Levamisole 25mg tablets
Requires a prescription from a doctor or prescriber
Levamisole is an antihelminthic drug that was commonly used for the treatment of parasitic, viral, and bacterial infections.
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Suspected adverse reactions reported for Levamisole
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Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
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Suspected adverse reactions reported for Levamisole
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1 branded products available
WHO defined daily dose (DDD)
150 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via the NHS dm+d supplementary BNF/ATC mapping files (NHSBSA). Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity is based on WHO Anatomical Therapeutic Chemical (ATC) classification and on a factual NHS dm+d therapeutic-grouping code prefix. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
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Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
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SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF code shown is the factual mapping value distributed by NHS Business Services Authority (NHSBSA) in the dm+d supplementary file under OGL v3.0; it is not affiliated with, nor licensed from, the publishers of the British National Formulary. ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Academic studies and reviews for this medicine's active substance
Showing the 50 most relevant studies.
Reviews & meta-analyses: 29 · Randomised trials: 8 · 1980–2026
Showing the 50 most relevant studies, sorted by most relevant.
A. Dartevel, B. Chaigne, L. Moachon, et al.
Seminars in arthritis and rheumatism, 2019
Scoglio M, Orlando C, Milani GP, et al.
2026
- Vasculitis
- Cocaine
- Levamisole
ObjectiveLevamisole, once used as anthelminthic or immunomodulator, is now a common cocaine adulterant. It is linked to a systemic vasculopathy/vasculitis. Our purpose was to review its clinical, serological, and histopathological features.MethodsWe conducted a registered systematic review (CRD42024558898) across three databases, without language or date restrictions. Reports documenting a vasculopathy/vasculitis temporally associated with levamisole - either prescribed or as a cocaine adulterant - were included.Results172 reports describing 302 patients were included. Most cases (N = 282; 93 %) involved cocaine adulterated with levamisole. The skin was involved in 274 (91 %) and the kidney in 64 (21 %) cases. Purpura (228; 83 %) and necrosis (141; 51 %) were the most common skin lesions, predominantly affecting ears and extremities. Among 186 classifiable skin biopsies, a thrombotic vasculopathy was detected in 65, a leukocytoclastic vasculitis in 52, and both a thrombotic vasculopathy and a vasculitis in 70 cases. Among 37 renal biopsies, a pauci-immune crescentic glomerulonephritis and a membranous nephropathy were the most detected features. Leukopenia occurred in 100 (33 %) cases. Among tested cases, anti-neutrophil cytoplasmic antibodies were detected in about 89 % of cases, mostly with a perinuclear (71 %) or an atypical (25 %) pattern. Antibodies targeting the myeloperoxidase were detected in 73 % of the cases. In patients receiving levamisole for therapeutic purposes, the vasculopathy resolved after levamisole withdrawal. A relapse of the vasculopathy was observed after re-exposed to levamisole.ConclusionsLevamisole-induced vasculopathy/vasculitis is a distinctive skin-predominant condition with characteristic clinical and serological features. Withdrawal of levamisole is the cornerstone of management.
Abstract licence: CC BY
ChunFu Cheng, Yoo-seong Jeong, William Jusko
Meta-Analysis of Levamisole Pharmacokinetics Across Diverse Species, 2024
Cheng C, Jeong YS, Jusko WJ
2026
Mariken Gruppen, A. Bouts, M. C. Jansen-van der Weide, et al.
Kidney international, 2017
A. Sinha, Mamta Puraswani, M. Kalaivani, et al.
Kidney international, 2019
Alexandre Larocque, R. Hoffman
Clinical Toxicology, 2012
Chesnais CB, Hemilembolo MC, Sahm BA, et al.
2025
- Loiasis
- Levamisole
- Loa
Pourahmad M, Soltani R, Noroozi MH, et al.
2024
- Levamisole
- Antiviral Agents
- COVID-19 Drug Treatment
C. Moertel, T. Fleming, J. Macdonald, et al.
The New England journal of medicine, 1990
Sources: aggregated from Europe PMC (EMBL-EBI), OpenAlex, Crossref, PubMed and other open scholarly databases. Retracted articles are excluded. Study information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
None known
Half-life
4.4-5.6 hours
Mechanism
The mechanism of action of levamisole as an antiparasitic agent appears to be ti…
Food interactions
1 warning
Human targets
3 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
2 hours
Half-life
4.4-5.6 hours
Protein binding
20-25%
Metabolism
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Because of its immunomodulatory effects, this drug has been studied in the treatment of various immune-mediated diseases, with some studies showing positive results. [A178117] This drug has also been used in combination with other drugs for the treatment of various cancers. [A178117][A178123]
Levamisole was withdrawn from the American market in 2000 due to its ability to cause serious adverse effects, including agranulocytosis. [A178123] Interestingly, levamisole has been found as an adulterant in cocaine and can lead to a variety of adverse effects in individuals using this drug.[A178120]
Known interactions with other medications. Always consult a healthcare professional.
Showing 2 of 2 interactions
How the body processes this drug — absorption, distribution, metabolism, and elimination
Proteins and enzymes this drug interacts with in the body
PMID:31488329 PMID:31708116
CHRNA3 forms heteropentameric neuronal acetylcholine receptors with CHRNB2 and CHRNB4, with CHRNA5, and CHRNB3 as accesory subunits .
PMID:20881005 PMID:8663494
CHRNA3:CHRNB4 being predominant in neurons of the autonomic ganglia, it is known as ganglionic nicotinic receptor .
PMID:31488329
CHRNA3:CHRNB4 or CHRNA3:CHRNA5:CHRNB4 play also an important role in the habenulo-interpeduncular tract, modulating the mesolimbic dopamine system and affecting reward circuits and addiction (By similarity). Hypothalamic CHRNA3:CHRNB4 nAChR activation by nicotine leads to activation of POMC neurons and a decrease in food intake (By similarity).
Also expressed in the urothelium where it modulates reflex bladder activity by increasing intracellular calcium through extracellular influx and basal ATP release (By similarity)
PMID:12162492 PMID:23688511 PMID:25982064
Has broad substrate specificity and can hydrolyze a considerable variety of compounds: however, only a few substrates, such as diphosphate (inorganic pyrophosphate; PPi), pyridoxal 5'-phosphate (PLP) and N-phosphocreatine are natural substrates .
PMID:12162492 PMID:2220817
Plays an essential role in skeletal and dental mineralization via its ability to hydrolyze extracellular diphosphate, a potent mineralization inhibitor, to phosphate: it thereby promotes hydroxyapatite crystal formation and increases inorganic phosphate concentration .
PMID:23688511 PMID:25982064
Acts in a non-redundant manner with PHOSPHO1 in skeletal mineralization: while PHOSPHO1 mediates the initiation of hydroxyapatite crystallization in the matrix vesicles (MVs), ALPL/TNAP catalyzes the spread of hydroxyapatite crystallization in the extracellular matrix (By similarity). Also promotes dephosphorylation of osteopontin (SSP1), an inhibitor of hydroxyapatite crystallization in its phosphorylated state; it is however unclear whether ALPL/TNAP mediates SSP1 dephosphorylation via a direct or indirect manner (By similarity). Catalyzes dephosphorylation of PLP to pyridoxal (PL), the transportable form of vitamin B6, in order to provide a sufficient amount of PLP in the brain, an essential cofactor for enzymes catalyzing the synthesis of diverse neurotransmitters .
PMID:20049532 PMID:2220817
Additionally, also able to mediate ATP degradation in a stepwise manner to adenosine, thereby regulating the availability of ligands for purinergic receptors (By similarity).
Also capable of dephosphorylating microbial products, such as lipopolysaccharides (LPS) as well as other phosphorylated small-molecules, such as poly-inosine:cytosine (poly I:C) .
PMID:28448526
Acts as a key regulator of adaptive thermogenesis as part of the futile creatine cycle: localizes to the mitochondria of thermogenic fat cells and acts by mediating hydrolysis of N-phosphocreatine to initiate a futile cycle of creatine dephosphorylation and phosphorylation (By similarity). During the futile creatine cycle, creatine and N-phosphocreatine are in a futile cycle, which dissipates the high energy charge of N-phosphocreatine as heat without performing any mechanical or chemical work (By similarity)
ATC P02CE01
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Levamisole
Additional database identifiers
Drugs Product Database (DPD)
4130
Drugs Product Database (DPD)
1326
Drugs Product Database (DPD)
2363
Drugs Product Database (DPD)
2801
ChemSpider
25037
BindingDB
50241179
ZINC
ZINC000000119839
HUGO Gene Nomenclature Committee (HGNC)
HGNC:1957
GeneCards
CHRNA3
GenBank Gene Database
M86383
GenBank Protein Database
177898
Guide to Pharmacology
464
UniProt Accession
ACHA3_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:438
GeneCards
ALPL
GenBank Gene Database
X14174
GenBank Protein Database
28738
UniProt Accession
PPBT_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:441
GenAtlas
ALPPL2
GeneCards
ALPG
GenBank Gene Database
J03252
GenBank Protein Database
178428
UniProt Accession
PPBN_HUMAN
UniProt Accession
ACH5_CAEEL
UniProt Accession
ACH6_CAEEL
UniProt Accession
ACH7_CAEEL
UniProt Accession
ACH2_CAEEL
DrugBank citations
If you use DrugBank data in your research, please cite the following publications:
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Structured knowledge from the free knowledge base
ATC classifications (Wikidata)
Linked open data from Wikidata (Q417097), a free and open knowledge base operated by the Wikimedia Foundation. Data is available under the Creative Commons CC0 1.0 Public Domain Dedication. WHO INN from the World Health Organization.