Suramin (Injection)

As a treatment for river blindness and African sleeping sickness, Suramin works by making the causative parasites lose energy, causing their death.

Overview

Suramin is a medicine that's commonly used for treating African sleeping sickness (African trypanosomiasis) and river blindness (onchocerciasis). It's a white tasteless and odorless powder, which dissolves in saline and is given intravenously by a doctor under the close supervision of a doctor. Suramin is an effective treatment for a variety of parasitic infections and has widely served this purpose since the beginning of the 1920s. More recently, this medicine has also shown good potential for treating certain cancers. Internationally, Suramin is available under various brand names, including Germanin, Naganin, Naganine, and Moranyl.

Suramin was first discovered in the early years of the 20th century by Paul Ehrlich, a German chemist who discovered that some napthaline-based dyes could partly treat African trypanosomiasis in cattle. Although the dyes themselves weren't highly successful and had the adverse side effect of discoloring the beef of treated cattle permanently, the results were good enough to warrant further studies. A synthetic variety of the dye's active compound was made by Ehrlich's former workmates in 1916, becoming the main treatment for river blindness and African sleeping sickness for the better part of the 1900s. Suramin remains a popular medicine for treating these infections in most parts of the globe because of its low price compared with many of today's synthetic treatments.

Suramin treats river blindness and African sleeping sickness by hindering growth factors in the parasites that bring about the diseases. By lowering the ability of nematodes and worms to make insulin, dermal cells, and platelets, Suramin restricts the ability of parasites to renew cells and generate energy. As their levels of energy decrease, the parasites eventually become immobile and die.

Suramin's potential usefulness as a cancer remedy relies on its capacity to slow down the development of inoperable tumors, increasing the potential effectiveness of other anticancer agents. Trials haven't gone beyond the clinical phase, mostly because of the uncertainty surrounding how exactly Suramin inhibits the growth of tumors and the finding that Suramin actually speeds up the growth of some kinds of cancer.

Suramin treatment can cause a number of possible side effects. The most common ones include vomiting, nausea, and itchy rash. On a more serious note, Suramin can also cause some people kidney damage and is usually not prescribed to people with renal problems. In rare cases, Suramin can temporarily or permanently damage the adrenal cortex. Overdosing on Suramin can cause kidney damage and probably renal failure. Serious Suramin side effects are quite rare and, in most cases, the medication is considered safe.

Conditions treated

  • African sleeping sickness
  • River blindness

Type of medicine

  • Antiprotozoal agent

Side effects

Apart from its positive effects, a drug can bring about some negative effects. While not all of the following effects do occur, if they happen they may require medical attention.

See your healthcare provider immediately if any of these Suramin side effects happen:

More common:

  • Headache
  • Increased skin color
  • Cloudy urine
  • Diarrhea
  • Faintness, especially after skipping meals
  • Crawling/tingling sensation of skin
  • Itching
  • Irritability
  • Loss of appetite
  • Joint pain
  • Nausea
  • Swelling on skin
  • Skin rash
  • Weakness or numbness in legs, feet, arms, or hands
  • Stinging feeling on skin
  • Tenderness of palms and soles
  • Vomiting
  • Tiring easily

Less common:

  • Loss of or changes in vision
  • Extreme fatigue or weakness
  • Extreme sensitivity of the eyes to light
  • Tender painful glands in the groin, armpits, or neck
  • Swelling around eyes
  • Watery eyes
  • Sores or ulcers in the mouth

Rare:

  • Pale skin
  • Convulsions
  • Cold, clammy skin
  • Decreased blood pressure
  • Increased heartbeat
  • Sore throat and fever
  • Difficulty in breathing
  • Fever with/without chills
  • Loss of consciousness
  • Red, scaly, or thickened skin
  • Red pinpoint spots on skin
  • Tenderness and/or swelling in stomach or upper abdominal area
  • Pain and/or swollen glands
  • Yellow skin or eyes
  • Unusual bleeding/bruising
  • Unusual tiredness/weakness

Some Suramin side effects that normally don't require treatment may occur. They may vanish as you adapt to the medicine during treatment. Moreover, your healthcare giver can help you find ways to reduce or prevent some of them. See your healthcare giver right away if any of these effects are bothersome, if they persist, or if you have queries about them.

More common:

  • Metallic taste
  • Abdominal pain
  • Fever
  • Overall feeling of discomfort

Other Suramin side effects not enumerated above can also happen in some people. If you feel any other effects, see your healthcare professional immediately.

Call your physician for advice about the above side effects. You can also notify the FDA about these side effects at 1-800-FDA-1088.

Dosage

To get rid of your infection completely, make sure to receive Suramin regularly for the entire period of your treatment. It's also vital that you are given Suramin in the clinic or hospital so your physician can monitor your condition.

The dose of this medication will vary between patients. Follow your physician's directions or the instructions on the medicine's label. The information provided below only includes the average Suramin doses. If you've got a different dose, don't alter it without consulting your doctor.

The amount of drug you use depends on the drug's strength. In addition, the number of times you take the drug daily, the interval between doses, as well as the duration in which you use the drug depend on the illness for which you're using the drug.

African trypanosomiasis (sleeping sickness):

For adults and kids, the dose will depend on their weight and only a doctor will determine this.

For river blindness:

For adults, the dose will be determined only by a doctor based on weight. As for children, their dose and use is determined only by a doctor.

Interactions

Although certain drugs shouldn't be combined at all, in some situations two different drugs may be taken together despite the fact that an interaction could happen. In such cases, your healthcare professional may want to modify the dose or give you other precautions. Tell your healthcare giver if you're using other drugs, including over-the-counter, prescription, and herbal drugs.

Certain medications shouldn't be taken when having a meal or eating some foods because interactions may happen. Interactions could also occur if you drink alcohol or smoke cigarettes while taking this medicine. Discuss with your physician the use of Suramin with food, alcoholic drinks, and cigarettes.

Warnings

Before using Suramin, let your physician know about the drugs you're currently using, over-the-counter products like herbal supplements, vitamins and so on, pre-existing medical conditions, and your current medical situation, for example, upcoming surgery, pregnancy, etc. Certain illnesses can make you more vulnerable to Suramin side effects. Take Suramin as ordered by your physician or follow the instructions on the product's packaging. Suramin dosage will depend on your condition. Let your physician know if your infection worsens or persists. Here are important counseling points to consider:

Allergies'tell your physician if you've ever had any allergic or unusual reaction to Suramin or any other drugs. Also inform your physician if you have other kinds of allergies, like to animals, foods, dyes, or preservatives. For over-the-counter products, carefully read the ingredients on the package or label.

Pediatric'Suramin may cause any patient some serious side effects. Thus, it's really important that you discuss with your doctor the positives this medicine may bring and the risks it may cause.

Geriatric'senior citizens are particularly sensitive to Suramin side effects. This can increase their risk of side effects while receiving treatment.

Breastfeeding'there aren't enough studies done on women to determine infant risk when taking Suramin during breastfeeding. Before taking Suramin while breastfeeding, be sure to weigh the possible benefits against the possible risks.

Storage

Suramin is normally administered and kept by healthcare providers. It's not stored at home.

Summary

Have your urine examined before treatment and every week during treatment.

Avoid overdosing on Suramin as it could damage your kidney or cause renal failure.

People with allergies to anything should not take Suramin.

To ensure your infection clears up completely, make sure to receive Suramin at regular intervals for the entire duration of treatment. It's also essential to receive the medication in a clinic or hospital environment so your healthcare provider can monitor your condition.

It's vital that your doctor monitors your progress on a regular basis. This is to ensure that your infection is gone completely. Your doctor should also check for any effects that may happen even after you complete treatment.

The presence of certain medical conditions may interfere with how Suramin works. Be sure to tell your physician if you suffer from any other medical conditions, especially liver or kidney disease. Patients with either disease may have a higher risk of side effects.

Suramin may bring about serious side effects. Be sure to talk about the good and bad side of receiving Suramin with your doctor before you start treatment.

Patients with a history of allergies, liver damage, decreased level of serum albumin, and malnutrition should exercise caution when using Suramin. The same case applies to children, pregnant women, breastfeeding women, and the elderly.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
April 05, 2018
Content Source: