Nifurtimox

Has found use only in the treatment of acute T. cruzi infections (Chagas disease), although treatment of the chronic stage of such infections has led to variable results. [Note: Nifurtimox is suppressive, not curative.] Being a nitroaromatic compound, nifurtimox undergoes reduction and eventually generates intracellular oxygen radicals, such as superoxide radicals and hydrogen peroxide These highly reactive radicals are toxic to T. cruzi, which lacks catalase.[Note: Mammalian cells are partially protected from such substances by the presence of enzymes, such as catalase, glutathione peroxidase, and superoxide dismutase.This drug is a nitrofurazone derivative that inhibits the parasiteunique enzyme trypanothione reductase. Nifurtimox is the drug of choice in American trypanosomiasis, an alternative agent in African forms of the disease, and has also been effective in mucocutaneous leishmaniasis.