VHOSPITAL.CLINIC · Antiparasitic Treatment

Amphotericin B for Leishmaniasis

Liposomal amphotericin B is the WHO-recommended first-line treatment for visceral leishmaniasis (kala-azar), achieving cure rates >95% with low toxicity.

AntifungalAmphotericin B Full Drug Profile →Condition-first view →

How Amphotericin B Treats Leishmaniasis

Amphotericin B binds ergosterol in the Leishmania cell membrane, forming pores that cause potassium leakage and osmotic lysis of the parasite. Liposomal formulation concentrates the drug in macrophages where parasites reside.

Clinical Dosing

Liposomal AmB: 3 mg/kg/day on days 1–5, day 14, and day 21 (total 21 mg/kg). Single-dose 10 mg/kg regimens available in some settings. IV infusion over 30–60 minutes.

This is a general reference. Always follow your physician's prescription and current treatment guidelines.

Side Effects

  • Infusion-related reactions: fever, chills, rigors (premedicate with paracetamol)
  • Hypokalaemia (monitor electrolytes)
  • Nephrotoxicity (less with liposomal vs conventional formulation)
  • Anaemia
Full side effects guide →

When to Seek Urgent Care

  • ⚠️Severe infusion reaction (anaphylaxis)
  • ⚠️Significant renal function decline
  • ⚠️Severe hypokalaemia (muscle weakness, cardiac arrhythmias)
  • ⚠️Treatment failure at day 28 (persistent splenomegaly/fever)

FAQ: Amphotericin B for Leishmaniasis

Why is liposomal amphotericin B preferred over conventional?

Liposomal AmB is taken up preferentially by macrophages (where Leishmania lives), achieving higher drug concentrations at the site of infection with dramatically lower nephrotoxicity than conventional amphotericin B.

How long until symptoms improve with amphotericin B treatment?

Fever typically resolves within 1–2 weeks. Splenomegaly regresses over weeks to months. Weight gain begins within 4–6 weeks. Full recovery of blood counts takes 2–3 months.

Is amphotericin B available in all countries?

Liposomal AmB is expensive and not universally available. WHO and DNDi provide it at reduced cost for endemic countries. Where unavailable, miltefosine or antimonials are used.

Alternative Treatments for Leishmaniasis

Symptoms Amphotericin B Helps Resolve

By treating Leishmaniasis, Amphotericin B addresses these associated symptoms:

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Medical References

Content on this page is informed by evidence-based clinical sources including: