Anti-helmintic agent. Occasionally used as a chemotherapeutic agent, but its side-effect profile and better alternatives, limit its usefulness. It has possible immunomodulatory activity which are exploited in the treatment of juvenile nephrotic syndrome. Significant side effects include an ANCA-positive vasculitis which can be systemic or cutaneous, the latter manifesting as a retiform purpuric skin rash, sometimes with skin necrosis. The other significant side-effect is bone marrow suppression and consequent agranulocytosis. These features may be seen in cocaine users as levamisole is frequently used as 'cutting agent' to bulk up drug cocaine, although levamisole may have its own psychotropic effects. Rat studies suggest it partially mitigates opioid withdrawal.
Reversibly inhibits certain isoforms of alkaline phosphatase, which has application in biomolecular techniques, e.g. Western blotting or immunohistochemistry, where levamisole is added to reduced background alkaline phosphatase activity (where alkaline phosphatase is used instead of peroxidase).
- Ascaris lumbricoides - drug of choice
Oral 120 to 150mg as single dose
Cautions and Interactions
- ↑ Levamisole for corticosteroid-dependent nephrotic syndrome in childhood. British Association for Paediatric Nephrology. Lancet. 1991 Jun 29; 337(8757):1555-7.
- ↑ Zhu NY, Legatt DF, Turner AR. Agranulocytosis after consumption of cocaine adulterated with levamisole. Annals of internal medicine. 2009 Feb 17; 150(4):287-9.
- ↑ Muirhead TT, Eide MJ. Images in clinical medicine. Toxic effects of levamisole in a cocaine user. The New England journal of medicine. 2011 Jun 16; 364(24):e52.(Link to article – subscription may be required.)
- ↑ Spector S, Munjal I, Schmidt DE. Effects of the immunostimulant, levamisole, on opiate withdrawal and levels of endogenous opiate alkaloids and monoamine neurotransmitters in rat brain. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 1998 Nov; 19(5):417-27.(Link to article – subscription may be required.)