VHOSPITAL.CLINIC · Antiparasitic Treatment
Miltefosine is the first oral treatment for visceral leishmaniasis, offering a significant advantage over IV amphotericin B in resource-limited settings where kala-azar is endemic.
Miltefosine is an alkylphosphocholine that disrupts Leishmania membrane phospholipid metabolism, interferes with signal transduction pathways, and induces apoptosis-like death in the parasite.
Adults (>25 kg): 2.5 mg/kg/day in 2–3 divided doses for 28 days. Adults: typically 50 mg twice daily (100 mg/day). Take with food to reduce nausea. Contraindicated in pregnancy.
This is a general reference. Always follow your physician's prescription and current treatment guidelines.
Miltefosine has a long half-life (7 days) and accumulates in tissues. Animal studies show significant embryotoxicity and teratogenicity. Women of childbearing age must use contraception during treatment and for 3 months after.
Miltefosine achieves initial cure rates of 90–95% in the Indian subcontinent. However, relapse rates are higher (~15% at 6 months) than with amphotericin B, particularly in HIV co-infected patients.
Yes. Miltefosine is also effective for cutaneous and mucosal leishmaniasis, particularly for L. braziliensis and L. donovani species. It is particularly valuable as an oral alternative to painful intralesional antimonials.
By treating Leishmaniasis, Miltefosine addresses these associated symptoms:
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