Benznidazole

• Chagas disease (children aged 2 to 12 years): Approximately 5-8 mg/kg/day, orally, divided into two daily doses for 60 days.
• Chagas disease (adults): Two 100mg tablets, orally, twice daily for 60 days.

• Known hypersensitivity to Benznidazole or any other nitroimidazole derivatives.
• Severe hepatic or renal impairment, due to the increased risk of toxicity.
• Pregnancy, particularly during the first trimester, due to the potential risk of fetal harm.

• Take the medication exactly as prescribed, and complete the full course of treatment even if symptoms improve, to ensure the infection is fully treated.
• Be aware of potential side effects, such as skin rash, nausea, and peripheral neuropathy, and report any unusual symptoms to their healthcare provider.
• Avoid alcohol consumption during treatment, as it can increase the risk of side effects such as nausea, vomiting, and flushing (similar to a disulfiram-like reaction).
• Use effective contraception during treatment and for some time afterward, as Benznidazole can harm the fetus if taken during pregnancy. Women of childbearing age should discuss contraceptive options with their healthcare provider.
• Keep follow-up appointments to monitor the effectiveness of the treatment and to detect any potential late complications of Chagas disease.

• Skin rash or itching
• Nausea and vomiting
• Abdominal pain
• Headache
• Dizziness
• Loss of appetite
• Fatigue

• Peripheral Neuropathy: Characterized by tingling, numbness, or pain in the hands and feet.
• Bone Marrow Suppression: Leading to anemia, leukopenia, or thrombocytopenia.
• Severe Skin Reactions: Such as Stevens-Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: Elevated liver enzymes or liver damage, particularly in patients with pre-existing liver conditions.

Patients should seek immediate medical attention if they experience severe or persistent side effects, especially signs of neuropathy, severe skin reactions, or symptoms indicative of bone marrow suppression (such as unusual bruising or bleeding).

Peripheral Neuropathy: Prolonged use of Benznidazole can cause peripheral neuropathy, which may be irreversible. Patients should report any tingling, numbness, or pain in the extremities immediately to their healthcare provider.

Bone Marrow Suppression: Benznidazole can lead to bone marrow suppression, increasing the risk of anemia, infections, and bleeding. Blood counts should be monitored regularly during treatment.

Severe Skin Reactions: Rare but serious skin reactions, such as Stevens-Johnson syndrome, have been reported. Treatment should be discontinued immediately if signs of severe skin reactions occur.

Hepatotoxicity: Patients with pre-existing liver conditions or those taking other hepatotoxic drugs should be monitored closely for signs of liver damage.

• Alcohol: Should be avoided during treatment, as it can cause a disulfiram-like reaction, leading to nausea, vomiting, and flushing.
• CYP3A4 Inhibitors: Such as ketoconazole or erythromycin, which can increase Benznidazole levels in the blood, potentially leading to increased side effects.
• Immunosuppressive Drugs: Concurrent use with immunosuppressive agents may reduce the effectiveness of Benznidazole or increase the risk of infections.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

• Nifurtimox: Another antiparasitic medication that is also used to treat Chagas disease. It is often used when Benznidazole is contraindicated or not tolerated.
• Supportive Care: In the chronic phase of Chagas disease, treatment focuses on managing symptoms and complications such as heart failure or arrhythmias, as antiparasitic treatments are less effective at this stage.