Drug reference

Suramin

Antiprotozoal · Antitrypanosomal

AntiprotozoalAntitrypanosomal

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Embryotoxic in animal studies, avoid if

FDA category + note

Mechanism

Suramin is an antitrypanosomal drug primarily utilized for the treatment of early-stage Trypanosoma brucei rhodesiense infections. It is an antiparasitic agent that directly targets and inhibits the growth or survival of the Trypanosoma parasites.

Indications

Treatment of early-stage Trypanosoma brucei rhodesiense infection (sleeping sickness)Early-stage African trypanosomiasis caused by T. brucei rhodesienseFirst-stage T. b. rhodesiense HAT

Dosing

Adult: (thiabendazole) by mouth [all unlicensed] (available from ‘special-order’ manufacturers or specialist importing companies). Strongyloidiasis Adult Strongyloides stercoralis live in the gut and produce larvae which penetrate the gut wall and invade the tissues, setting up a cycle of auto-infection.…
Pediatric: 4–5 mg/kg on day 1 followed by 5 weekly injections of 20 mg/kg (e.g., days 3, 10, 17, 24, 31). Maximal dose 1 g per injection, diluted in distilled water (IV).

Pharmacokinetics

Onset

binds to plasma proteins and persists at low levels for several weeks after infusion

Protein binding

99.7% serum protein bound (in blood plasma, not CSF or other compartments. It is a general systemic drug. Plasma protein binding is usually high.) This refers to serum protein binding. It is better to use 'serum protein bound' rather than 'plasma protein bound' as text specifies 'serum protein bound'. No. The text says 'plasma proteins'. So let's stick with that.…

Metabolism

negligible

Contraindications

Late-stage Trypanosoma brucei infection
Onchocerciasis (due to toxicity)

Side effects

Common

MalaiseNauseaFatigueVomitingDiarrheaStomatitisChillsAbdominal painEdemafeverurticariahypotensionexfoliative dermatitisparesthesiasphotophobiarenal dysfunctionPyrexiaNephrotoxicity (usually mild and reversible)

Serious

Toxicity (leads to its discontinuation for onchocerciasis)
Nausea (immediate reaction)
Vomiting (immediate reaction)
Shock (rare, ~1 in 2000 patients)
Loss of consciousness (rare, ~1 in 2000 patients)
Renal toxicity (most common problem after several doses, manifested by albuminuria)
Delayed neurological complications (headache, metallic taste, paresthesias, peripheral neuropathy)
nephrotoxicity
adrenal toxicity
optic atrophy
anaphylaxis