II. Indications
- Topical: Unwanted facial hair
- Systemic: Cancer
- Systemic: Protozoa
- Severe Stage 2 West African Trypanosomiasis (T. gambiense) with CSF Leukocytes >100 wbc/uL (any age)
- Used in a combination known as NECT (with Nifurtimox)
- Severe Stage 2 West African Trypanosomiasis (T. gambiense) with CSF Leukocytes >100 wbc/uL (any age)
III. Mechanism
- Difluoromethylated Ornithine with antineoplastic and Antiprotozoal activity
- Eflornithine irreversibly inhibits Ornithine decarboxylase, a key enzyme in polyamine biosynthesis
- Inhibiting polyamine synthesis suppresses tumor cell formation and proliferation
- Also suppresses Protozoal growth and replication
IV. Dosing: West African Trypanosomiasis
- Eflornithine renal dose adjustment needed for eGFR <30 ml/min
- NECT (Eflornithine/Nifurtimox)
- Indications
- Severe Stage 2 West African Trypanosomiasis with CSF Leukocytes >100 wbc/uL (any age)
- Dosing
- Eflornithine 400 mg/kg/day IV divided every 12 hours for 7 days AND
- Nifurtimox 15 mg/kg/day divided every 8 hours for 10 days
- Indications
V. Adverse Effects
- Gastrointestinal
- Vomiting
- Diarrhea
- Abdominal Pain
- Hepatotoxicity
- Hematologic (Bone Marrow suppression)
- Neurologic
- Miscellaneous
VI. Safety
- Monitoring
- Complete Blood Count with Platelet Count
- Baseline before starting therapy
- Repeat twice weekly during therapy
- Repeat weekly after stopping therapy until normalizes
- Complete Blood Count with Platelet Count
-
Lactation
- May continue Lactation while taking Eflornithine
- Pregnancy
- Avoid if possible during pregnancy
- However, may be used for rescue therapy in West African Trypanosomiasis if alternatives are unavailable
VII. References
- Freedman (2025) Sanford Guide, accessed on IOS, 7/12/2025
- Priotto (2008) BMJ 336(7646):705-8 +PMID: 18321960 [PubMed]