U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C10H13N3O5S
Molecular Weight 287.292
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 1
Charge 0

SHOW SMILES / InChI
Structure of NIFURTIMOX

SMILES

CC1CS(=O)(=O)CCN1\N=C\C2=CC=C(O2)[N+]([O-])=O

InChI

InChIKey=ARFHIAQFJWUCFH-IZZDOVSWSA-N
InChI=1S/C10H13N3O5S/c1-8-7-19(16,17)5-4-12(8)11-6-9-2-3-10(18-9)13(14)15/h2-3,6,8H,4-5,7H2,1H3/b11-6+

HIDE SMILES / InChI

Molecular Formula C10H13N3O5S
Molecular Weight 287.292
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 1
Optical Activity ( + / - )

Description
Curator's Comment: description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/27282514 | https://www.drugs.com/international/nifurtimox.html | https://www.ncbi.nlm.nih.gov/pubmed/23518280

Nifurtimox is a nitrofuran derivative used as a primary agent in the treatment of American trypanosomiasis (Chagas' disease) caused by Trypanosoma cruzi, especially in the acute, early stage of the disease. The efficacy of nifurtimox in the treatment of chronic Chagas' disease varies from one country to another, possibly due to variation in the sensitivity of different strains of the organism. Nifurtimox has also been used to treat African trypanosomiasis (sleeping sickness) and is active in the second stage of the disease (central nervous system involvement). When nifurtimox is given on its own, about half of all patients will relapse, but the combination of melarsoprol with nifurtimox appears to be efficacious. Nifurtimox forms a nitro-anion radical metabolite that reacts with nucleic acids of the parasite causing significant break down of DNA. Nifurtimox undergoes reduction and creates oxygen radicals such as superoxide. These radicals are toxic to T. cruzi. Mammalian cells are protected by the presence of catalase, glutathione, peroxidases, and superoxide dismutase. Accumulation of hydrogen peroxide to cytotoxic levels results in parasite death. Side effects occur following chronic administration, particularly in elderly people. Major toxicities include immediate hypersensitivities such as anaphylaxis and delayed hypersensitivity reaction involving icterus and dermatitis. Central nervous system disturbances and peripheral neuropathy may also occur.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
1.8 µM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
Lampit

Approved Use

Unknown
Primary
Lampit

Approved Use

Unknown
Primary
Lampit

Approved Use

Unknown
Curative
Lampit

Approved Use

Unknown
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
568 μg/L
120 mg single, oral
dose: 120 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FED
568 μg/L
120 mg 1 times / day unknown, oral
dose: 120 mg
route of administration: Oral
experiment type: UNKNOWN
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: FEMALE / MALE
food status: HIGH-FAT
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
2670 μg × h/L
120 mg single, oral
dose: 120 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FED
2670 μg × h/L
120 mg 1 times / day unknown, oral
dose: 120 mg
route of administration: Oral
experiment type: UNKNOWN
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: FEMALE / MALE
food status: HIGH-FAT
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
3.3 h
120 mg single, oral
dose: 120 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FED
3.3 h
120 mg 1 times / day unknown, oral
dose: 120 mg
route of administration: Oral
experiment type: UNKNOWN
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: FEMALE / MALE
food status: HIGH-FAT
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
58%
120 mg single, oral
dose: 120 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: FED
57.6%
120 mg 1 times / day unknown, oral
dose: 120 mg
route of administration: Oral
experiment type: UNKNOWN
co-administered:
NIFURTIMOX plasma
Homo sapiens
population: UNHEALTHY
age: UNKNOWN
sex: FEMALE / MALE
food status: HIGH-FAT
Doses

Doses

DosePopulationAdverse events​
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Other AEs: Anorexia, AST increased...
Other AEs:
Anorexia (grade 2-3, 40%)
AST increased (grade 1, 80%)
ALT increased (grade 1, 20%)
Limb pain (grade 3, 20%)
Seizure (grade 3, 20%)
Sources:
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
DLT: Neuropathy, Pulmonary hemorrhage...
Other AEs: Anorexia, Seizure...
Dose limiting toxicities:
Neuropathy (grade 3, 50%)
Pulmonary hemorrhage (grade 3, 25%)
Other AEs:
Anorexia
Seizure (100%)
Nausea
Sources:
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Other AEs: Stomach pain, Anorexia...
Other AEs:
Stomach pain (33.3%)
Anorexia
Neuropathy (50%)
Seizure (16.7%)
Nausea
Sources:
AEs

AEs

AESignificanceDosePopulation
ALT increased grade 1, 20%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
AST increased grade 1, 80%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Anorexia grade 2-3, 40%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Limb pain grade 3, 20%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Seizure grade 3, 20%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Anorexia
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Nausea
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Seizure 100%
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Pulmonary hemorrhage grade 3, 25%
DLT
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Neuropathy grade 3, 50%
DLT
40 mg/kg 3 times / day multiple, oral
Highest studied dose
Dose: 40 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 40 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Anorexia
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Nausea
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Seizure 16.7%
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Stomach pain 33.3%
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
Neuropathy 50%
30 mg/kg 3 times / day multiple, oral
MTD
Dose: 30 mg/kg, 3 times / day
Route: oral
Route: multiple
Dose: 30 mg/kg, 3 times / day
Sources:
unhealthy, CHILD
Health Status: unhealthy
Age Group: CHILD
Sex: M+F
Food Status: UNKNOWN
Sources:
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no [IC50 >50 uM]
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
Drug as victimTox targets

Tox targets

PubMed

PubMed

TitleDatePubMed
Nitroreductive metabolic activation of some carcinogenic nitro heterocyclic food contaminants in rat mammary tissue cellular fractions.
2009-01
Nifurtimox plus pyrimethamine for treatment of murine toxoplasmosis.
1998-10
Treatment of experimental pneumocystosis: review of 7 years of experience and development of a new system for classifying antimicrobial drugs.
1992-09
Patents

Sample Use Guides

In Vivo Use Guide
For acute and chronic infections: Oral, 8 to 10 mg per kg of body weight per day in three or four divided doses after meals, for ninety to one hundred twenty days.
Route of Administration: Oral
Neural tumor cell lines (U-87, U373, CHLA-02-ATRT and PFSK-1), medulloblastoma cell lines (Daoy and D283) and TC-71, 143B, MG-63, MMH-ES, RD-ES, SK-ES-1 and SK-N-MC cell lines were used for activity evaluation. The viability of cells exposed to nifurtimox and BSO was determined using a modified methyl tetrazolium (MTT; Sigma) assay. 0.5–1.0 × 10^4 cells/well of exponentially growing cells were plated in 96-well plates. 24 hours later, nifurtimox or BSO was added to each well at concentrations up to 200mkM. After 72, 96, or 120 hours of continuous drug exposure, 15 μL of 5 mg/ml MTT was added to each well and the plates were incubated for 4 hours at 37 °C. Medium was replaced with 150 μL of DMSO and the optical density (OD) was measured at 550 nm using a microplate spectrophotometer (Anthos Analytical, Durham, NC). Cell numbers were estimated from OD measurements in individual wells. Relative cell viability was calculated by subtracting the background OD of media alone and then dividing by the OD of control wells.
Substance Class Chemical
Created
by admin
on Mon Mar 31 21:32:38 GMT 2025
Edited
by admin
on Mon Mar 31 21:32:38 GMT 2025
Record UNII
M84I3K7C2O
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
NIFURTIMOX
INN   MART.   MI   USAN   WHO-DD   WHO-IP  
INN   USAN  
Official Name English
nifurtimox [INN]
Preferred Name English
BAYER-2502
Code English
4-[(5-Nitrofurfurylidene)amino]-3-methylthiomorpholine 1,1-dioxide
Systematic Name English
NIFURTIMOX [USAN]
Common Name English
NIFURTIMOX [ORANGE BOOK]
Common Name English
NIFURTIMOX [MART.]
Common Name English
NIFURTIMOX [WHO-IP]
Common Name English
Nifurtimox [WHO-DD]
Common Name English
BAYER 2502
Code English
THIOMORPHOLINE, 3-METHYL-4-((5-NITROFURFURYLIDENE)AMINO)-, 1,1-DIOXIDE
Systematic Name English
4-THIOMORPHOLINAMINE, 3-METHYL-N-((5-NITRO-2-FURANYL)METHYLENE)-, 1,1-DIOXIDE
Systematic Name English
DNDI1613515
Code English
(RS)-3-METHYL-N-((1E)-(5-NITRO-2-FURYL)METHYLENE)THIOMORPHOLIN-4-AMINE 1,1-DIOXIDE
Systematic Name English
BAY-2502
Code English
NIFURTIMOX [MI]
Common Name English
BAY-A2502
Code English
TETRAHYDRO-3-METHYL-4-((5-NITROFURFURYLIDENE)AMINO)-4H-1,4-THIAZINE 1,1-DIOXIDE
Systematic Name English
LAMPIT
Brand Name English
(±)-NIFURTIMOX
Common Name English
NIFURTIMOXUM [WHO-IP LATIN]
Common Name English
Classification Tree Code System Code
WHO-ESSENTIAL MEDICINES LIST 6.5.5.1
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
WHO-VATC QP51AC01
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
FDA ORPHAN DRUG 310110
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
WHO-ESSENTIAL MEDICINES LIST 6.5.5.2
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
NCI_THESAURUS C277
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FDA ORPHAN DRUG 419213
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
WHO-ATC P01CC01
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Code System Code Type Description
MERCK INDEX
m7892
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PRIMARY Merck Index
DRUG BANK
DB11820
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PRIMARY
LACTMED
Nifurtimox
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PRIMARY
ECHA (EC/EINECS)
245-531-0
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PRIMARY
SMS_ID
100000083878
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PRIMARY
ChEMBL
CHEMBL290960
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PRIMARY
RXCUI
7421
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PRIMARY RxNorm
DAILYMED
M84I3K7C2O
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PRIMARY
EPA CompTox
DTXSID3045439
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PRIMARY
MESH
D009547
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PRIMARY
CAS
23256-30-6
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PRIMARY
WIKIPEDIA
Nifurtimox
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PRIMARY
EVMPD
SUB09280MIG
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PRIMARY
USAN
CD-134
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PRIMARY
INN
2615
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PRIMARY
DRUG CENTRAL
1929
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PRIMARY
FDA UNII
M84I3K7C2O
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
PRIMARY
WHO INTERNATIONAL PHARMACOPEIA
NIFURTIMOX
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
PRIMARY Description: A yellow to orange-yellow, crystalline powder; odourless. Solubility: Practically insoluble in water and ether R; freely soluble in dimethylformamide R; sparingly soluble in dioxan R. Category: Antitrypanosomal drug. Storage: Nifurtimox should be kept in a well-closed container. Definition: Nifurtimox contains not less than 98.0% and not more than 102.0% of C10H13N3O5S, calculated with reference to thedried substance.
PUBCHEM
6842999
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
PRIMARY
NCI_THESAURUS
C71734
Created by admin on Mon Mar 31 21:32:38 GMT 2025 , Edited by admin on Mon Mar 31 21:32:38 GMT 2025
PRIMARY
Related Record Type Details
BINDER->LIGAND
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TARGET ORGANISM->INHIBITOR
TARGET ORGANISM->INHIBITOR
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TARGET ORGANISM->INHIBITOR
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ACTIVE MOIETY
Name Property Type Amount Referenced Substance Defining Parameters References
Tmax PHARMACOKINETIC FED CONDITION

Biological Half-life PHARMACOKINETIC