5.1.0.14.0.20020522114426.00a0dc70@postoffice.sandybay.utas.edu.au
Sender: owner-e-drug@usa.healthnet.org
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E-drug: Source of metrifonate?
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Was rerouted to INDICES, but for technical reasons also put here. INDICES
and E-drug moderators' comments at the end. USAN name is trichlorfon. Bayer
(Neguvon) and Sanofi (Necrovar) have products for veterinary use. Since 1996
there have been several publications on using metrifonate, an
acetylcholinesterase inhibitor, for Alzheimer patients so I am surprised to
see that no supplier can be found. KM]
Dear e-druggers,
The major hospital in Hobart has a patient with praziquantel resistant
schistosomiasis, presumably caused by S. haematobium. Metriphonate
("Vansil"), which is manufactured by Pfizer but unavailable in Australia,
is indicated but we have been unable to find a supplier. Pfizer Australia
have been unable to find out whether it is still marketed elsewhere,
although they are still trying.
Any suggestions as to sourcing the drug, or alternative treatments?
Best wishes,
Stuart McLean
Tasmanian School of Pharmacy
Stuart McLean
School of Pharmacy
University of Tasmania
GPO Box 252-26
Hobart Tasmania 7001
AUSTRALIA
Stuart.McLean@utas.edu.au
[Praziquantel resistance? That is worrying!
Metriphonate (BAN) or metrifonate (INN) only works on S.Haematobium, so
please ensure the patient has that parasite, and not S.Mansoni. Suggestions
please direct to Stuart.McLean@utas.edu.au. WB]
[Not relevant in this case, but a paper from Kenya, Evidence Against Rapid
Emergence of Praziquantel Resistance in Schistosoma haematobium, Kenya can
be found on the CDC website: http://www.cdc.gov/ncidod/eid/vol6no6/king.htm.
It has many useful references on this topic.
There is a Cochrane review on treatment of S Haematobium, but it only
reviews praziquantel and metrifonate effectiveness and concludes:
Praziquantel (single dose) appears to be more effective than metrifonate
(split dose) in terms of parasitological cure of Schistosomiasis
haematobium, but the reinfection rate is high with both drugs.For S mansoni
it seems like also oxamniquine works, but not for S Haematobium. KM]
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