E-DRUG: E-DRUG Melarsoprol /Interactions

Dear E-druger,

Melarsoprol is a trivalent arsenical derivative which results from a
reaction between melarsenoxyde and BAL or British antilewisite (from
which the other name < mel B >) to reduce toxicity.
The drug which is produced only by Rh�ne Poulenc since 1947 ( Arsobal
TM for IV administration : 3.6 % solution in propylene glycol /
ampoule 5 ml, with an arsenic-content of 0,68% ) can be considered as
an orphan drug (mainly because of recent european environmental
regulations - arsenical wastes - its manufacture is called in question
although there is no substitute : eflornithine, a new drug effective
against resistant strains, has been abandonned due to its
non-profitability).

As for interactions:
- Chemical : the compound is practically insoluble in water (in
alcohol, ether...). (i) With water or a watery solutions (NaCl /
Dextrose...) or moisture there is a precipitation (needles and
syringes must be absolutly dry and if resterilization, Poupinel must
be used) , (ii) because of solvent (propylene glycol) injection is
very irritant and extravasation during administration should be
avoided.
- Physical : the compound is unstable with light and heat (to be
protect < 25 degrees centigrade)
- With other drugs (suramin, corticosteroids, diazepam, adrenaline,
phenothiazine) : there are no pharmacological interaction reported
(however, we need to note there are no publications on this particular
point: I have consulted Drugs and Pharmacology embase 1986- 1997, The
Martindale, a resume on melarsoprol made by S. Kernbaum and P. De
Raadt).

Patrice Trouiller, Pharm.D
Hospital pharmacist C.H.U. Grenoble France
<pat.trouiller@wanadoo.fr>
Observer of the Committee of the Programme Against African
Trypanosomiasis (WHO / FAO / IAAE)

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