Eflornithine (Injection)

Eflornithine is an injected medication available only by doctor's prescription to treat a sleeping sickness that is caused by protozoa cells.

Overview

What is Eflornithine?

The injected form of Eflornithine is effective in the second stage of African trypanosomiasis or sleeping sickness. On the list of the World Health Organization Essential Medicines, Eflornithine is injected along with nifurtimox to reduce the treatment time.

Beginning in 1990, Eflornithine was approved for the gambiense form of African trypanosomiasis, until 1995 when the company making the drug discontinued its production due to low profits. Since restarting production in 2001, Eflornithine has been credited with the contribution of saving nearly 110,000 lives.

How does Eflornithine work?

Also known under its trade name of Ornidyl, Eflornithine binds to an enzyme in the small, single celled animal that causes trypanosomiasis and essentially poisons the protozoa causing the disease.

What is African trypanosomiasis?

Often called sleeping sickness, African trypanosomiasis is a disease caused by parasites in humans and other mammals. The bite of a tsetse fly that has been infected with the parasite Trypanosoma brucei is the way the disease is transmitted. African trypanosomiasis is a common disease in sub-Saharan Africa and the Congo.

Persons suffering from African trypanosomiasis often experience symptoms including headache, itching, pain in joints, fevers and other maladies from one to three weeks after having been bitten. The disease evolves into the second stage when the patient begins to be confused, poorly coordinated, has trouble sleeping and has incidences of numbness in their bodies. During this phase, patients will be treated with Eflornithine and other drugs to combat not only the symptoms but kill the parasite. If left untreated, African trypanosomiasis always results in death.

Conditions Treated

  • African trypanosomiasis

Type Of Medicine

  • Ornithine decarboxylase inhibitor

Side Effects

Though Eflornithine is tolerated well by the body, there are some instances of unwanted symptoms and effects reported by certain patients. If you exhibit any of the following symptoms, contact your physician right away:

  • Bruising or bleeding that is unusual
  • Weakness
  • Fatigue
  • Fever
  • Convulsions
  • Hearing loss
  • Sore throat

Other patients have been known to experience mild, non-distressing side effects that stopped happening after an adjustment period. There are methods for patients to use in order to lessen these side effects or stop them completely. Your physician will be able to advise you on how to deal with unwanted symptoms such as:

  • Pains in the abdominal area
  • Vomiting
  • Nausea
  • Diarrhea
  • Loss of hair
  • Headache

Other patients may experience unwanted effects of Eflornithine treatment that are not listed here. Contact your physician if you notice any health symptoms while being treated with this drug.

Dosage

Take Eflornithine exactly as prescribed by your health care provider, without altering the size or frequency of dosage. Each patient is different and therefore your prescribed dosage may differ from the information provided here.

For the treatment of African trypanosomiasis, adults receive a dose based on their body size and determined by their physician. In general, this dose is 100 milligrams per kilogram of body weight or 45 milligrams per pound of body weight. This dose will be injected by trained medical professionals into a vein over a forty-five minute period of time. Adult patients can expect a course of injections every six hours for a fourteen day period.

Use of Eflornithine in children is to be individually determined as this age group has not been studied to any degree of knowledge of how effective or how safe it is for them to take this medication.

Interactions

If, in the past, you have experience reactions to a medication, food or even artificial dyes or preservatives, you should let your physician know as this could indicate a risk of allergy to Eflornithine as well. If you are on other medications, you should also disclose their details to your physician, being sure to include over-the-counter, herbal and vitamin therapies as well.

Eflornithine has been known to react adversely with the Rotavirus live vaccine and the combination is not recommended. Additionally, the following live vaccines should be avoided when being treated with Eflornithine, if possible:

  • Adenovirus Type 4 and Type 7
  • Guerin
  • Bacillus of Calmette
  • Influenza
  • Mumps
  • Measles
  • Pollovirus
  • Smallpox
  • Typhoid
  • Rubella
  • Varicella
  • Yellow Fever

Eflornithine may or may not be taken with food; your doctor will advise you on any food interactions in your prescription information. Additionally, use of tobacco products, alcoholic beverages and certain specific foods may interact with this medication in an unwanted, unexpected way. Read all patient information supplied with your prescription including the leaflet given to you by your doctor or pharmacist.

Some pre-existing medical conditions can also limit the effectiveness or cause a high risk situation for unwanted side effects. Use of Eflornithine may also make certain illnesses worse, depending on what they are. For this reason, it is advised that you disclose your full medical history to your cancer treatment specialist physician before being given a dose of Eflornithine. Your doctor will specifically want to know if you suffer from the following conditions currently or have in the past had:

  • Blood diseases such as anemia
  • Loss of hearing
  • Disease of the kidneys

Treatment with Eflornithine could make these diseases worsen or make the symptoms worsen. Your medical team will need to be aware of any conditions in your past or current medical details that may be affected by treatment regimes that include Eflornithine.

Warnings

Regular visits to your physician will be required to keep an eye on the progress that Eflornithine treatment has had with your disease. Use of Eflornithine may increase chances for blood diseases including a reduction in the number of white blood cells in your body, increasing chances of contracting an infection. Blood platelets can also become low and reduce the effectiveness of the body to form clots to stop any bleeding.

If you suspect that you are getting an infection, including exhibiting symptoms such as chills or fever, contact your doctor right away. Any unusual bruising or bleeding or stools that appear tar-like or show signs of blood, blood in urine or tiny red dots on the skin should also be reported immediately.

Use caution when brushing your teeth or performing other dental hygiene, using other methods instructed to you by your physician during your treatment. Before you have any work done by a dentist, consult your doctor to make sure it is safe for you. Avoid sharp tools such as razors or nail cutters, only using these items with caution.

Adequate studies do not exist that provide specific data on whether this drug is safe for pediatric patients or not. Therefore, use of Eflornithine in patients in this age group should only be done with caution. Along the same line, geriatric patients have not been studied either, so it is unknown whether Eflornithine will have a different effect on these patients.

Women who are pregnant or who may become pregnant while being treated with Eflornithine have the possibility of adversely affecting their unborn child with the use of this drug. It is not advised that women who are pregnant be treated with Eflornithine. Women who are breastfeeding may pass on the drug to their children. It may be necessary to stop breastfeeding during your treatment period with Eflornithine.

Storage

Eflornithine is an injected medication, administered only by physicians or trained medical professionals in a medical or hospital setting. It is, therefore, up to the medical staff to store this medication according to the manufacturer's instructions for safety and effectiveness. This instruction will include protection from extreme temperatures, moisture and excessive light.

Summary

Eflornithine is an injected medication known as an Ornithine decarboxylase inhibitor. Used by physicians in the treatment of African trypanosomiasis, Eflornithine works by killing the parasite known to cause the disease.

Prevalent in Africa, trypanosomiasis is transmitted via bites from the tsetse fly and can affect humans and other mammals. Headaches, fevers, itching and pain in the joints are the first signs of the disease, which appears one to three weeks after being bitten. Eflornithine is used in combination with other drugs to treat the disease when it enters its second phase.

Side effects include fever, sore throat, bruising, bleeding, fatigue or weakness, which typically stop happening once the drug has run its course through the system. Severe or prolonged side effects should be reported to your physician immediately so that medical care can be provided.

It is advised that women who are pregnant or nursing do not begin treatment with Eflornithine, as there is no record of safety for the infant or child. Additionally, pediatric patients and elderly patients are to be treated with caution, as their groups have not been studied to determine safety or effectiveness.

Patients should be regularly monitored while being treated with Eflornithine and watch for any signs of internal bleeding such as blood in urine or stool, bruises or bleeding that shows up unexpectedly.

Resources
Last Reviewed:
March 26, 2018
Last Updated:
April 23, 2018