suramin

Action and Spectrum

suramin is believed to work by blocking enzymes involved in cellular metabolism and signalling pathways, while its precise mode of action is yet unclear. suramin has been demonstrated to inhibit the activity of growth factors involved in the growth and proliferation of cancer cells, including insulin-like growth factor-1 (IGF-1), fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF). 

suramin has been found to be effective against a variety of parasites, including Trypanosoma brucei, which causes African sleeping sickness, Leishmania donovani, which causes visceral leishmaniasis, and Onchocerca volvulus, which causes river blindness. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Urticaria 

Pancytopenia 

Blood dyscrasias 

Polyuria 

Shock 

Optic atrophy 

Paraesthesia 

Polydipsia 

Vomiting 

Kidney damage 

Peripheral neuropathy 

Black Box Warning

It includes lethal anaphylaxis. It can occur during or after the infusion of suramin. The risk can be severe and fatal on the liver and renal.

Contraindication / Caution

Patient who are hypersensitive to this drug or any components of it must not use it.

Suramin can increase the damage to liver or kidney. It must not be used in patient who have these diseases.

Patient who has renal or liver disease and any history of blood clotting disease or heart disease must use it with caution.

Suramin cab ne harmful to the fetus. Pregnant women must not use it.

Suramin can interact with medications like anticoagulants. It must not be taken along with it till the benefits is more than the risk.

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excretion into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology 

An inhibitor of numerous enzymes, including those involved in cellular metabolism and signaling pathways, is a polyanionic substance known as suramin. Additionally, it is believed to bind to several cell surface receptors, including growth factor receptors. 

Another theory for how suramin functions is by preventing the parasite’s ability to metabolize energy and killing them as a result. 

Pharmacodynamics 

suramin has been demonstrated to inhibit the activity of growth factors involved in the growth and proliferation of cancer cells, including insulin-like growth factor-1 (IGF-1), fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF). suramin can impede the growth and metastasis of cancer cells by preventing the function of these growth factors. 

Pharmacokinetics 

Absorption  

Oral absorption of suramin is poor, and it has a limited bioavailability. suramin is rapidly transported throughout the body when administered intravenously. 

Distribution 

suramin can build up in a variety of tissues, including the liver, kidneys, and spleen. It is heavily attached to plasma proteins. The medication can collect CSF fluid and pass the blood-brain barrier. 

Metabolism 

suramin is broken down in the liver by several different enzymatic processes, such as oxidation, hydroxylation, and conjugation with glucuronic acid. suramin’s metabolites have lower biological activity than the original substance. 

Elimination and excretion 

suramin is predominantly removed from the body through the kidneys, with 90% of the medicine ending up in urine unchanged. suramin has a half-life of 50 to 60 days for elimination, and it can take several months for the drug to be totally gone from the body. 

Adminstartion

The most common route for the administration of suramin is by IV in clinic and by trained healthcare provider.

Patient Information Leaflet

Generic Name: suramin

Why do we use suramin?

Suramin is used to treat the African sleeping sickness diseases. It is a parasitic infection caused by Trypanosoma brucei.

River blindness which is caused by worm Onchocerca volvulus is also treated by suramin drug.