Medicines

Levamisole for nephrotic syndrome

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of medicine

Levamisole

Why is it important for my child to take Levamisole?

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

  • Tablets should be swallowed with a glass of water, squash 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 mashed potato. 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).
  • Occasionally, 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, pharmacist or epilepsy nurse 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, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, 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 think you may have given your child too much Levamisole, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging 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 cause seizures (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 them away from furniture).

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 www.mhra.gov.uk/yellowcard

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

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 medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Levamisole.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.
  • You can give your child medicines that contain paracetamol, unless your doctor has told you not to.

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 this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • 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 medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

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

Where should I keep this medicine?

  • Keep the medicine 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 doctor, pharmacist or nurse will be able to give you more information about Levamisole and about other medicines used to treat nephrotic syndrome.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

Kidney Care UK

National Kidney Federation

0800 169 09 36

www.kidney.org.uk/

Nephrotic Syndrome Trust (NeST)

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by June 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.