Chagas Disease (American Trypanosomiasis) Medication

Updated: Jul 06, 2023
  • Author: Louis V Kirchhoff, MD, MPH; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Medication Summary

The goals of pharmacotherapy are to eradicate the infection, to prevent the development of or progression of clinical manifestations, and to reduce morbidity and mortality. 


Antiprotozoal agents

Class Summary

These agents are used to treat infections caused by the protozoan T cruzi.

Benznidazole (Rochagan, Radanil)

Nitroimidazole antimicrobial. Generates radical species in both aerobic and anaerobic conditions that are capable of damaging parasitic DNA. Inhibits DNA, RNA, and protein synthesis within the T cruzi parasite. Studies suggest benznidazole is reduced by a type I nitroreductase (NTR) enzyme of T cruzi, producing a series of short-lived intermediates that may promote damage to several macromolecules, including DNA. Approved by the FDA for treatment of Chagas disease in children aged 2-12 years. There is a general consensus in favor of antiparasitic treatment for all cases of acute or reactivated Chagas disease, for chronic T cruzi infection of children up to age 18 years, and for all women of child‑bearing age. Data regarding the efficacy of treating adults aged 50 years or younger with benznidazole are of low quality, and thus such treatment is controversial. As noted, there is a general consensus that persons who already have developed cardiac or gastrointestinal symptoms should not be given antiparasitic treatment. Repeated PCR testing can be used to look for treatment failure.

Nifurtimox (Lampit)

Trypanocidal drug that acts on circulating trypomastigotes, as well as intracellular amastigotes. The mechanism of action may depend on the formation of nitro anion radicals, but precise details are not known. Approved by the FDA for treatment of Chagas disease in children from birth to age 18. The guidance regarding which groups of T cruzi‑infected persons can be treated with nifurtimox are the same as those listed above for benznidazole. As is the case for persons treated with the latter, evidence of treatment failure can be sought with repeated PCR testing.