Nurses Compass
Drug Guide
Eflornithine Hydrochloride
Classification
Therapeutic: Antineoplastic, Antiviral, Cosmetic adjunct
Pharmacological: Amino acid decarboxylase inhibitor
FDA Approved Indications
- Treatment of African trypanosomiasis (sleeping sickness)
- Reduction of facial hair in women (Vaniqa)
Mechanism of Action
Eflornithine inhibits the enzyme ornithine decarboxylase, leading to decreased polyamine synthesis, which is essential for cell proliferation, thus exerting antitumor, antiparasitic, and anti-hirsutism effects depending on indication.
Dosage and Administration
Adult: For African trypanosomiasis: IV or intramuscular injection as per protocol. For facial hirsutism: topically applied twice daily.
Pediatric: Dosing varies; generally not first-line, consult specific guidelines.
Geriatric: No specific dose adjustments, but renal function should be monitored.
Renal Impairment: Adjust dose based on renal function.
Hepatic Impairment: No specific adjustment, but caution advised.
Pharmacokinetics
Absorption: Rapid absorption following IV administration; minimal oral absorption.
Distribution: Widely distributed, crosses blood-brain barrier.
Metabolism: Not significantly metabolized.
Excretion: Primarily excreted unchanged in urine.
Half Life: Approximately 3 hours.
Contraindications
- Hypersensitivity to eflornithine.
Precautions
- Monitor renal function during therapy, especially in renal impairment.
- Use with caution in pregnancy and lactation; inform patients of potential risks.
Adverse Reactions - Common
- Gastrointestinal upset (Common)
- Hypotension (Common)
Adverse Reactions - Serious
- Myelosuppression, including leucopenia and thrombocytopenia (Uncommon)
- Anaphylaxis (Rare)
Drug-Drug Interactions
- Cimetidine may increase serum levels of eflornithine.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for signs of infection, blood counts, renal function.
Diagnoses:
- Risk for infection
- Imbalanced nutrition: less than body requirements due to GI upset.
Implementation: Administer as prescribed. Monitor blood counts and renal function regularly.
Evaluation: Observe for adverse effects and therapeutic response.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report signs of infection or bleeding.
- Follow up for blood tests.
- Use sunscreen and limit sun exposure during Vaniqa therapy.
Special Considerations
Black Box Warnings:
- Potential for severe hypersensitivity reactions.
- In pregnancy, use only if clearly needed, as safety is not established.
Genetic Factors: None well-established.
Lab Test Interference: May interfere with urine tests for amino acids.
Overdose Management
Signs/Symptoms: Nausea, vomiting, confusion, hypotension.
Treatment: Supportive care, dialysis in severe cases, monitor vital signs and laboratory parameters.
Storage and Handling
Storage: Store at room temperature, away from moisture and light.
Stability: Stable for 2-3 years when stored properly.