Melarsoprol

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 30.09.2022

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Definition
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Antiprotozoal agent, organic arsenic compound.

Pharmacodynamics (Effect)
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Binding to essential SH groups of enzymes.

Spectrum of action
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Trypanosoma brucei gambiense and rhodiense.

Indication
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Cerebral stage of sleeping sickness.

Dosage and method of use
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3 times 0.6-1.2 mg/kg bw/day for 3 days, repeated after 10-21 days Because of the danger of the Herxheimer reaction, treatment is often carried out according to the scheme (see Table 1) in combination with suramin or pentamidine diisethionate.

Undesirable effects
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At first administration in 60% fever. Albuminuria, vomitus, myocardial damage, hypertension, colic, Herxheimer reaction, encephalopathy (occurs in 10%, fatal in up to 40%), peripheral neuropathy.

Notice. Because of possible life-threatening complications, the preparation should only be used in the clinic!

Contraindication
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None, because of the lethality of the disease.

Preparations
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Arsobal, Mel B (available through the international pharmacy)

Tables
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Dosage of melarsoprol in combination therapies

Day

Preparation

Dose

[mg/kg bw]

Preparation

Dose

[mg/kg bw]

Preparation

Dose

[mg/kg bw]

Kenya/Sambia (Tr. b. rhod.)

Uganda/Tanzania (Tr. b. rhod.)

Ivory Coast (Tr. b. gamb.)

1.

Suramin

5

Suramin

5

Pentamidine i.m.

4

2.

-

-

-

-

-

-

3.

Suramin

10

Suramin

10

Pentamidine i.m.

4

4.

-

-

-

-

Melarsoprol

1,2

5.

Suramin

20

Melarsoprol

1,8

Melarsoprol

2,4

6.

-

-

Melarsoprol

2,2

Melarsoprol

3,6

7.

Melarsoprol

0,36

Melarsoprol

2,56

-

-

8.

Melarsoprol

0,72

-

-

-

-

9.

Melarsoprol

1,1

-

-

-

-

10.

-

-

-

-

-

-

11.

-

-

-

-

-

-

12.

-

-

-

-

-

-

13.

-

-

-

-

-

14.

-

-

Melarsoprol

2,56

-

-

15.

-

-

Melarsoprol

2,9

-

-

16.

Melarsoprol

1,4

Melarsoprol

3,26

-

-

17.

Melarsoprol

1,8

-

-

Melarsoprol

1,2

18.

Melarsoprol

1,8

-

-

Melarsoprol

2,4

19.

-

-

-

-

Melarsoprol

3,6

20.

-

-

-

-

Melarsoprol

3,6

21.

-

-

-

-

-

-

22.

-

-

-

-

-

-

23.

-

-

Melarsoprol

3,6

-

-

24.

-

-

Melarsoprol

3,6

-

-

25.

Melarsoprol

2,2

Melarsoprol

3,6

-

-

26.

Melarsoprol

2,9

End

-

-

27.

Melarsoprol

3,6

-

-

28.

-

-

-

-

29.

-

-

-

-

30.

-

-

Melarsoprol

1,2

31.

-

-

Melarsoprol

2,4

32.

-

-

Melarsoprol

3,6

33.

-

-

Melarsoprol

3,6

34.

Melarsoprol

3,6

End

35.

Melarsoprol

3,6

36.

Melarsoprol

3,6

End

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Last updated on: 30.09.2022