Treatment

Praziquantel:

• Mode of action:  Praziquantel increases cell membrane permeability in the flukes, which allows their intracellular calcium levels to decrease.  This results in contractions and paralysis of the flukes musculature, which in turn allows the host immune system to phagocytose the parasite.
• Dosage:  25mg/kg every 5-6 hours for one day (3 doses)
• Cure rate:  98-100%
• Problems:  The bile duct dilatation, irregularities and ductal proliferation persist despite eradication of the parasite.
• Possible side effects:
• Drowsiness
• Abdominal discomfort
• Nausea
• Vomiting
• Headache
• Dizziness
• Mild fever
• Sore throat
• Dysuria
• Retention of urine
• Severe apprehension

(Eastern Medical Health Journal )

Albendazole:

• Mode of action: Inhibits metabolism in the cells of the fluke, resulting in their immobilization and subsequent death. 
• Dosage: 10mg/kg daily for 7 days
• Cure rate: around 100%
• Problems:  The bile duct dilatation, irregularities and ductal proliferation persist despite eradication of the parasite.
• Possible side effects: 
• Abdominal pain
• Nausea
• Vomiting
• Alopecia
• Increased serum amino-transferase
• Neutropenia

(The New England Journal of Medicine )

Surgery:

• Mode of action:  Rids the body of the adult worms and can help return the gastric system to normal physiologic function. 
• When to use:  Surgery is the usual course of action when fulminant cholangiohepatitis is prominent.

If the disease is isolated to a single hepatic segment or lobe, a partial hepatectomy may work.
If there is diffuse involvement, a biliary-enteric anastomosis is often necessary.

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