Therapeutic action
Indications
- Meningoencephalitic stage of African trypanosomiasis due to T.b. gambiense, in combination with nifurtimox (first choice treatment) or in monotherapy if nifurtimox is not available or is contra- indicated
Forms and strengths, route of administration
20 g in 100 ml ampoule (200 mg/ml) to be diluted in 250 ml of sterile distilled water (or, if not available, 0.9% sodium chloride), for IV infusion administered over 2 hours
Dosage and duration
In combination with nifurtimox
- Child and adult: 200 mg/kg every 12 hours for 7 days
In monotherapy
- Child under 12 years: 150 mg/kg every 6 hours for 14 days
- Child 12 years and over and adult: 100 mg/kg every 6 hours for 14 days
Contra-indications, adverse effects, precautions
- May cause: haematological disorders (anaemia, leucopenia, thrombocytopenia), gastrointestinal disturbances (diarrhoea, abdominal pain, vomiting), seizures, tremor, fever, deep tissue infection, headache, alopecia, dizziness.
- The catheter must be handled with great attention to avoid local or general bacterial super infections: thoroughly disinfect the insertion site, protect the site with a sterile dressing, ensure secure catheter fixation and change the catheter every 48 hours or earlier in the event of phlebitis.
- Pregnancy: CONTRA-INDICATED unless,due to the mother’s general condition, treatment cannot be delayed until after delivery.
Remarks
- When administering nifurtimox-eflornithine combined therapy, the dosage of nifurtimox in children and adults is 5 mg/kg every 8 hours for 10 days.
- Eflornithine is also called difluoromethylornithine or DFMO.
Storage
– Below 25 °C
Diluted solution must be kept refrigerated (2 °C to 8 °C) and used within 24 hours.