BNF for Children 2011-2012

BNFC 2011–2012 5.4 Antiprotozoal drugs 329ing decrease in height and weight), thyroid disorders,hyperglycaemia, menstrual disturbances, virilism, breastpain, testicular pain, sexual dysfunction, micturition disorders,leucopenia, thrombocytopenia, lymphadenopathy,dehydration, hypocalcaemia, myalgia, arthralgia, hyperuricaemia,visual disturbances, eye pain, dry eyes, hearingimpairment, tinnitus, earache, dry mouth, taste disturbances,mouth ulcers, stomatitis, glossitis, tooth disorder, gingivitis,alopecia, pruritus, dry skin, skin discoloration, rash (includingvery rarely Stevens-Johnson syndrome and toxic epidermalnecrolysis), increased sweating, psoriasis, photosensitivity,and acne; less commonly pancreatitis, gastrointestinalbleeding, and hypertriglyceridaemia; rarely pepticulcer, arrhythmias, cardiomyopathy, myocardial infarction,pericarditis, stroke, interstitial pneumonitis, pulmonaryembolism, seizures, renal failure, vasculitis, rheumatoidarthritis, systemic lupus erythematosus, sarcoidosis, opticneuropathy, and retinal haemorrhage; very rarely aplasticanaemia and peripheral ischaemiaLicensed use inhalation licensed for use in children(age range not specified by manufacturer); intravenouspreparation not licensedIndication and doseBronchiolitis. By aerosol inhalation or nebulisation (via smallparticle aerosol generator)Child 1 month–2 years inhale solution containing20 mg/mL for 12–18 hours for at least 3 days; max.7 daysLife-threatening RSV, parainfluenza virus, andadenovirus infection in immunocompromisedchildren (seek expert advice). By intravenous infusion over 15 minutesChild 1 month–18 years 33 mg/kg as a singledose, then 16 mg/kg every 6 hours for 4 days, then8 mg/kg every 8 hours for 3 daysChronic hepatitis C (in combination with interferonalfa or peginterferon alfa) in previouslyuntreated children without liver decompensation. By mouthChild over 3 years; body-weight under 47 kg15 mg/kg daily in 2 divided dosesChild body-weight 47–50 kg 200 mg in themorning and 400 mg in the eveningChild body-weight 50–65 kg 400 mg twice dailyChild body-weight 65–86 kg 400 mg in themorning and 600 mg in the eveningChild body-weight 86–105 kg 600 mg twicedailyChild body-weight over 105 kg 600 mg in themorning and 800 mg in the eveningRebetol c (Schering-Plough) ACapsules, ribavirin 200 mg, net price 84-cap pack =£160.90, 140-cap pack = £267.81, 168-cap pack =£321.38. Label: 21Oral solution, ribavirin 200 mg/5 mL, net price100 mL (bubble-gum-flavoured) = £67.08. Label: 21Virazole c (Meda) AInhalationU, ribavirin 6 g for reconstitution with300 mL water for injections. Net price 3 6-g vials =£349.00Intravenous infusion, 100 mg/mL, 10-mL ampAvailable on a named-patient basis from Valeant5.4 Antiprotozoal drugs5.4.1 Antimalarials5.4.2 Amoebicides5.4.3 Trichomonacides5.4.4 Antigiardial drugs5.4.5 Leishmaniacides5.4.6 Trypanocides5.4.7 Drugs for toxoplasmosis5.4.8 Drugs for pneumocystis pneumoniaAdvice on specific problems available from:Advice for healthcare professionalsHPA (Health Protection Agency) MalariaReference Laboratorywww.hpa.org.uk/infections/topics_az/malariaNational Travel Health Network andCentreTravel Medicine Team, Health Protection,Scotland(registered users of Travax only)www.travax.nhs.uk(for registered users of the NHS Travaxwebsite only)(020) 7637 0248(Fax)(prophylaxis only)0845 602 6712(0141) 300 1100(weekdays 2–4p.m. only)Birmingham (0121) 424 0357Liverpool (0151) 705 3100London 0845 155 5000(treatment)Oxford (01865) 225 430Advice for travellersHospital for Tropical Diseases, Travel 020 7950 7799Healthlinewww.fitfortravel.nhs.ukWHO advice on international travel and healthwww.who.int/ithNational Travel Health Network andCentre (NaTHNaC)www.nathnac.org/travel/index.htm5.4.1 AntimalarialsRecommendations on the prophylaxis and treatment ofmalaria reflect guidelines agreed by UK malaria specialists.Choice will depend on the age of the child (seebelow).The centres listed above should be consulted for adviceon special problems.Treatment of malariaIf the infective species is not known, or if the infection ismixed, initial treatment should be as for falciparum5 Infections