Indications
Miltefosine is an oral medicine used to treat leishmaniasis, a parasitic disease spread by sandfly bites. This includes visceral leishmaniasis (kala-azar), which affects the liver, spleen and bone marrow, and is a public health problem in parts of Bangladesh, as well as skin and mucosal forms, and post kala-azar dermal leishmaniasis (PKDL).
How It Works
Miltefosine damages the cell membrane of the Leishmania parasite and disturbs how it uses energy and fats. This kills the parasite and helps the body clear the infection.
Dosage and Administration
Take as prescribed. The dose is based on body weight and age, and the course usually lasts several weeks (often 28 days for kala-azar, longer for PKDL). Treatment is usually started and supervised by a doctor or a national kala-azar programme. Swallow capsules whole with food to reduce stomach upset, and finish the full course even if you feel better.
Interactions
Few interactions are known, but tell your doctor about all medicines. Vomiting and diarrhoea can reduce the effect of the oral contraceptive pill, so extra contraception is needed. Avoid other medicines that harm the kidneys or liver unless the doctor agrees.
Contraindications
- Pregnancy.
- Women who could become pregnant and are not using reliable contraception.
- Breastfeeding.
- Allergy to miltefosine.
- Sjögren-Larsson syndrome (a rare inherited condition).
Side Effects
Common: vomiting, nausea, diarrhoea, loss of appetite, tummy pain, headache, and raised liver and kidney test results. Less common: dizziness, itching and eye problems. Rare: severe skin reactions and low platelets.
Get urgent medical help for persistent vomiting or diarrhoea with signs of dehydration (very dry mouth, little urine, dizziness), reduced urine, yellow skin or eyes, unusual bleeding, a severe rash or eye pain or vision changes.
Pregnancy and Lactation
Miltefosine can harm or kill an unborn baby. A pregnancy test is needed before starting. Women must use reliable contraception during treatment and for 5 months after the last dose. Do not breastfeed during treatment and for 5 months after.
Precautions and Warnings
- Drink plenty of fluids to prevent dehydration.
- Kidney and liver function and blood counts are checked during treatment.
- Men should discuss possible effects on fertility with the doctor.
Overdose
Overdose may cause severe vomiting and diarrhoea. Seek medical help; fluids and supportive care are given.
Therapeutic Class
Antiprotozoal (antileishmanial) agent.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.