Miltefosin-drug for Leishmaniasis

MILTEFOSIN

• Miltefosin is a broad spectrum antimicrobial drug.
• It is a phospholipid compound.
• Chemically it is a derivative of lysophosphatidylcholine.
• It is used in visceral leshmaniasis as an anti-parasitic.

PHARMACOKINETICS:
• Metabolism: slow hepatic independent of CYP enzyme.
• Half-life: generally it is about 6-8 days.
• Excretion: primarily fecal

ANTIMICROBIAL SPECTRUM:
Broad spectrum antimicrobial effective against:
• Pathogenic bacteria.
• Fungi.
• Human trematode, Schistoma mantoni.

USES:
• It is used in the treatment of visceral & cutaneous leishmaniasis.
• Also used in amoebic meningoencephalitis caused by Naegleria fowleri.
• Granulomatous amoebic encephalitis by Balamuthia mandrillaris and acanthamoeba.

ADVERSE EFFECTS:
• Nausea.
• Vomiting.
• Embryotoxic & fetotoxic so contraindicated in pregnancy.

DRUG INTERACTION:
• MILTEFOSIN + AMPHOTERICIN B = Potentiation in activity of miltefosin.
• MILTEFOSIN + PAROMOMYCIN = Potentiation in activity of miltefosin.

Reference-Tripathi K.D,"Essentials of medical pharmacognosy",7th edition,page no-845-847