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Human helminth care manual: Difference between revisions
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=== Antihistamines === | === Antihistamines === | ||
==== ❌ Piperazine related antihistamines ==== | |||
<blockquote> | |||
Popular antihistamines derived from, or closely related to, the anthelminthic drug ❌ [https://en.wikipedia.org/wiki/Piperazine piperazine] (See the separate entry for piperazine). | |||
These include: | |||
* ⚡ [http://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine), | |||
* ⚡ [http://en.wikipedia.org/wiki/Levocetrizine_dihydrochloride levocetrizine] (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem), | |||
* ⚡ [http://en.wikipedia.org/wiki/Phenylephrine phenylephrine], | |||
* ⚡ [http://en.wikipedia.org/wiki/Desloratadine desloratadine] (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot) | |||
* and possibly ⚡ [http://en.wikipedia.org/wiki/Acrivastine acrivastine] (Semprex-D in the US). | |||
While some people have taken cetirizine, levocetirizine or desloratadine concurrently with helminthic therapy - | |||
sometimes for very long periods - and had no loss of benefit from their worms (for example [https://www.facebook.com/groups/htsupport/permalink/892594554129834/?comment_id=892794274109862&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/893959107326712/?qa_ref=qd&comment_id=893959580659998&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R7%22%7D]), there | |||
have been others who have suspected that these drugs have been responsible for adversely affecting or even killing | |||
their worms. | |||
Less common antihistamines derived from, or related to piperazine. At the present time, there is no indication whether or not these affect human helminths. They include: | |||
* ❔ [http://en.wikipedia.org/wiki/Buclizine buclizine], | |||
* ❔ [http://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan), | |||
* ❔ [http://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5), | |||
* ❔ [http://en.wikipedia.org/wiki/Cyclizine cyclizine], | |||
* ❔ [http://en.wikipedia.org/wiki/Hydroxyzine hydroxyzine] (Vistaril, Atarax), | |||
* ❔ [http://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs), | |||
* ❔ [http://en.wikipedia.org/wiki/Dramamine dimenhydrinate] (Dramamine) | |||
* ❔ [http://en.wikipedia.org/wiki/Niaprazine niaprazine] | |||
</blockquote> | |||
==== Antihistamines as marked ==== | |||
<blockquote> | |||
* ❔ [https://en.wikipedia.org/wiki/Chlorphenamine Chlorphenamine] (chlorpheniramine, piriton) <br>While we don’t yet have any confirmation of the effect on helminths of this first-generation antihistamine, it has been suggested by someone who has investigated this that it is unlikely to be harmful to worms. | |||
* ✅ [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium, plus Gastrocrom and Intercron) <br>This is a mast cell stabiliser which prevents the release of histamine from mast cells and is used to treat some allergic conditions. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D] | |||
* ⚡ [https://en.wikipedia.org/wiki/Doxylamine Doxylamine] (Dozile, Restavit, Valocordin-Doxylamine and Vomentin) <br>One hookworm host believes that an unexpected return of gut symptoms and dry skin may have been caused by taking a quarter of a tablet of this firstgeneration antihistamine every night for a couple of weeks. [https://www.facebook.com/groups/htsupport/permalink/927991007256855/?comment_id=1007272959328659&comment_tracking=%7B%22tn%22:%22R%22%7D] | |||
* ⚡ [http://en.wikipedia.org/wiki/Ketotifen Ketotifen] - This antihistamine and mast cell stabilizer, which has similar effects to cromoglicic acid (see separate listing), is sold under a large variety of trade names[https://www.drugs.com/international/ketotifen.html] that include Allerban, Allergan, Bentifen, Ketasma, Mastifen, Zaditen and Zylofen. In a small in vitro test, one hookworm self-treater found that exposing a sample of Necator americanus larvae to Naziden left them “a bit lethargic but alive” [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1041766029212685&comment_tracking=%7B%22tn%22:%22R8%22%7D] and that they were still alive the next day. [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1042321262490495&comment_tracking=%7B%22tn%22:%22R3%22%7D] However, effects in vivo don’t always correspond with those observed in a petri dish, and ketotifen is a piperazine-related substance so it may have an adverse effect on human helminths in vivo in at least some users. | |||
* ⚡ [http://en.wikipedia.org/wiki/Promethazine Promethazine] (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex). This does not appear to kill helminths, especially when administered by intramuscular injection. However, one helminth host has reported that this drug reduced his worm benefits when taken orally. | |||
* ✅ Worm-safe antihistamines are | |||
** [http://en.wikipedia.org/wiki/Diphenhydramine diphenhydramine] -- most likely to cause drowsiness | |||
** [http://en.wikipedia.org/wiki/Loratadine loratadine] (Claritin) | |||
** [http://en.wikipedia.org/wiki/Fexofenadine fexofenadine] (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness | |||
* ✅ Most '''Benadryl-branded products''' sold in the '''US''' contain only diphenhydramine so are worm-safe, e.g. | |||
** [http://www.benadryl.com/products/allergy/benadryl-ultratab-tablets Benadryl Allergy Ultratab Tablets] | |||
** [http://www.benadryl.com/products/allergy/benadryl-liquid-gels Benadryl Allergy Dye-Free Liqui-gels] | |||
** [http://www.benadryl.com/products/children-allergy/benadryl-allergy-liquid Children’s Benadryl Allergy Liquid] | |||
* ⚡ except | |||
** [https://www.benadryl.com/products/children-allergy/benadryl-allergy-and-sinus-liquid Childrens’ Benadryl Allergy Plus Congestion] which also contains ⚡ phenylephrine, which has anthelminthic properties [http://www.ncbi.nlm.nih.gov/pubmed/6127426] and has caused a brief return of disease symptoms in one worm host after a single dose. | |||
'''Benadryl products''' sold in the '''UK''' all contain drugs with anthelminthic potential - either | |||
* ⚡ cetirizine | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-liquid-capsules Benadryl Allergy Liquid Release Tablets/Capsules] | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-one-day Benadryl One a Day Relief Tablets/Capsules] | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-aged-two-plus Benadryl Allergy Children’s (2+ years) 1mg/ml Oral Solution] | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-children Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution] | |||
* ⚡ acrivastine | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief-plus Benadryl Allergy Relief Plus Decongestant Capsules] | |||
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief Benadryl Allergy Relief Capsules] | |||
</blockquote> | |||
==== ✅ H2 antagonists are safe ==== | |||
<blockquote> | |||
H2 antagonists are a separate class of drugs from '''proton-pump Inhibitors''' (see separate section). | |||
The term, “antihistamine” is usually reserved for [https://en.wikipedia.org/wiki/H1_antagonist H1 antagonists] whose main therapeutic effect is mediated by | |||
negative modulation of histamine receptors, but [https://en.wikipedia.org/wiki/H2_antagonist H2 histamine receptor antagonists] can also be considered to be a | |||
type of antihistamine. H2 antagonists include | |||
* [https://en.wikipedia.org/wiki/Ranitidine ranitidine] (Zantac) which works by blocking histamine and thus decreasing the amount of acid released by the cells of the stomach. | |||
Other common H2 antagonists are | |||
* [https://en.wikipedia.org/wiki/Cimetidine cimetidine] (Tagamet) | |||
* [https://en.wikipedia.org/wiki/Famotidine famotidine] (Pepcid) | |||
* [https://en.wikipedia.org/wiki/Nizatidine nizatidine] (Axid, Tazac). | |||
</blockquote> | |||