Suramin Reconstitution Calculator

Yes, for exactly one indication: early-stage (hemolymphatic) human African trypanosomiasis caused by Trypanosoma brucei rhodesiense; it is listed on the WHO Model List of Essential Medicines. Every other proposed application (cancer, autism spectrum disorder, viral infection, inflammatory disease) is investigational. Human phase I/II data exist for metastatic breast cancer and a double-blind, placebo-controlled RCT in children with autism (SAT-1), but no additional indications are licensed.

No practical oral route exists. Suramin's large size and six anionic sulfonate groups limit oral bioavailability and brain penetration; human dosing is intravenous. Animal models also use intraperitoneal injection, e.g., 60 mg/kg twice weekly in mice. No human subcutaneous pharmacokinetic data support SC use (practitioner consensus).

Human phase I/II cancer protocols target a plasma concentration of 10–50 μM via weekly IV infusion, hitting target in 88% of treatments. A single 10 mg/kg IV dose attenuated renal inflammation in diabetic mice; rat Parkinson's models used 100 mg/kg IV on days 11 and 18; PKD mice received 60 mg/kg IP twice weekly; the SAT-1 autism trial used low-dose IV suramin in children. No validated consumer dosing exists; animal mg/kg values do not translate directly to humans (practitioner consensus).

Dose-dependent sensory-motor polyneuropathy (mouse single dose 250 mg/kg; cultured dorsal root ganglion neuron IC50 283 μM); renal tubular injury with phospholipidosis at chronics 60 mg/kg dosing; and suramin keratosis in prostate cancer patients (case report). Low-dose protocols (10–50 μM plasma) were reasonably well tolerated in phase I/II trials.

Exceptionally long. Cattle pharmacokinetics after a single 10 mg/kg IV dose: distribution half-life ~9–11.6 h, elimination half-life ~200–289 h (8–12 days). This drives intermittent schedules: weekly infusions, single doses, or twice-weekly injections. The drug itself is hydrolytically stable in aqueous solution (2% degradation after 42 days at 37 °C), so the dosing interval is set by clearance and toxicity, not degradation.

No adequate human data. Maternal suramin exposure in rats programmed hypertension in male offspring; co-administration of N-acetylcysteine prevented the effect. Given rodent evidence of fetal programming effects, suramin should be avoided in pregnancy and lactation outside its licensed indication (practitioner consensus).

As a broad P2 purinergic antagonist, suramin outperformed metformin in a rotenone Parkinson's rat model on motor function and P2X7/P2X4 suppression. But pan-purinergic blockade has trade-offs: in a systematic review of skin wound models, purinergic antagonists including suramin delayed wound closure, angiogenesis, and collagen deposition, whereas agonists accelerated repair. Suramin's polypharmacology spans P2 receptors, growth factors, viral polymerases, and mitochondrial transporters, making it a blunt tool relative to receptor-selective agents (practitioner consensus).

Aqueous suramin is stable for weeks even at 37 °C; refrigerated, light-protected storage is nonetheless standard for injectables (practitioner consensus). Suramin is not a controlled substance and is a WHO essential medicine. International travel with the injectable should be accompanied by a prescription and physician letter, as with any injectable medication (practitioner consensus).