Benznidazole
Benznidazole is used as a first-choice treatment of Chagas disease, a serious illness caused by a parasite transmitted by triatomine bugs that can lead to heart and stomach problems. Currently, it's only approved for children 2 to 12 years of age.
What is Benznidazole?
What is Benznidazole used for?
Chagas disease in children 2 to 12 years of age
How Benznidazole works
Benznidazole is an antiprotozoal. It works by damaging DNA in the parasite that causes Chagas disease, Trypanosoma cruzi (T. cruzi). This kills the parasite and clears the infection.
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What are the side effects of Benznidazole?
Common Side Effects
- Stomach pain (25%)
- Rash (16%)
- Weight loss (13%)
- Sores and damage on the skin (11%)
- Nausea (5%)
- Vomiting (5%)
- Feeling less hungry (5%)
Other Side Effects
- Diarrhea
- Dizziness
- Tingly, prickly, or shooting nerve pain in the hands and feet
- Tremor (shaking)
- Headache
- Joint pain
Serious Side Effects
- Serious allergic skin reaction: fever, chills, stinging in the eyes, pain when you swallow, and large patches of rash, blisters, peeling skin, small red or purple bumps on the skin
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, or sore throat
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Pain, tingling, or numbness in the hands or feet
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Loss of appetite with weight loss
- Nausea
- Stomach pain
- Vomiting
Pros and cons of Benznidazole
Pros
Not many drug interactions
Two different tablet strengths available
Can be taken with or without food
Can split (100 mg) tablets in half or in quarters
Can make liquid version for people with trouble swallowing pills
Cons
Usually need to take it for 60 days
Not FDA-approved for people under 2 or over 12 years of age
Not safe for use in pregnancy
Can cause stomach upset
Available only by prescription
Pharmacist tips for Benznidazole
Make sure your child takes benznidazole for the full 60 days in order to treat Chagas disease. Don't stop treatment before this time, unless your provider tells you to do so. Stopping treatment too early might allow the infection to come back.
If your child has trouble swallowing tablets, ask your child's provider or pharmacist for directions on how to dissolve benznidazole tablets in water to make a liquid form. The amount of water needed to dissolve the tablets and the amount of water that your child will need to drink after taking the liquid form depends on the dose of the medication.
The 100 mg tablets are scored so that, if needed, you can easily split them into one-half (50 mg) tablets or one-quarter (25 mg) tablets. Make sure you break the tablets along the lines so that they break evenly.
Benznidazole might cause harm to unborn babies and mothers during pregnancy. If you're able to become pregnant, you're recommended to take a pregnancy test before starting benznidazole. You're also recommended to use contraception (birth control) during and for 5 days after benznidazole treatment.
Benznidazole isn't recommended in breastfeeding because it can get into breastmilk. If you're already breastfeeding and need to use benznidazole, ask your provider about options to temporarily pause feeding your baby breastmilk during treatment with this medication.
Don't take benznidazole if you've taken disulfiram (Antabuse) in the past 2 weeks, since this can cause serious mood changes.
Frequently asked questions about Benznidazole
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What are the risks and warnings for Benznidazole?
Benznidazole can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Damage to DNA (genetic material)
Benznidazole can cause damage to genetic material. But we don't know exactly how this affects a growing child. Medications similar to benznidazole have caused cancer in animal studies, but we don't know whether benznidazole will cause cancer in humans. If you have concerns about this medication, speak to your provider.
Harm to unborn babies
Risk factors: Currently pregnant
In animal studies, benznidazole caused harm to unborn babies when taken during pregnancy. Females who are able to get pregnant should take a pregnancy test before starting benznidazole and also use contraception (birth control) while taking benznidazole and for 5 days after stopping this medication.
Serious skin reactions
Benznidazole can cause severe and life-threatening allergic skin reactions. This typically happens within 10 days of starting this medication and will go away after the medication is stopped. If you notice symptoms of a severe skin reaction such as fever, chills, stinging in the eyes, pain when you swallow, and large patches of rash, blisters, or peeling skin, stop taking benznidazole and get medical help right away.
Nerve problems
Benznidazole can cause nerve problems with symptoms such as a loss of feeling, a burning or prickling sensation, shooting pains, headache, or dizziness. This can happen as soon as you start the medication, but occur more commonly after you been taking it for a while. These side effects typically go away after you stop benznidazole. Tell your provider if you notice any symptoms of nerve problems, you might need to stop benznidazole.
Blood problems
Risk factors: History of blood problems | Taking other medications that can lower blood cell counts
Although rare, benznidazole can cause low red and white blood cell counts and low platelet counts. This can raise your risk for problems such as infections, extreme tiredness, and bruising more easily. This is temporary and your blood cell counts will return to normal after you stop benznidazole. If you already have blood problems, your provider will monitor your health more closely while you're taking this medication. You might need to get blood tests before, during, and after treatment. Let your provider know right away if you experience symptoms blood problems, such as shortness of breath, feeling more tired than usual, dizziness, headaches, pale skin, fever, or chills.
Benznidazole dosage forms
Typical dosing for Benznidazole
Dosing will depend on your child’s weight.
The typical daily dose is 5 mg/kg to 8 mg/kg, divided into two separate doses, taken by mouth every 12 hours for 60 days.
How much does Benznidazole cost?
Benznidazole contraindications
Have taken disulfiram (Antabuse) in the last 2 weeks
Cockayne syndrome
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