Piperazine
Piperazine is a narrow-spectrum anthelmintic used primarily for the treatment of **ascarids (roundworms)** in dogs, cats, horses, swine, and poultry. * It is considered safe to use in animals with concurrent gastroenteritis and during pregnancy. * **Clinical Pearl**: Because piperazine is only effective against adult ascarids and lacks efficacy against hookworms, whipworms, or tapeworms, its use in modern veterinary medicine has largely been replaced by broader-spectrum anthelmintics such as pyrantel, fenbendazole, and macrocyclic lactones. * Available in various salt forms (citrate, adipate, phosphate, hexahydrate, dihydrochloride), which contain varying amounts of the active piperazine base.
Mecanismo: Piperazine exerts a **'curare-like' effect** on susceptible nematodes. * It acts as a **GABA receptor agonist** and blocks **acetylcholine** at the myoneural junction of the parasite. * This causes **flaccid paralysis** (narcotizing the worm), allowing the live, paralyzed worms to be passed out of the host's gastrointestinal tract with the feces. * In ascarids, it also inhibits succinic acid production.
Dosificación por especie
- Treatment of ascarids · 45-65 mg of base/kg PO; 150 mg maximum · PO · once · Retreat in 2-3 weeks · Larval stages in tissues are not affected, necessitating retreatment
- Treatment of ascarids · 110 mg/kg PO · PO · once · Repeat in 21 days
- Treatment of ascarids · 100 mg/kg PO · PO · once · Repeat in 3 weeks
- Treatment of ascarids · 20-30 mg/kg PO once · PO · once
- Treatment of ascarids · 110 mg/kg (base) PO · PO · once · Repeat in 3-4 weeks · Retreating at 10-week intervals for P. equorum infections in young animals is recommended
- Treatment of ascarids · 200 mg/kg, PO · PO · once · Maximum of 80 grams in adults, 60 grams in yearlings, and 30 grams in foals
- Ascarids in poultry · 100-500 mg/kg PO once · PO · once · Repeat in 10-14 days · Not effective in psittacines
- Nematodes in raptors · 100 mg/kg · PO · once · Piperazine citrate
- Nematodes in parakeets and canaries · 0.5 mg/gram · PO · once · Piperazine citrate
- Ascaridia galli in poultry · 32 mg/kg (as base) (approximately 0.3 grams for each adult) · PO · once · Given in each of 2 successive feedings or for 2 days in drinking water · Citrate or adipate salts usually used in feed; hexahydrate in drinking water
Vías de administración
Contraindicaciones
- Chronic liver disease
- Chronic kidney disease
- Gastrointestinal hypomotility
- Chronic renal failure
- Hepatic impairment
- Heavy worm burdens (relative contraindication due to risk of intestinal impaction)
Efectos adversos
- Diarrhea
- Emesis
- Ataxia
- Transient softening of feces (horses)
- Neurological signs at high doses (ataxia, tremors)
Interacciones farmacológicas
- Chlorpromazine · May precipitate seizures if used concomitantly (data conflicts, but caution is advised) · moderate
- Laxatives (Purgatives) · Not recommended; may eliminate piperazine from the GI tract before its full efficacy is established
- Pyrantel / Morantel · Antagonistic modes of action (pyrantel causes spastic paralysis, piperazine causes flaccid paralysis); should not be used together
- Pyrantel · Antagonistic mechanism of action (Pyrantel causes spastic paralysis, Piperazine causes flaccid paralysis) · major
- Morantel · Antagonistic mechanism of action · major
Monitorización
- Clinical and/or laboratory efficacy (fecal examinations)
- Adverse effects (neurological signs, GI upset)
- Fecal flotation (to confirm clearance of roundworms)
- Adverse neurological signs
Sobredosis
Piperazine generally has a wide margin of safety (oral LD50 of piperazine adipate in mice is 11.4 g/kg). However, acute massive overdosage can lead to **paralysis and death**. **Feline Toxicity:** In cats, adverse effects occur within 24 hours after a toxic dose is ingested. Clinical signs include: * Emesis, hypersalivation, dehydration * Weakness, dyspnea, depression * Muscular fasciculations of ears, whiskers, tail, and eyes * Rear limb ataxia, head-pressing * Positional nystagmus and slowed pupillary responses *(Many of these effects may also be seen in dogs after toxic ingestions.)* **Treatment:** * Symptomatic and supportive care. * If ingestion was recent, use of **activated charcoal** and a cathartic is suggested. * Intravenous fluid therapy. * Keep the animal in a quiet, dark place. * Recovery generally takes place within 3-4 days.
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.