Pinworms are the most common worm infection in the US, especially in children aged 5 to 10. The good news is that they’re easy to treat. In the US, the main over-the-counter treatment is pyrantel pamoate, sold under names such as Pin-X and Reese’s Pinworm Medicine. Here’s how to use it properly.
How pyrantel works
Pyrantel paralyses adult pinworms in the gut so they lose their grip and pass out in the stool. It acts mainly inside the bowel, and very little is absorbed into the body.
Who can use it
- Adults and children aged 2 and over, following the label
- Children under 2 or weighing under 25 lb (about 11 kg): ask a doctor first
- Pregnant or breastfeeding: ask a doctor before use
How to take it
- Dose is based on body weight. Use the weight chart on the pack, and the measuring cup or spoon supplied. Don’t guess.
- It’s a single dose, taken at any time of day, with or without food. The liquid can be mixed with milk or juice.
- A second dose after 2 weeks is commonly recommended by doctors, because pyrantel doesn’t kill eggs, and newly hatched worms can restart the infection. Check with your doctor or pharmacist.
Treat the whole household
Pinworm eggs spread easily on hands, bedding, towels and toys, so doctors often recommend treating everyone in the home at the same time, even if they have no symptoms. Ask your doctor about anyone under 2 or pregnant.
Stop pinworms coming back
- Wash hands with soap after using the toilet and before eating, and keep nails short
- Shower each morning to wash away eggs laid overnight
- Change underwear daily and wash pyjamas, bedding and towels in hot water
- Discourage nail-biting and scratching around the bottom
- Vacuum and wipe surfaces such as toilet seats and door handles
Possible side effects
Most people have none. Some get nausea, vomiting, tummy cramps, diarrhoea, headache or dizziness. Stop and see a doctor if you have a rash or anything that worries you.
When to see a doctor
- Symptoms don’t clear after the second dose
- The child is under 2, or the person is pregnant
- You’re not sure it’s pinworms. A doctor can confirm it with a simple “tape test”.
- Severe tummy pain, or worms seen in other places
Doctors may prescribe a different medicine, such as mebendazole or albendazole, if pyrantel isn’t suitable. Read more in our guide to pinworm symptoms and treatment.
Frequently asked questions
How fast does pyrantel work?
It starts working within a day, and the itching usually eases within a few days. Eggs can survive on surfaces for 2 to 3 weeks, so hygiene and the second dose matter.
Can I buy pyrantel without a prescription?
Yes, in the US it’s available over the counter for adults and children aged 2 and over.
Do pets spread pinworms?
No. Human pinworms only live in people, so you don’t need to treat your pets.
More in our Lice and Parasites guide: all our articles on this topic in one place.
This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist. Always read and follow the label.
