Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

Antiparasitic Treatment

Antiparasitic treatment is indicated for all cases of acute or reactivated Chagas disease and for chronic Trypanosoma cruzi infection in children up to age 18. Congenital infections are considered acute disease. Treatment is strongly recommended for adults up to 50 years old with chronic infection who do not already have advanced Chagas cardiomyopathy. For adults older than 50 years with chronic T. cruzi infection, the decision to treat with antiparasitic drugs should be individualized, weighing the potential benefits and risks for the patient. Physicians should consider factors such as the patient's age, clinical status, preference, and overall health.

The two drugs used to treat infection with Trypanosoma cruzi are nifurtimox and benznidazole. In the United States, these drugs are not FDA approved and are available only from CDC under investigational protocols. For both drugs, side effects are fairly common, and tend to be more frequent and more severe with increasing age.

Common side effects of benznidazole treatment include:

  • allergic dermatitis
  • peripheral neuropathy
  • anorexia and weight loss
  • insomnia

The most common side effects of nifurtimox are:

  • anorexia and weight loss
  • polyneuropathy
  • nausea
  • vomiting
  • headache
  • dizziness or vertigo

Contraindications for treatment include severe hepatic and/or renal disease. As safety for infants exposed through breastfeeding has not been documented, withholding treatment while breastfeeding is also recommended. The following table outlines recommended dosage regimens by age group:

DrugAge groupDosage and duration
Benznidazole< 12 years5-7.5 mg/kg per day orally in 2 divided doses for 60 days
12 years or older5-7 mg/kg per day orally in 2 divided doses for 60 days
Nifurtimox≤ 10 years15-20 mg/kg per day orally in 3 or 4 divided doses for 90 days
11-16 years12.5-15 mg/kg per day orally in 3 or 4 divided doses for 90 days
17 years or older8-10 mg/kg per day orally in 3 or 4 divided doses for 90 days

Questions regarding treatment should be directed to Parasitic Diseases Public Inquiries (404-718-4745; e-mail chagas@cdc.gov).

For emergencies (for example, acute Chagas disease with severe manifestations, Chagas disease in a newborn, or Chagas disease in an immunocompromised person) outside of regular business hours, call the CDC Emergency Operations Center (770-488-7100) and ask for the person on call for Parasitic Diseases.

Guidance for Evaluation and Treatment

For more detailed information on evaluation and treatment, this link provides free access to a review article:
 Evaluation and Treatment of Chagas Disease in the United States: A Systematic Review (JAMA 2007: 298:2171-81)* 

 

Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd.
    Atlanta, GA 30333
  • 1-800-CDC-INFO
    (1-800-232-4636)
    TTY: 1-888-232-6348
    Hours of Operation
    8am-8pm EST /Monday-Friday
    Closed Holidays
  • Contact CDC-INFO

  • Health care professionals:
  • 1-404-718-4745
    8am–4pm EST/
    Monday–Friday
  • After-hours emergencies:
    1-770-488-7100
  • parasites@cdc.gov
  • Page last reviewed: July 19, 2013
  • Page last updated: July 19, 2013
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO