Suramin

This polyanionic compound is a drug of choice for the early hemolymphatic stages of African trypanosomiasis (before CNS involvement). It is very reactive and inhibits many enzymes, among them those involved in energy metabolism (for example, glycerol phosphate dehydrogenase), which appears to be the mechanism most closely correlated with trypanocidal activity. The drug must be injected intravenously. It binds to plasma proteins and remains in the plasma for a long time, accumulating in the liver and in the proximal tubular cells of the kidney. The severity of the adverse reactions demands that the patient be carefully followed, especially if he or she is debilitated.It is also an alternative to ivermectin in the treatment of onchocerciasis Suramin is used parenterally