Levamisole acts by interfering with the carbohydrate metabolism of the nematodes and inhibiting the production of succinate dehydrogenase, causing muscular paralysis of the worms. It also acts as a non-humoral immunostimulant in immunosupressed individuals. The mechanism of this stimulation is unknown. Lymphatic incompetence due to filarial infection causes lymph stasis and allows opportunistic microbial infections to develop. Antiseptic hygiene minimises these complications.
Surgery can remove and provide bypasses around the damaged lymphatics.