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2D structure from PubChem
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Generic Names
  • L-Tetramisole
  • Levamisol [INN-Spanish]
  • Levamisole hydrochloride
  • Levamisolum [INN-Latin]
  • Phenyl imidothiazole
  • dl-Tetramisol
  • dl-Tetramisole
Trade Names
  • Ergamisol
  • Ketrax
  • Lepuron
  • Levamisol
  • Nilverm base
  • Tetramisol
  • Tetramisole
  • Tramisol
  • Vermisol 150
  • Wormicid
Brand Mixture Names

PharmGKB Accession Id:


An antihelminthic drug that has been tried experimentally in rheumatic disorders where it apparently restores the immune response by increasing macrophage chemotaxis and T-lymphocyte function. Paradoxically, this immune enhancement appears to be beneficial in rheumatoid arthritis where dermatitis, leukopenia, and thrombocytopenia, and nausea and vomiting have been reported as side effects. (From Smith and Reynard, Textbook of Pharmacology, 1991, p435-6)

Source: Drug Bank


For adjuvant treatment in combination with fluorouracil after surgical resection in patients with Dukes' stage C colon cancer. Also used to treat malignant melanoma and head/neck cancer.
Levamisole was originally used as an antihelminthic to treat worm infestations in both humans and animals.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

The mechanism of action of levamisole as an antiparasitic agent appears to be tied to its agnositic activity towards the L-subtype nicotinic acetylcholine receptors in nematode muscles. This agonistic action reduces the capacity of the males to control their reproductive muscles and limits their ability to copulate. The mechanism of action of Levamisole as an anticancer drug in combination with fluorouracil is unknown. The effects of levamisole on the immune system are complex. The drug appears to restore depressed immune function rather than to stimulate response to above-normal levels. Levamisole can stimulate formation of antibodies to various antigens, enhance T-cell responses by stimulating T-cell activation and proliferation, potentiate monocyte and macrophage functions including phagocytosis and chemotaxis, and increase neutrophil mobility, adherence, and chemotaxis.

Source: Drug Bank


Levamisole is a synthetic imidazothiazole derivative that has been widely used in treatment of worm infestations in both humans and animals. As an anthelmintic, it probably works by targeting the nematode nicotinergic acetylcholine receptor. As an immunomodulator, it appears that Levamisole is an immunostimulant which has been shown to increase NK cells and activated T-cells in patients receiving this adjuvantly along with 5FU for Stage III colon cancer.

Source: Drug Bank

Food Interaction

Take on an empty stomach.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity


Primarily hepatic (extensive) with both active and inactive metabolites.

Source: Drug Bank

Protein Binding


Source: Drug Bank


Levamisole is rapidly absorbed (2 hours) from the gastrointestinal tract.

Source: Drug Bank


4.4-5.6 hours (biphasic)

Source: Drug Bank


LD 50 = 40 mg/kg (Pigs, subcutaneous); LD 50 = 180 mg/kg (rat, oral)

Source: Drug Bank

Chemical Properties

Chemical Formula


Source: Drug Bank

Isomeric SMILES


Source: OpenEye

Canonical SMILES


Source: Drug Bank

Average Molecular Weight


Source: Drug Bank

Monoisotopic Molecular Weight


Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Drug Targets

Gene Description
ALB (source: Drug Bank)
ALPPL2 (source: Drug Bank)
CHRNA3 (source: Drug Bank)

Drug Interactions

Drug Description
acenocoumarol The agent increases the anticoagulant effect (source: Drug Bank)
acenocoumarol Levamisole may increase the anticoagulant effect of acenocoumarol. (source: Drug Bank)
anisindione Levamisole may increase the anticoagulant effect of anisindione. (source: Drug Bank)
dicumarol The agent increases the anticoagulant effect (source: Drug Bank)
dicumarol Levamisole may increase the anticoagulant effect of dicumarol. (source: Drug Bank)
warfarin The agent increases the anticoagulant effect (source: Drug Bank)
warfarin Levamisole may increase the anticoagulant effect of warfarin. (source: Drug Bank)

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to levamisole: 3

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Drug hypersensitivity and human leukocyte antigens of the major histocompatibility complex. Annual review of pharmacology and toxicology. 2012. Bharadwaj Mandvi, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Human leukocyte antigens and drug hypersensitivity. Current opinion in allergy and clinical immunology. 2007. Chung Wen-Hung, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Cancer and leukemia group B gastrointestinal cancer committee. Clinical cancer research : an official journal of the American Association for Cancer Research. 2006. Goldberg Richard M, et al. PubMed


Web Resource:
KEGG Compound:
KEGG Drug:
PubChem Compound:
PubChem Substance:
Drugs Product Database (DPD):
Therapeutic Targets Database:

Clinical Trials

These are trials that mention levamisole and are related to either pharmacogenetics or pharmacogenomics.

No trials found.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.