In the pharmaceutical industry, Levamisole is a specialized anthelmintic and immunomodulatory agent. As a pharmacist and manufacturer, I view its administration through the lens of Weight-Based Precision: because it has a narrow therapeutic index, the dosage must be strictly calculated to ensure efficacy against parasites (like Ascaris lumbricoides) while avoiding neurotoxicity.
At your WHO-GMP facility in Mumbai, where you likely produce the 50 mg and 150 mg tablets, providing these clear administration protocols is a vital technical value-add for your B2B infectious disease and “Essential Medicines” portfolio.
Therapeutic Profile: Optimal Administration
Levamisole is primarily used as a single-dose treatment for common worm infestations.
| Variable | Recommended Protocol | Technical Rationale |
| Standard Dose | 2.5 mg/kg of body weight | A single dose is typically sufficient for Ascariasis. For an average 60 kg adult, this is a single 150 mg tablet. |
| Timing | With or After Food | While it can be taken on an empty stomach, taking it with a light meal can reduce common gastrointestinal side effects like nausea. |
| Frequency | Single Dose | For simple infestations, one dose is standard. In severe cases, a second dose may be required after 7 days, but only under medical supervision. |
| Liquid Intake | Full Glass of Water | Ensures rapid transit to the gut where the parasites reside. |
Mechanism: Nicotinic Acetylcholine Receptor Agonism
Levamisole works by causing “spastic paralysis” in the parasite:
Ganglion Stimulation: It acts as a potent agonist at the nicotinic acetylcholine receptors on the parasite’s nerve ganglia.
Muscle Contraction: This causes continuous, forceful muscle contractions in the worm.
Neuromuscular Blockade: The sustained contraction leads to paralysis; the worm loses its “grip” on the intestinal wall and is expelled naturally through bowel movements.
Immunomodulation: In specialized cases, Levamisole “primes” human T-cells and macrophages, though this use is less common in 2026 due to newer alternatives.
The Pharmacist’s “Technical Warning”
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The “Alcohol” Conflict: Advise patients to avoid alcohol for 24 hours after taking Levamisole. It can occasionally cause a Disulfiram-like reaction (flushing, palpitations, nausea).
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Agranulocytosis Risk: Long-term or repeated use is associated with a severe drop in white blood cells. This is why it is strictly a “short-course” medication.
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Neurological Monitoring: High doses can lead to “Levamisole-induced leucoencephalopathy.” Any signs of confusion, dizziness, or muscle weakness require immediate medical attention.
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Pediatric Safety: For children, the 50 mg tablet is typically used to allow for precise weight-based dosing ($2.5\text{ mg/kg}$).
The Manufacturer’s Perspective: Technical & Export
From a production and B2B standpoint at your facility in Mumbai:
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The “Deworming Campaign” USP: On your digital marketplace, position Levamisole as a cost-effective solution for mass deworming programs. Its high efficacy with a single dose makes it a favorite for international NGOs and health ministries.
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Stability for Export: Levamisole is stable but sensitive to moisture. Utilizing Alu-Alu blister packaging is the industry standard for ensuring a 36-month shelf life in Zone IVb tropical regions.
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Dossier Support: We provide full WHO-standard CTD/eCTD Dossiers to support your firm’s registration in international tenders for neglected tropical diseases (NTDs).