Levamisole for nephrotic syndrome

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Levamisole for nephrotic syndrome

This leaflet is about the use of levamisole for nephrotic syndrome in children.

Information Standard logoThis leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

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Why is it important for my child to take this medicine?

This medicine may be recommended if your child’s nephrotic syndrome keeps coming back and they need frequent treatment with steroids. Levamisole stimulates the immune system and should reduce the need for steroid treatment.

What is levamisole available as?  

  • Tablets: usually 50 mg, available as a special order from your pharmacist

When should I give levamisole?

Levamisole is usually given on alternate days (every other day), for example, Monday, Wednesday, Friday, Sunday, Tuesday, Thursday, Saturday, Monday, etc.).

  • It is given once a day on those days it is due. This is usually in the morning but you can choose another time if it helps you to give it regularly.
  • Try to give it at about the same time of the day each time.

How much should I give?

Your doctor will work out the amount of levamisole (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give levamisole?

Tablets-imageTablets should be swallowed with a glass of water, milk or juice. Your child should not chew the tablet.

You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Make sure your child swallows it straight away, without chewing.

You can also crush the tablet and mix it with water (it will not dissolve but will make a cloudy suspension). 

  • Occcasionally, the only way to provide the correct dose of Levamisole for your child will be to give part of a tablet or to disperse a tablet in a small amount of water and give some of the mixture. Your doctor or pharmacist will let you know if this is necessary and explain what to do.
  • This method should only be used when there is no other option and you have been told to do it. 
  • Any unused mixture should be poured into a paper towel and put in the bin. Do not pour it down the sink. 

When should the medicine start working?

Levamisole should prevent or reduce relapses (another episode or bout) of nephrotic syndrome and the need for treatment with steroids. Your doctor will probably suggest that your child takes levamisole regularly for many months, for example 6 months, to see whether it helps them to have fewer relapses.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of levamisole, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of levamisole, you do not need to give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, pharmacist or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it? 

If you remember on the day that the dose is due, give it as soon as you remember, then continue to give levamisole every other day in your usual pattern at the usual time.

If you remember after the day the dose was due, give a dose as soon as you remember. Then continue to give your usual dose every other day from that point.

What if I give too much?

If you accidently give your child too much levamisole, you are unlikely to do harm. Your child may get an upset stomach, dizziness or a headache.

If you worried that you may have given your child too much levamisole, or your child seems unwell, contact your doctor or local NHS services (details at end of leaflet). Have the packet with you if you telephone for advice.

Are there any possible side-effects? 

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects). 

Side-effects you must do something about 

Very rarely, levamisole can causes seizures (convulsions or fits). If your child has a seizure, telephone for an ambulance. Do not restrain your child, but try to make sure that they cannot hurt themselves (e.g. put a cushion under their head and move obstacles away).

Other side-effects you need to know about

Your child may have side-effects when they first start taking levamisole. These usually wear off after a week or so. If they continue to be a problem after 2 weeks, contact your doctor for advice.

  • Your child may feel sick or be sick (vomit). It may help if your child takes the medicine with some food or a small glass of milk.
  • Your child may get diarrhoea, headache, dizziness, a rash or muscle pains.
  • Levamisole sometimes affects blood cells. Your doctor will test your child’s blood regularly to check for this.

There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at http://www.mhra.gov.uk/yellowcard.

Can other medicines be given at the same time as levamisole?

  • You can give your child medicines that contain paracetamol, unless your doctor has told you not to. 
  • Levamisole can be safely taken with ibuprofen, although this medicine is not recommended for children with kidney disease. Contact your doctor for advice if you feel that your child needs ibuprofen.
  • Levamisole should not be taken with some common drugs that you get on prescription. Tell your doctor and pharmacist about any medicines your child is taking before starting levamisole. 
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

  • Levamisole is also used to treat round worm and hookworm infections. Usually only a single dose is used for these infections.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Only give levamisole to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm. 

If you think someone else may have taken the medicine by accident, contact your doctor for advice.

  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

  • Keep the medicines in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge. 
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information 

Your child’s doctor, pharmacist or nurse will be able to give you more information about levamisole and about other medicines used to treat nephrotic syndrome.

You can also get useful information from: 
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