POVAN
Clinical safety rating: caution
Comprehensive clinical and safety monograph for POVAN (POVAN).
Pyrvinium pamoate inhibits oxidative metabolism and glucose uptake in susceptible helminths, leading to energy depletion and paralysis of the worm. It also binds to DNA and inhibits RNA synthesis in the parasite.
| Metabolism | Pyrvinium pamoate is minimally absorbed from the gastrointestinal tract; systemic metabolism is negligible. The small absorbed fraction is metabolized in the liver, but specific enzymes are not well defined. |
| Excretion | Primarily fecal (90%) as unchanged drug via bile; renal excretion is minimal (<1%) |
| Half-life | Terminal elimination half-life is approximately 16 hours; clinically, this supports single-dose administration with slow elimination |
| Protein binding | Bound to plasma proteins (especially albumin) approximately 75–80% |
| Volume of Distribution | Apparent volume of distribution is 0.5–0.7 L/kg, consistent with moderate tissue distribution |
| Bioavailability | Oral bioavailability is low (<10%) due to poor absorption; acts topically in the GI tract |
| Onset of Action | Oral: onset of action occurs within 2–4 hours; drug acts locally in the GI tract with minimal systemic absorption |
| Duration of Action | Duration is sustained for 7–10 days due to slow GI transit and enterohepatic recycling; single dose eradicates Enterobius vermicularis |
Pyrantel pamoate: 11 mg/kg (maximum 1 g) orally once; repeat in 2 weeks for pinworm. For ascariasis, hookworm, trichostrongyliasis: 11 mg/kg (max 1 g) once daily for 3 days.
| Dosage form | TABLET |
| Renal impairment | No specific guidelines; caution in severe renal impairment (CrCl <30 mL/min) due to limited data. |
| Liver impairment | Contraindicated in acute hepatic disease or significant liver impairment (Child-Pugh class B or C); use not recommended. |
| Pediatric use | Weight-based: 11 mg/kg (maximum 1 g) orally once for pinworm; repeat in 2 weeks. For other infections: 11 mg/kg once daily for 3 days. |
| Geriatric use | No specific adjustments; use standard dosing with caution due to potential comorbidities and reduced hepatic function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for POVAN (POVAN).
| Breastfeeding | Unknown if pyrvinium pamoate is excreted in human milk. M/P ratio not available. Caution advised, consider alternative treatment during breastfeeding. |
| Teratogenic Risk | Pyrvinium pamoate (Povan) is not recommended during pregnancy due to insufficient human data. Animal studies have not shown teratogenicity, but risk cannot be excluded. In first trimester, avoid use unless clearly needed. Second and third trimester: consider risk-benefit; no known fetal harm from limited reports. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to pyrvinium or any component of the formulation","Intestinal obstruction or acute abdominal conditions"]
| Precautions | ["Gastrointestinal disturbances may occur; caution in patients with inflammatory bowel disease or severe hepatic impairment. May cause staining of stools and emesis. Avoid in pregnancy unless clearly needed."] |
Loading safety data…
| No specific monitoring required. Monitor for gastrointestinal adverse effects. In pregnancy, assess maternal tolerance and confirm need for antiparasitic therapy. |
| Fertility Effects | No known adverse effects on fertility in animal studies. Human data lacking. |