Drug | Age group | Dosing regimen |
Benznidazole | 2 to 12 years | 5 to 8 mg/kg per day orally in 2 divided doses for 60 days |
>12 years* | 5 mg/kg per day orally in 2 divided doses for 60 days | |
Nifurtimox¶ | Birth to 17 years | Body weight 2.5 to 40 kg: 10 to 20 mg/kg/day in 3 divided doses for 60 days |
Body weight 41 kg or more: 8 to 10 mg/kg/day in 3 divided doses for 60 days | ||
≥18 yearsΔ | 8 to 10 mg/kg/day in 3 divided doses for 60 to 90 days |
For additional notes regarding use, adverse effects, and availability, refer to the UpToDate topic on antitrypanosomal drug therapy.
Similar recommendations are included in the 2015 Brazilian Consensus on Chagas Disease, which recommend for adults 5 mg/kg of benznidazole per day in two or three divided doses for 60 days or 10 mg/kg of nifurtimox per day in three divided doses for 60 days; for children, these guidelines recommend 5 to 10 mg/kg of benznidazole for 60 days or 15 mg/kg of nifurtimox for 60 to 90 days.[1]* Use in patients 12 years or older is off-label. Some investigators treat adults with 300 mg per day for 60 days, regardless of body weight,[2] whereas others use an upper limit of 300 mg per day but prolong treatment to complete the total dose corresponding to 5 mg per kilogram per day for 60 days.[1,3]
¶ There are no published recommendations regarding an upper dose limit for nifurtimox. The standard nifurtimox dosing schedule for human African trypanosomiasis is 15 mg per kilogram per day for 10 days (in combination with efluornithine).[4] Dosing regimens of up to 30 mg per kilogram per day in multiple 21-day cycles have been used in trials for neuroblastoma involving children.[5] Some adverse effects appear to be related to length of treatment rather than daily dose; regimens from 60 days to 120 days have been used.[6,7] Because of the side effects, only 50 to 60% of adult patients complete the entire treatment course.[6]
Δ Use in adults 18 years or older is off-label.Do you want to add Medilib to your home screen?