Home Drug Guide Nifurtimox

Drug Guide

Generic Name

Nifurtimox

Brand Names Lampit

Classification

Therapeutic: Antiparasitic agent

Pharmacological: Nitrofuran derivative

FDA Approved Indications

Treatment of American trypanosomiasis (Chagas disease) in pediatric and adult patients

Mechanism of Action

Nifurtimox generates reactive oxygen species that damage parasitic DNA and proteins, leading to parasite death.

Dosage and Administration

Adult: Initial dose is typically 10-15 mg/kg/day divided into three doses, administered over 60-90 days.

Pediatric: Same as adult dosing; dose is weight-based, usually 10-15 mg/kg/day divided into three doses, over 60-90 days.

Geriatric: Use with caution; adjust dose based on renal and hepatic function.

Renal Impairment: Adjust dose carefully; consult specific guidelines.

Hepatic Impairment: Use with caution; monitor hepatic function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily in urine.

Half Life: Approx. 3-4 hours.

Contraindications

Known hypersensitivity to nifurtimox or components.

Precautions

Use with caution in patients with hepatic or renal impairment; monitor organ function.
Potential for neuropsychiatric adverse effects; monitor accordingly.

Adverse Reactions - Common

Gastrointestinal upset (nausea, vomiting, anorexia) (Common)
Neurological symptoms (headache, dizziness, peripheral neuropathy) (Common)

Adverse Reactions - Serious

Neuropsychiatric effects (psychosis, depression, seizures) (Potentially serious, rare)
Myocarditis or cardiomyopathy (rare) (Rare)

Drug-Drug Interactions

Potential increased neurotoxicity with other neurotoxic agents.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of neurotoxicity (neurological, psychiatric), cardiac function, and hepatic/renal labs.

Diagnoses:

Risk for neurotoxicity
Risk for hepatic side effects

Implementation: Administer with food to reduce gastrointestinal upset; monitor patient closely.

Evaluation: Assess for resolution of parasitic infection and monitor adverse effects.

Patient/Family Teaching

Take medication with food to reduce gastrointestinal symptoms.
Report any neurological, psychiatric, or cardiac symptoms immediately.
Complete full course of therapy as prescribed.
Avoid alcohol and certain foods if advised by provider.

Special Considerations

Black Box Warnings:

Potential for neurotoxicity and hypersensitivity reactions.

Genetic Factors: Genetic variations in drug metabolism may affect response.

Lab Test Interference: May cause elevations in liver enzymes; monitor hepatotoxicity.

Overdose Management

Signs/Symptoms: Nausea, vomiting, neurotoxicity, seizures.

Treatment: Supportive care, including symptomatic treatment; consider gastric lavage or activated charcoal if early.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended conditions; protect from moisture.