SURAMIN (Systemic)*?

Some commonly used brand names are:

*? Not commercially available in the U.S. and Canada.

Category

• Antiprotozoal; Anthelmintic, systemic

Description

Suramin (SOO-ra-min) is used in the treatmentof African sleeping sickness (African trypanosomiasis) and river blindness(onchocerciasis), infections caused by parasites. This medicine works by causingthe parasites to lose energy, which causes their death.

Suramin may cause serious side effects. Before you begin treatment withthis medicine, you and your doctor should talk about the good this medicinewill do as well as the risks of receiving it.

Suramin is administered in the hospital only by or under the immediatesupervision of your doctor. It is available in the following dosage form:

Parenteral
• Injection (Germany and South Africa)

Before Receiving This Medicine

In deciding to use a medicine, the risks of taking the medicine must beweighed against the good it will do. This is a decision you and your doctorwill make. For suramin, the following should be considered:

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to suramin. Also tell your health care professional if youare allergic to any other substances, such as foods, preservatives, or dyes.

Before giving the full dose of suramin, your doctor will give you a testdose to make sure you are not allergic to this medicine.

Pregnancy?Suramin has not been studied in pregnant women. However,studies in animals have shown that suramin may cause birth defects or deathof the fetus. If you have a very serious disease, such as African sleepingsickness, and there are no other medicines available for use, your doctormay want to treat you with suramin even if you are pregnant. However, suraminis not recommended for use in pregnant women with less serious conditions,such as river blindness. Before receiving this medicine, make sure your doctorknows if you are pregnant or if you may become pregnant.

Breast-feeding?It is not known whether suramin passes into breastmilk. Although most medicines pass into breast milk in small amounts, manyof them may be used safely while breast-feeding. Mothers who are receivingthis medicine and who wish to breast-feed should discuss this with their doctor.

Children?Suramin can cause serious side effects in any patient.Therefore, it is especially important that you discuss with the child's doctorthe good that this medicine may do as well as the risks of receiving it.

Older adults?Elderly people are especially sensitive to the effectsof suramin. This may increase the chance of side effects during treatment.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. Tell your health careprofessional if you are taking any other prescription or nonprescription (over-the-counter[OTC]) medicines.

Other medical problems?The presence of other medicalproblems may affect the use of suramin. Make sure you tell your doctor ifyou have any other medical problems, especially:

• Kidney disease or
• Liver disease?Patients with kidney or liver disease may havean increased chance of side effects

Proper Use of This Medicine

To help clearup your infection completely, you must receive suraminon a regular schedule for the full time of treatment. It is also necessaryfor you to receive this medicine in the hospital so your doctor can checkon your condition.

Dosing?The dose of suramin will be different for differentpatients. The following information includes only the average doses of suramin.

The dose you receive each day, the time allowed betweendoses, and the length of time you receive the medicine depend on the medicalproblem for which you are receiving suramin.

• For injection dosage form:
  • For African sleeping sickness:
    • Adults and children?Dose is based on body weight and must bedetermined by your doctor.
  • For river blindness:
    • Adults?Dose is based on body weight and must be determinedby your doctor.
    • Children?Use and dose must be determined by your doctor.

Precautions After Receiving This Medicine

It is important that your doctor check your progress at regular visits.This is to help make sure that the infection is cleared up completely. Yourdoctor may also want to check for any side effects that may occur even afteryour treatment has ended.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.

Check with your doctor or nurse as soon as possibleif any of the following side effects occur:

More common

Cloudy urine; crawling or tingling sensationof the skin; diarrhea; faintness, especially after missing meals; headache; increased skin color; irritability; itching; joint pain; loss of appetite; nausea; numbness or weakness in arms, hands, legs,or feet; skin rash; stingingsensation on skin; swelling on skin; tenderness of the palms and the soles; tire easily; vomiting

Less common

Changes in or loss of vision; extremetiredness or weakness; increased sensitivity of eyesto light; painful tender glands in the neck, armpits,or groin; swelling around eyes; ulcers or sores in mouth; watery eyes

Rare

Cold and clammy skin; convulsions; decreased blood pressure; difficultyin breathing; fever and sore throat; fever with or without chills; increasedheartbeat; loss of consciousness; pale skin; pinpoint red spots on skin; red, thickened, or scaly skin; swellingand/or tenderness in upper abdominal or stomach area; swollen and/or painful glands; unusual bleeding orbruising; unusual tiredness or weakness; yellow eyes or skin

Other side effects may occur that usually donot need medical attention. These side effects may go away during treatmentas your body adjusts to the medicine. However, check with your doctor if anyof the following side effects continue or are bothersome:

More common

Abdominal pain; fever; general feeling of discomfort; metallictaste

Other side effectsnot listed above may also occur in some patients. If you notice any othereffects, check with your doctor.