Pinworm Medicine: OTC or Prescription?

Yes. In the United States you can buy pinworm medicine over the counter: pyrantel pamoate is sold without a prescription at most pharmacies. Mebendazole, the other common pinworm medicine, is prescription-only here, so it needs a licensed clinician's review first. Which one makes sense depends on who is being treated, how sure you are of the diagnosis, and whether an earlier round of treatment has already been tried.

This page lays out the difference and the situations where a clinician's review is worth having.

The short comparison

| | Pyrantel pamoate (over the counter) | Mebendazole (prescription) | |---|---|---| | Prescription needed in the US? | No, sold on the pharmacy shelf | Yes | | What the product is labeled for | Pinworm | Pinworm, whipworm, common roundworm and hookworm (per the labeling for the brand-name mebendazole chewable tablet) | | How it acts | On the worms' nerves and muscles | On the worms' ability to take up glucose | | Is a clinician involved? | Only if you choose to see one | Always, before anything is prescribed |

Whichever medicine is used, the CDC advises treating the infected person, their household members and their caregivers at the same time, because pinworm spreads easily at home.

What over-the-counter pinworm medicine is

The pinworm medicine you can buy without a prescription in US pharmacies is pyrantel pamoate, sold as a liquid or as tablets under store brands and brand names. It acts on the worms' nerves and muscles. MedlinePlus notes that pyrantel is also used for some other worm infections, but the package sold without a prescription is labeled for pinworm.

Why pinworm often comes back

The CDC lists both over-the-counter and prescription medicines for pinworm. No medicine on its own prevents reinfection. According to the CDC, pinworm eggs can survive for two to three weeks on bedding, clothing and other objects, and they are easy to swallow again without noticing. That is why the hygiene steps below, and involving everyone in the household at the same time, are part of the plan.

Read the package before you buy

Follow the package directions exactly. The label tells you to consult a doctor before giving it to very young children, and, as with most nonprescription medicines, it advises anyone who is pregnant or breastfeeding to ask a health professional first. If you have liver disease or take other regular medicines, ask the pharmacist before you buy. If any of these apply to you, it is worth talking to a clinician rather than choosing on your own.

When a prescription medicine may make more sense

The over-the-counter option is not the right fit for everyone. A clinician's review is worth it when:

• The diagnosis is not clear. Itching around the anus has other causes, including skin conditions and irritation. Treating the wrong problem wastes time.
• Symptoms keep coming back. Repeated infections are common, and recurring symptoms deserve a closer look at the diagnosis, the household and the hygiene plan.
• A different worm is possible. Pyrantel sold over the counter is labeled for pinworm only. If there has been travel or other exposure that raises the possibility of roundworm, whipworm or hookworm, a clinician should decide what is being treated. Mebendazole's labeling covers all four of these infections, but it does not cover every parasite; see which parasites mebendazole's labeling covers.
• You are pregnant, have liver disease, or take other medicines. A clinician should weigh the choice rather than a store shelf.
• You want a plan for the whole household. A clinician can help decide who else should be treated and what to do if symptoms return.

How pinworm is diagnosed

Many people notice itching around the anus that is worse at night, trouble sleeping, or, occasionally, tiny white thread-like worms about the size of a staple. The CDC describes three ways a provider confirms it with your help: looking for worms around the anus a few hours after the person falls asleep, a "tape test" that collects eggs from the skin around the anus first thing in the morning, and checking samples from under the fingernails. If you are not sure it is pinworm, a diagnosis before treatment is the better path, whichever medicine you end up using.

About the mebendazole available through Get It Prescribed

If you and a provider decide a prescription is the right route, the mebendazole dispensed through Get It Prescribed is a 222 mg capsule prepared by a licensed compounding pharmacy. It is a compounded preparation. It is not FDA-approved, it has not been reviewed by the FDA for safety, effectiveness or quality, and it is not a generic of or substitute for the brand-name mebendazole chewable tablet. For more on that difference, see mebendazole information.

The cost is a one-time $50 provider consultation fee, plus $3.50 per capsule if a prescription is issued, with the quantity decided by the reviewing provider. An independent licensed provider reviews your information and makes their own decision. No prescription is guaranteed, and the provider may recommend an in-person visit or testing instead. The service is for adults (see pinworm treatment for adults) and is available in all 50 states and the District of Columbia; some states require a live phone or video visit, which you can check on the availability page. For a child, talk with the child's pediatrician. You can see every step of the process on how it works, and the medicine's known side effects on mebendazole side effects.

A practical plan, whichever medicine you use

• Treat the household together. Treating one person while others still carry eggs keeps the cycle going.
• Follow the package directions or your prescriber's instructions exactly. Ask a pharmacist or clinician if anything is unclear.
• Wash hands with soap and warm water after using the toilet or changing diapers, and before handling food. Keep fingernails short and discourage scratching.
• Shower in the morning to remove eggs laid overnight.
• Wash underwear, pajamas, towels and bedding in hot water, and handle them gently rather than shaking them, so eggs are not spread through the air.
• Call a clinician if symptoms continue after treatment is finished, if they keep returning, or if new symptoms such as significant abdominal pain appear.

This article is general education, not medical advice. It does not replace an evaluation by a licensed clinician who knows your history.

Related questions

Can you buy pinworm medicine over the counter?

Yes. Pyrantel pamoate is sold without a prescription at most US pharmacies and is labeled for pinworm. Follow the package directions, and check with a doctor or pharmacist first for young children, during pregnancy or breastfeeding, or if you have liver disease.

Is over-the-counter pinworm medicine as good as prescription medicine?

This site does not rank one medicine above another. The CDC lists both over-the-counter and prescription options for pinworm. The prescription route adds a clinician's review, which matters most when the diagnosis is unclear, the infection keeps returning, or another type of worm is possible.

How long can pinworm eggs survive in the home?

According to the CDC, pinworm eggs can survive for two to three weeks on bedding, clothing and other objects. That is why hygiene steps and involving the whole household at the same time matter alongside any medicine. Follow the package directions or your prescriber's instructions exactly.

Do I need a prescription for mebendazole?

Yes. Mebendazole is prescription-only in the United States, so a licensed clinician has to review your situation before it can be prescribed and dispensed.

Should everyone in the house take pinworm medicine?

The CDC advises treating the infected person, their household members and caregivers at the same time, because pinworm spreads easily at home. Check the package or ask a clinician before treating young children or anyone who is pregnant.

Sources

• CDC: About Pinworm Infection — symptoms, spread, diagnosis, and treatment of the whole household.
• MedlinePlus: Pinworms — National Library of Medicine overview of pinworm infection.
• MedlinePlus: Pyrantel — consumer drug information for the over-the-counter pinworm medicine.
• MedlinePlus: Mebendazole — consumer drug information from the National Library of Medicine.
• DailyMed: mebendazole chewable tablet prescribing information — prescribing information for the brand product.
• FDA: Compounding and the FDA — Questions and Answers — what compounded preparations are and how they are regulated.