yearlings, and 30 grams in foals. (Brander et al. 1982)
For Ascaris suum and Oesophagostomum:
a) 0.2–0.4% in the feed, or 0.1–0.2% in the drinking water. All medicated water or feed must be consumed within 12 hours, so fasting or withholding water overnight may be beneficial to ensure adequate dosing; retreat in 2 months. Safe in young animals, and during pregnancy. Drug withdrawal times not determined for swine. (Paul 1986)
b) 110 mg/kg (as base). Citrate salt usually used in feed as a one-day treatment, and hexahydrate in drinking water. Dose must be consumed in 8–12 hours. Withholding water or feed the previous night may be beneficial. (Roberson 1988)
a) For nematodes: 40–60 mg/kg PO. Repeat in two weeks, followed by a fecal examination 14 days after the second dose. If positive for parasites, a third dose is given and the cycle continued until the parasites are cleared from the animal. (de la Navarre 2008)
110-200 mg/kg
200-300 mg/kg
a) For ascarids in poultry (not effective in psittacines): 100–500 mg/kg PO once; repeat in 10–14 days (Clubb 1986)
b) For nematodes: Piperazine citrate: 45–100 mg/kg single dose or 6–10 grams/gallon for 1–4 days. In raptors: 100 mg/kg. In parakeets and canaries: 0.5 mg/gram (Stunkard 1984)
c) For Ascaridia galli in poultry: 32 mg/kg (as base) (approximately 0.3 grams for each adult) given in each of 2 successive feedings or for 2 days in drinking water. Citrate or adipate salts are usually used in feed and the hexahydrate in drinking water. (Roberson 1988)
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Poultry: used for the treatment of infestation caused by round worm such as Ascaridia galli, Heterakis gallinarum, Syngamus trachea etc.
Cattle, Buffalo, Horse, Sheep, Goat, Dog & Cat: used for the treatment of infestation caused by round worm.
Piperazine should be considered contraindicated in patients with chronic liver or kidney disease, and those with gastrointestinal hypomotility. There is some evidence in humans that high-dose piperazine may provoke seizures in patients with a history of seizures, or with renal disease.
Piperazine is one of the oldest and still widely used antiparasitic drugs used in animals. Piperazine produces neuromuscular blockade in parasites through selective antagonism of GABA receptors, resulting in opening of chloride channels, hyperpolarization of parasite membrane, and paralysis of worms. Efficacy is limited primarily to roundworms. In horses, it is active against small strongyles and roundworms.
Piperazine is thought to exert “curare-like” effects on susceptible nematodes, thereby paralyzing or narcotizing the worm and allowing it to be passed out with the feces. The neuromuscular blocking effect is believed to be caused by blocking acetylcholine at the myoneural junction. In ascarids, succinic acid production is also inhibited.
The following drug interactions have either been reported or are theoretical in humans or animals receiving piperazine and may be of significance in veterinary patients:
CHLORPROMAZINE: Although data conflicts, piperazine and chlorpromazine may precipitate seizures if used concomitantly
LAXATIVES: The use of purgatives (laxatives) with piperazine is not recommended as the drug may be eliminated before its full efficacy is established
PYRANTEL/MORANTEL: Piperazine and pyrantel/morantel have antagonistic modes of action and should generally not be used together
Piperazine is remarkably safe in all species but can cause ataxia, muscle tremors, and changes in behavior.
Acute massive overdosage can lead to paralysis and death, but the drug is generally considered to have a wide margin of safety.
If used in horses with heavy infestations of P. equorum, rupture or blockage of intestines is possible due to the rapid death and detachment of the worm.
Meat: 1.5 days
Milk: 1 day