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Antihelminthic / immunomodulator

Levamisole

Levamisole is an anthelmintic agent with immunomodulatory properties; it has been used to treat certain nematode (roundworm) infections and, in some specialist settings, as a steroid-sparing agent in childhood nephrotic syndrome.

Dosing — no UK product information found

We found no UK product information (SmPC) for this medicine or presentation on the eMC or MHRA Products (checked October 2026). It may be unlicensed in the UK, imported, a medical device, or no longer marketed. ClinCalc Pro shows only doses it can trace to official product information, so none is shown — follow your specialist service or local guideline.

Clinical monograph

How it works

As an anthelmintic it acts as a nicotinic acetylcholine receptor agonist at the worm neuromuscular junction, causing spastic paralysis of the parasite; it also has poorly understood immunomodulatory effects in humans.

Prescribing in practice

  • Agranulocytosis is a recognised serious adverse effect, so unexplained fever, sore throat or infection should prompt an urgent full blood count and review.
  • Its use is limited and largely confined to specialist indications, and availability varies, so prescribing should follow current prescribing references and local guidance.
  • It has been reported as an adulterant of illicit cocaine and can cause vasculitis and neutropenia in that context, which is relevant to differential diagnosis.

Monitoring

Monitor the full blood count, particularly the neutrophil count, and review for signs of infection during treatment.

Counselling the patient

  • Seek urgent medical advice if you develop a fever, sore throat or mouth ulcers.
  • Take the medicine exactly as directed for the prescribed course.
  • Attend any blood tests requested while you are taking this medicine.

Evidence & guidelines

Use is based on established pharmacology and specialist guidance rather than a single landmark trial, and its profile is informed by post-marketing safety reports.

Reference: KDIGO guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways