SURAMIN SODIUM

Microfilaricide and antitrypanosomal for use against Onchocerca volvulus and Trypanosoma brucei respectively

Dosage Forms

Powder for injection

1 g

Uses

  • Curative treatment of onchocerciasis (River blindness)
  • Treatment of haemolytic stage of trypanosomiasis due to T. brucei rhodesiense

Dose and Duration

Onchocerciasis

Adult: by slow IV injection, initially 3.3 mg/kg as a single test dose (inject a few microlitres and wait for at least 1 minute, then inject the next 0.5 ml over 30 seconds and wait for 1 minute, then inject the remainder over several minutes), followed by incremental doses at weekly intervals of 6.7 mg/kg, 10.0 mg/kg, 13.3 mg/kg, 16.7 mg/kg, and 16.7 mg/kg on weeks 2 to 6 respectively (total dose, 66.7 mg/kg over 6 weeks).

Trypanosomiasis

Adult and child: by slow IV injection, 5 mg/kg on day 1, 10 mg/kg on day 3, and 20 mg/kg on days 5, 11, 17, 23, and 30.

Preparation

  • Reconstitute with water for injections to 10% solution.

Contra-indications

  • Previous anaphylaxis or suramin sensitivity
  • Severe liver or renal function impairment
  • Elderly or debilitated

Side Effects

  • Immediate and potentially fatal reaction with 1ˢᵗ dose with nausea, vomiting, shock and loss of consciousness
  • Albuminuria
  • Abdominal pain, severe diarrhoea, stomal ulceration

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • In pregnancy, delay treatment until after delivery in onchocerciasis but treat if meningoencephalopathic involvement in T. brucei rhodesiense is involved
  • Suramin sodium is very toxic and should only be used in a hospital under medical supervision
  • There is a risk of loss of consciousness with first dose
  • Maintain satisfactory food and fluid intake
  • Urine tests should be done before and weekly during treatment. Reduce dose if there is moderate albuminuria. Discontinue immediately if severe albuminuria or casts develops.