• Antiprotozoal; Anthelmintic, systemic

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

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

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

Parenteral
• Injection (Germany and South Africa)

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

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

Before giving the full dose of suramin, your doctor will give you a test dose 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 death of the fetus. If you have a very serious disease, such as African sleeping sickness, and there are no other medicines available for use, your doctor may want to treat you with suramin even if you are pregnant. However, suramin is not recommended for use in pregnant women with less serious conditions, such as river blindness. Before receiving this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—It is not known whether suramin passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are receiving this 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 doctor the good that this medicine may do as well as the risks of receiving it.

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

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

• Kidney disease or
• Liver disease—Patients with kidney or liver disease may have an increased chance of side effects

To help clear up your infection completely, you must receive suramin on a regular schedule for the full time of treatment. It is also necessary for you to receive this medicine in the hospital so your doctor can check on your condition.

Dosing—

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

The dose you receive each day, the time allowed between doses, and the length of time you receive the medicine depend on the medical problem 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 be determined by your doctor.
  • For river blindness:
    • Adults—Dose is based on body weight and must be determined by your doctor.
    • Children—Use and dose must be determined by your doctor.

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. Your doctor may also want to check for any side effects that may occur even after your treatment has ended.

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 may need medical attention.

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

• More common
  • Cloudy urine;  crawling or tingling sensation of 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;  stinging sensation on skin;  swelling on skin;  tenderness of the palms and the soles;  tire easily;  vomiting 
  
  

• Less common
  • Changes in or loss of vision;  extreme tiredness or weakness;  increased sensitivity of eyes to 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;  difficulty in breathing;  fever and sore throat;  fever with or without chills;  increased heartbeat;  loss of consciousness;  pale skin;  pinpoint red spots on skin;  red, thickened, or scaly skin;  swelling and/or tenderness in upper abdominal or stomach area;  swollen and/or painful glands;  unusual bleeding or bruising;  unusual tiredness or weakness;  yellow eyes or skin 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• More common
  • Abdominal pain;  fever;  general feeling of discomfort;  metallic taste 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.