SURVIDIM GRANULES FOR SOLUTION FOR INJECTION (Each sachet of 2.36g contains Diminazene diacetate 1.05g)

Indications

• Metabolic disorders
• Energy substrate in clinical nutrition
• Potential use in conditions requiring enhanced energy metabolism

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines.

Adults: Refer to specific clinical guidelines as dosages may vary based on the condition being treated. Consultation with a healthcare professional is recommended.

Mechanism of action

Diacetate is metabolized into acetate, which can enter various metabolic pathways. Acetate serves as a substrate for the synthesis of acetyl-CoA, a key molecule in energy metabolism and fatty acid synthesis. The conversion of acetate into acetyl-CoA is facilitated by the enzyme acetyl-CoA synthetase, linking it to the citric acid cycle and enabling ATP production.

Pharmacodynamics

Diacetate functions primarily through its conversion to acetate, influencing energy metabolism. Acetate plays a role in the regulation of gluconeogenesis and lipogenesis. The pharmacodynamics of diacetate are linked to its ability to provide energy substrates and regulate metabolic pathways, impacting overall metabolic homeostasis.

Pharmacokinetics

Diacetate is absorbed and metabolized in the liver, where it is converted to acetate. The systemic circulation allows acetate to be distributed throughout the body. The elimination of acetate is primarily through urinary excretion, with a half-life that varies based on metabolic demand and individual patient factors. The metabolism of acetate is influenced by dietary intake and metabolic state.

Pregnancy

Safety in pregnancy has not been established. Use with caution and only if the benefits outweigh the risks.

Breast-feeding

Limited data available. Use with caution and only if the benefits outweigh the risks.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Trypanosomiasis (sleeping sickness)
• Nagana in livestock
• Infections caused by Trypanosoma brucei
• Infections caused by Trypanosoma congolense

Dosage

Children: Paediatric dosing of diminazene should be derived from the BNF for Children, taking into account the weight and age of the child. Refer to the BNF for Children for specific dosing recommendations.

Adults: The dosage for adults should be determined based on the specific condition and patient factors. Refer to the BNF for accurate dosing guidelines.

Mechanism of action

Diminazene acts by inhibiting the enzyme dihydrofolate reductase, which is crucial for the synthesis of folate in protozoa. This inhibition disrupts the folate metabolic pathway, leading to a decrease in nucleic acid synthesis and ultimately resulting in the death of the protozoan parasites. Additionally, it may interfere with the mitochondrial function of the parasites, further contributing to its antiparasitic effects.

Pharmacodynamics

The pharmacodynamics of diminazene involve its selective action on trypanosomes, with the drug being less toxic to host cells. It has a high affinity for the target enzyme, allowing for effective suppression of protozoan growth. The drug's therapeutic index is favorable, meaning it can effectively treat infections at doses that are relatively safe for the host.

Pharmacokinetics

Diminazene is well-absorbed following parenteral administration. It is widely distributed throughout the body, with a significant volume of distribution. The drug undergoes hepatic metabolism, and its elimination half-life can vary depending on species and individual health. Excretion is primarily via the urine, with metabolites detected in both urine and feces.

Adverse effects

• Anorexia
• Vomiting
• Diarrhoea
• Lethargy
• Neurological signs (e.g., tremors, ataxia)
• Hypersensitivity reactions

Precautions

• Use with caution in animals with hepatic or renal impairment.
• Monitor for signs of toxicity, especially in cases of overdose.

Pregnancy

Safety during pregnancy has not been established; use only if the benefits outweigh the risks.

Breast-feeding

Safety during breastfeeding has not been established; use with caution.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Injection solution