Levamisole
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
- Levamisole
- Pharmacist Assessment Report
- Levamisole: From Ascaridiasis and Ancylostomiasis to Drug-Induced Osteoporosis
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- India Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Levamisole: From Ascaridiasis and Ancylostomiasis to Drug-Induced Osteoporosis
One-Sentence Summary
Levamisole is an anthelmintic and immunomodulator. Its original uses are ascaridiasis and ancylostomiasis. The TxGNN model predicts it may be useful for drug-induced osteoporosis, but this is a computational prediction only, with 0 clinical trials and 0 publications directly studying this disease.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Ascaridiasis and ancylostomiasis (relations recorded in the knowledge graph; no approved indication text is available in the licence records) |
| Predicted New Indication | Drug-induced osteoporosis |
| TxGNN Prediction Score | 1.0000 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data |
| Number of Listed Products | at least 20 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, levamisole is an anthelmintic with immunomodulatory and cholinergic agonist activity. Its known use is for roundworm and hookworm infections.
No plausible mechanism linking levamisole to bone metabolism is supported by the data compiled for this report. The high TxGNN score (1.0000) comes from the TxGNN model (deep learning) and may reflect similarities the model learned between related diseases, not biological evidence. Any connection between the original indications (parasitic infections) and drug-induced osteoporosis remains speculative.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available for drug-induced osteoporosis.
For context, other lower-ranked predictions have a small amount of indirect literature, none of which studies drug-induced osteoporosis:
| PMID | Year | Type | Journal | Related Prediction | Key Findings |
|---|---|---|---|---|---|
| 11735172 | 2001 | RCT | Eur J Surg Oncol | Benign neoplasm of hypopharynx | Adjuvant levamisole plus UFT chemotherapy in head and neck squamous cell carcinoma (combination regimen, malignant disease) |
| 7003457 | 1980 | Clinical study | Oncology | Benign neoplasm of hypopharynx | Placebo-controlled pilot of levamisole as an adjuvant in localized laryngeal or hypopharyngeal carcinoma (24 patients) |
| 403486 | 1977 | Animal study | Oral Surg Oral Med Oral Pathol | Benign neoplasm of buccal mucosa | Effect of levamisole on chemical carcinogenesis in hamster buccal pouch |
| 105023 | 1979 | Animal study | J Dent Res | Benign neoplasm of buccal mucosa | Levamisole modified the response to DMBA at six weeks, but not at 12 weeks |
India Market Information
At least 20 single-ingredient registrations were found; the list below may be partial. No approved indication text is recorded in these licence records.
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 123312 | Levomol 150mg Tablet | Strip of 1 tablet | Not stated |
| 123339 | Levomol 50mg Tablet | Strip of 1 tablet | Not stated |
| 75722 | Elseal 150mg Tablet | Strip of 4 tablets | Not stated |
| 59226 | Deworm Syrup | Bottle of 10 ml syrup | Not stated |
| 129627 | Leris 150mg Tablet | Strip of 2 tablets | Not stated |
Safety Considerations
- Drug Interactions: 73 interactions are recorded. Major-level interactions include deferiprone, samarium (153Sm) lexidronam, adalimumab, baricitinib, certolizumab pegol and cladribine. Moderate-level interactions include ethanol, warfarin, zidovudine, azathioprine and chloramphenicol, along with several immunosuppressants and live or inactivated vaccines.
- Levamisole has also been reported to cause a fixed drug eruption (case report, 1994).
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction rests only on a model score. No trials or publications address drug-induced osteoporosis, and no mechanism links levamisole to bone biology. The evidence level is L5.
To proceed, the following is needed:
- Mechanism of action data for levamisole and a plausible link to bone metabolism
- Preclinical studies of levamisole in bone loss models, such as glucocorticoid-induced osteoporosis
- Package insert warnings and contraindications from the India regulatory source
- Review of the immunosuppressant and bone-marrow-related interactions before any use in osteoporosis populations
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.