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Nifurtimox
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| Systematic (IUPAC) name | |
| N-(3-methyl-1,1-dioxo-1,4-thiazinan-4-yl)- 1-(5-nitro-2-furyl)methanimine |
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| Identifiers | |
| CAS number | |
| ATC code | P01 |
| PubChem | |
| Chemical data | |
| Formula | C10H13N3O5S |
| Mol. mass | 287.293 g/mol |
| Pharmacokinetic data | |
| Bioavailability | Low |
| Metabolism | Hepatic (CYP involved) |
| Half life | 2.95 ± 1.19 hours |
| Excretion | Renal, very low |
| Therapeutic considerations | |
| Pregnancy cat. |
Undetermined |
| Legal status | |
| Routes | Oral |
Nifurtimox is a 5-nitrofuran and is used to treat diseases caused by trypanosomes (Chagas disease and sleeping sickness). It is given by mouth and not by injection.
Contents |
Uses
Nifurtimox has been used to treat Chagas disease, when it is given for 30 to 60 days,1 but gastrointestinal and neurological side effects have meant that benznidazole is now preferred for that indication.
Nifurtimox has also been used to treat African sleeping sickness and is active in the second stage of African sleeping sickness (CNS disease). Unfortunately, when nifurtimox is given on its own, about half of all patients will relapse,2 but the combination of melarsoprol with nifurtimox appears to be efficacious.3 Trials are awaited comparing melarsoprol/nifurtimox against melarsoprol alone for African sleeping sickness.4
The use of Nifurtimox is currently in Phase II clinical trial[1] for the treatment of Pediatric Neuroblastoma and Medulloblastoma.
Dosing
Nifurtimox is dosed as 15 mg/kg/day in two to three divided doses. It is given by mouth. Refer to the articles on Chagas disease and sleeping sickness for more detailed information on dosing for these diseases.
Manufacturing and availability
Nifurtimox is sold as Lampit by Bayer. It was previously known as Bayer 2502.
Nifurtimox is only licensed for use in Argentina and Germany, where it is sold as 120 mg tablets.
References
- ^ Coura JR, de Castro SL. (2002). "A critical review of Chagas disease chemotherapy". Mem Inst Oswaldo Cruz 97: 3–24. doi:.
- ^ Pepin J, Milord F, Mpia B, et al. (1989). "An open clinical trial of nifurtimox for arseno-resistant T.b. gambiense sleeping sickness in central Zaire". Trans R Soc Trop Med Hyg 83: 514–7. doi:.
- ^ Bisser S, N'Siesi F-X, Lejon V, et al. (2007). "Equivalence Trial of Melarsoprol and Nifurtimox Monotherapy and Combination Therapy for the Treatment of Second-Stage Trypanosoma brucei gambiense Sleeping Sickness" (dead link – Scholar search). J Infect Dis 195: 322–329. doi:, http://www.journals.uchicago.edu/JID/journal/issues/v195n3/36827/36827.html.
- ^ Jacques Pepin (2007). "Combination Therapy for Sleeping Sickness: A Wake-Up Call" (dead link – Scholar search). J Infect Dis 195: 311–13. doi:, http://www.journals.uchicago.edu/JID/journal/issues/v195n3/37356/37356.html.
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- This page was last modified on 18 June 2008, at 01:33.
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