Because melarsoprol is toxic, patients undergoing therapy with this medication should be treated in the hospital. Dosage should be based upon clinical assessment or the general condition of the patient other than body weight.

Treatment protocols for melarsoprol may vary. Usually, this medication is given in short courses of 3 or 4 days' duration and separated by `rest periods' of 7 to 10 days. In children and debilitated patients, melarsoprol should be given in low doses initially, then gradually increased to the maximum daily dose of 3.6 mg / kg of body weight.

Melarsoprol should be administered by slow intravenous injection as a 3.6% solution in propylene glycol. Because melarsoprol injection is intensely irritating due to its propylene glycol content, care should be taken to avoid leakage into the surrounding tissues. Extravasation during intravenous administration may result in extreme local tissue damage and destruction.

Dosing regimen

Trypanosomiasis, African (treatment)
Intravenous, 3.6 mg / kg per day for three days [2,5-7]. This three-day regimen can be repeated three or four times with an interval of one week between courses of treatment [2,6]. 

Usual adult prescribing limits
Up to 180 mg per day [5-8]. However, up to 200 mg per day was used in one study [3].

Usual pediatric dose
Trypanosomiasis, African (treatment)
Intravenous, 18 to 25 mg / kg total over one month given as follows: initially, 0.36 mg / kg / day, gradually increasing to 3.6 mg / kg / day at intervals of one to five days, for a total of nine to ten doses [2].