Benznidazole

Benznidazole Brand Name– Benznidazole

What is Benznidazole

Benznidazole is an antiprotozoal used for the treatment of Chagas disease or American trypanosomiasis, a parasitic infection caused by Trypanosoma cruzi. Benznidazole is the first treatment for Chagas disease approved in the US.

It was granted approval from the FDA based on the number of treated pediatric patients (6 to 12 years) who became Immunoglobulin G (IgG) antibody negative (55% to 60% vs. 5% to 15% for placebo) against the recombinant antigens of T. cruzi. Benznidazole is only FDA-approved for pediatric patients 2 to 12 years, although it is used off-label in patients ranging in age from infants to adults, and is recommended by the CDC as a treatment choice.

Indications

  • American trypanosomiasis (Chagas disease)
  • Trypanosoma cruzi

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agranulocytosis
  4. amnesia
  5. anemia
  6. anorexia
  7. arthralgia
  8. asthenia
  9. blepharedema
  10. confusion
  11. diarrhea
  12. dizziness
  13. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  14. edema
  15. elevated hepatic enzymes
  16. eosinophilia
  17. exfoliative dermatitis
  18. fatigue
  19. fever
  20. headache
  21. hepatitis
  22. hypoesthesia
  23. insomnia
  24. leukopenia
  25. lymphadenopathy
  26. maculopapular rash
  27. musculoskeletal pain
  28. myalgia
  29. nausea
  30. neutropenia
  31. paresthesias
  32. peripheral edema
  33. peripheral neuropathy
  34. pruritus
  35. rash
  36. thrombocytopenia
  37. toxic epidermal necrolysis
  38. tremor
  39. urticaria
  40. vomiting
  41. weight loss
  42. xerostomia

Monitoring Parameters

  • CBC with differential
  • pregnancy testing

Contraindications

  • bone marrow suppression
  • breast-feeding
  • contraception requirements
  • ethanol ingestion
  • hematological disease
  • infertility
  • neoplastic disease
  • pregnancy
  • pregnancy testing
  • reproductive risk
  • serious rash

Interactions

  • Disulfiram
  • Ethanol

Disulfiram: (Severe) Coadministration of benznidazole with disulfiram or in patients who have taken disulfiram within the last 2 weeks is contraindicated. Although not reported with benznidazole, psychotic reactions have been reported in patients concurrently taking disulfiram and other nitroimidazole agents, of which benznidazole is structurally similar to. 

Ethanol: (Severe) Consumption of alcohol or products containing propylene glycol during and for at least 3 days after therapy with benznidazole is contraindicated. Although not reported with benznidazole, disulfiram-like reactions (i.e., abdominal cramps, nausea, vomiting, headaches, and flushing) have been reported in patients concurrently taking alcohol and other nitroimidazole agents, of which benznidazole is structurally similar to.

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