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ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS › ANTIPROTOZOALS › AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS › Nitrofuran derivatives
nifurtimox
P01CC01
Forms & Strengths
- Tablets: 30 mg
- Tablets: 120 mg
Adult Dosing
- Chagas disease (American trypanosomiasis): 8 to 10 mg/kg/day orally divided in 3 doses for 60 days
- Alternative extended regimen: 15 to 20 mg/kg/day for severe or refractory cases under expert guidance
Pediatric Dosing
- Neonates and infants (< 1 year): 15 to 20 mg/kg/day orally divided in 3 doses for 60 days
- Children 1 to 10 years: 15 to 18 mg/kg/day orally divided in 3 doses for 60 days
- Children 11 to 16 years: 12.5 to 15 mg/kg/day orally divided in 3 doses for 60 days
Indications
- Treatment of Chagas disease caused by Trypanosoma cruzi in pediatric patients from birth to less than 18 years of age
Mechanism of Action
- Prodrug reduced by parasite nitroreductase enzymes to form reactive intermediates and free radicals
- Induces oxidative stress, lipid peroxidation, and DNA damage leading to parasite death
Contraindications
- Hypersensitivity to nifurtimox or any components of the formulation
- Severe hepatic impairment
- Severe renal impairment
- History of neurological or psychiatric disorders
Adverse Reactions
- Decreased appetite and weight loss
- Abdominal pain, nausea, and vomiting
- Irritability, restlessness, and sleep disturbances
- Peripheral neuropathy and paresthesias
- Headache, dizziness, and tremors
Drug Interactions
- Alcohol: Avoid concurrent use due to increased risk of central nervous system side effects
- Monoamine oxidase inhibitors (MAOIs): Potential for enhanced neurotoxicity or hypertensive effects
- Cytochrome P450 inhibitors/inducers: Use with caution as metabolism may be altered
Curated Content: Needs Vetting Before Put to Clinical Use