Meglumine antimoniate dosage and administration: Difference between revisions
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==Dosage and Administration== | |||
Intramuscular doses are expressed in terms of the equivalent amount of pentavalent antimony (Sb5+). All doses, which are weight-related, are suitable for both adults and children. | |||
====Visceral leishmaniasis==== | |||
Injection of 20 mg Sb5+/kg i.m. daily (to a maximum of 850 mg Sb5+) for a minimum of 20 days. Treatment should be continued until no parasites are detected in consecutive splenic aspirates taken at 14-day intervals. | |||
<ref>{{Cite web | last = | first = | title = WHO Model Prescribing Information: Drugs Used in Parasitic Diseases - Second Edition: Protozoa: Leishmaniasis: Meglumine antimoniate and sodium stibogluconate | url = http://apps.who.int/medicinedocs/en/d/Jh2922e/2.4.1.html#Jh2922e.2.4.1 | publisher = | date = | accessdate = }}</ref> | Patients who relapse following the first course of treatment should be re-treated immediately using the same daily dosage. | ||
====Cutaneous leishmaniasis==== | |||
Except: L. braziliensis (see below) and L. aethiopica (see pentamidine). | |||
Intralesional injections are effective for early nodular lesions. Infiltration must be thorough and produce complete blanching of the base of the lesion. Systemic therapy is required when lesions are inflamed, ulcerated or situated where scarring can result in disability or disfigurement, and particularly when there is lymphatic obstruction or involvement of cartilage. | |||
'''Local therapy''' | |||
Injection of 1-3 ml into the base of the lesion, repeated once, or twice if no response is apparent, at intervals of 1 to 2 days. | |||
'''Systemic therapy''' | |||
Injection of 10-20 mg Sb5+/kg i.m. daily until a few days after clinical cure and slit-skin smears are negative. Relapse is unusual. | |||
====Cutaneous leishmaniasis (L. braziliensis)==== | |||
Injection of 20 mg Sb5+/kg daily i.m. until the lesion is healed and for at least 4 weeks. Relapse is usually associated with inadequate dosage or interrupted treatment. Should relapse occur following a full course of treatment, pentamidine should be used. | |||
====Mucocutaneous leishmaniasis (L. braziliensis)==== | |||
Injection of 20 mg Sb5+/kg daily i.m. until slit-skin smears are negative and for at least 4 weeks. In the event of toxicity or inadequate response, 10-15 mg Sb5+/kg should be administered every 12 hours for the same period. Patients who relapse should be retreated for at least twice as long. Those who are unresponsive should receive amphotericin B or pentamidine. | |||
====Diffuse cutaneous leishmaniasis (L. amazonensis)==== | |||
Injection of 20 mg Sb5+/kg daily i.m. for several months after clinical improvement occurs. Relapse must be expected until immunity develops.<ref>{{Cite web | last = | first = | title = WHO Model Prescribing Information: Drugs Used in Parasitic Diseases - Second Edition: Protozoa: Leishmaniasis: Meglumine antimoniate and sodium stibogluconate | url = http://apps.who.int/medicinedocs/en/d/Jh2922e/2.4.1.html#Jh2922e.2.4.1 | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Latest revision as of 03:40, 7 January 2014
| Meglumine Antimoniate |
|---|
| GLUCANTIM® WHO Prescribing Information |
| Description |
| Indications and Usage |
| Contraindications |
| Warnings and Precautions |
| Adverse Reactions |
| Dosage and Administration |
| How Supplied |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Dosage and Administration
Intramuscular doses are expressed in terms of the equivalent amount of pentavalent antimony (Sb5+). All doses, which are weight-related, are suitable for both adults and children.
Visceral leishmaniasis
Injection of 20 mg Sb5+/kg i.m. daily (to a maximum of 850 mg Sb5+) for a minimum of 20 days. Treatment should be continued until no parasites are detected in consecutive splenic aspirates taken at 14-day intervals.
Patients who relapse following the first course of treatment should be re-treated immediately using the same daily dosage.
Cutaneous leishmaniasis
Except: L. braziliensis (see below) and L. aethiopica (see pentamidine).
Intralesional injections are effective for early nodular lesions. Infiltration must be thorough and produce complete blanching of the base of the lesion. Systemic therapy is required when lesions are inflamed, ulcerated or situated where scarring can result in disability or disfigurement, and particularly when there is lymphatic obstruction or involvement of cartilage.
Local therapy
Injection of 1-3 ml into the base of the lesion, repeated once, or twice if no response is apparent, at intervals of 1 to 2 days.
Systemic therapy
Injection of 10-20 mg Sb5+/kg i.m. daily until a few days after clinical cure and slit-skin smears are negative. Relapse is unusual.
Cutaneous leishmaniasis (L. braziliensis)
Injection of 20 mg Sb5+/kg daily i.m. until the lesion is healed and for at least 4 weeks. Relapse is usually associated with inadequate dosage or interrupted treatment. Should relapse occur following a full course of treatment, pentamidine should be used.
Mucocutaneous leishmaniasis (L. braziliensis)
Injection of 20 mg Sb5+/kg daily i.m. until slit-skin smears are negative and for at least 4 weeks. In the event of toxicity or inadequate response, 10-15 mg Sb5+/kg should be administered every 12 hours for the same period. Patients who relapse should be retreated for at least twice as long. Those who are unresponsive should receive amphotericin B or pentamidine.
Diffuse cutaneous leishmaniasis (L. amazonensis)
Injection of 20 mg Sb5+/kg daily i.m. for several months after clinical improvement occurs. Relapse must be expected until immunity develops.[1]
References
Adapted from the FDA Package Insert.