Suramin or pentamidine is effective during


the early stages but not for the later


neurological manifestations for which melarsoprol should be used. Eflornithine is effective for both early and late stages. Expert advice is recommended.


Prolonged (t -3 months) treatment with


benznidazole or nifurtimox may be



Notes on drugs for protozoal infections

Atovaquone is a quinone; it may cause gastrointestinal and mild neurological side effects, and rare hepa-totoxicity and blood dyscrasias.

Benznidazole is a nitroimidazole that may occasionally cause peripheral neuritis but is generally well tolerated, including by infants.

Dehydroemetine inhibits protein synthesis; it may cause pain at the site of injection, weakness and muscular pain, hypotension, precordial pain and cardiac dysrhythmias.

Diloxanide furoate may cause troublesome flatulence, and pruritus and urticaria may occur.

Eflornithine inhibits protozoal DNA synthesis; it may cause anaemia, leucopenia and thrombocytopenia, and seizures.

Iodoquinol may cause abdominal cramps, nausea and diarrhoea. Skin eruptions, pruritus ani and

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