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Melarsoprol is a trivalent arsenical derivative effective in the treatment of all stages of African trypanosomiasis (African sleeping sickness) caused by Trypanosoma brucei gambiense or T. brucei rhodesiense, but due to its toxicity, its use is reserved for stages of the disease affecting the central nervous system. Daily intravenous administration in cycles of 3 to 4 days separated by 7 to 10 days between cycles.
At the date of the last update, we found no published data on its excretion in breast milk.
Its low oral bioavailability makes it difficult for it to pass into infant plasma from ingested breast milk, except in premature infants and the immediate neonatal period in which there may be greater intestinal permeability.
Arsenic is very toxic and causes frequent and severe adverse reactions. It is reserved for advanced stages of the disease, in which it is very unlikely that the woman will be able to breastfeed.
The existing alternatives are not very effective. The lack of research and investment in this disease, which is considered unprofitable by the pharmaceutical industry, means that thousands of people die every year in Africa because it is not considered profitable.