LEVAMISOLE 於牙科的使用 傅任巧 藥劑科

Levamisole 藥理生理學 immunomodulatory activity T-cell activity and to have enhancing effects on the functions of B-lymphocytes and macrophages

Levamisole 使用方向 健保 : 抗蛔蟲及鉤蟲病 At present, the primary indication of levamisole is as adjunctive treatment of stage C colon cancer, in combination with fluorouracil. mood-elevating effects in humans and convulsant effects at high doses

AIDS AMYOTROPHIC LATERAL SCLEROSIS APHTHOUS STOMATITIS BAYLIS ASCARIASIS BILIARY CIRRHOSIS BREAST CANCER COLON CANCER (HAVE FDA CHECKED) CROHN'S DISEASE HELMINTHIASIS HEPATITIS LEUKEMIA- ACUTE NONLYMPHOCYTIC LEUKEMIA LUNG CANCER MALIGNANT MELANOMA NEPHROTIC SYNDROME ONCHOCERCIASIS ORAL ULCERS, CHRONIC PULMONARY TUBERCULOSIS RHEUMATOID ARTHRITIS SOLID TUMORS SYSTEMIC LUPUS ERYTHEMATOSUS ULCERATIVE COLITIS

ONCHOCERCIASIS 1. OVERVIEW: FDA APPROVAL: Adult, no; pediatric, no EFFICACY: Adult, ineffective DOCUMENTATION: Adult, fair 2. SUMMARY: - LEVAMISOLE is not effective therapy for the treatment of onchocerciasis 3. ADULT: –a. Levamisole 150 milligrams orally weekly for 5 weeks was reported ineffective in the treatment of onchocerciasis in a randomized study. In this trial, the combination of levamisole plus mebendazole appeared to offer no significant advantage over mebendazole alone (Rivas- Alcala et al, 1981).

ORAL ULCERS, CHRONIC 1. OVERVIEW: FDA APPROVAL: Adult, no; pediatric, no EFFICACY: Adult, possibly effective DOCUMENTATION: Adult, fair 2. SUMMARY: - The combination of levamisole and low-dose prednisolone is effective and relatively safe, compared to high-dose prednisolone

3. ADULT: –a. Results of an open clinical trial indicate that addition of levamisole to low-dose prednisolone is beneficial for controlling such MUCOCUTANEOUS DISEASE as oral lichen planus (OLP), erythema multiforme (EM), mucous membrane pemphigoid (MMP), and early pemphigus vulgaris (PV) (Lu et al, 1998). In a study population of 41 patients (30 with OLP, 6 with EM, 3 with MMP, and 2 with early PV), levamisole 50 milligrams (mg) and prednisolone 5 mg, each given 3 times per day for 3 consecutive days each week and used either alone or in combination with topical dexamethasone, were used until no evidence of OLP, EM, MMP, or PV was found.

–The time to response after start of therapy ranged from 1 to 4 weeks, and all patients showed marked improvement. Of the 30 patients with OLP, 29 remained free of symptoms for 4 to 6 months. Although neither OLP nor EM were eradicated, recurrences were mild, and continued to respond to the drug regimen whenever it was reinstated. Of the remaining patients, all 6 with EM, all 3 with MMP, and both with early PV remained completely free of disease symptoms without additional medication for the 3 years of follow-up. Patients showing an excellent response had all medication stopped in cases of EM, 2 weeks of maintenance in cases of OLP, and 4 weeks of maintenance in cases of MMP and PV. One patient with OLP reported a minor skin rash.

Dental The leukopenic effects of levamisole may result in an increased incidence of microbial infection, delayed healing, and gingival bleeding. If leukopenia occurs, dental work should be deferred until blood counts have returned to normal and patients should be instructed in proper oral hygiene, including caution in use of regular toothbrushes, dental floss, and toothpicks.

LEVAMISOLE 於牙科牙蟲病的用法 levamisole 50 mg(1 TAB) TID and prednisolone 5 mg TID levamisole 150 mg(3 TAB) QD