Meglumine Antimoniate (Intravenous)

Meglumine Antimoniate injections are used to treat various forms of Leishmaniasis, a parasitic infection that may be deadly if left untreated.

Overview

Meglumine Antimoniate is indicated for the treatment of Leishmaniasis, a serious condition resulting from protozoa, a minute single-cell parasite, otherwise known as the Leishmania parasite. Typically, this parasite is spread through the bite of a sand fly. The treatment is given intravenously in a hospital setting.

Leishmaniasis is known by many names, including;

  • Bay sore
  • Black sickness
  • Chiclero ulcer
  • Espundia
  • Kala-azar
  • Oriental sore
  • Ulcera de bejuco
  • Uta

Leishmaniasis is more prevalent in certain regions of the world, including the tropics and subtropics, according to the Center for Disease Control. The condition is considered an epidemic in more than 85 countries, including:

  • India
  • Afghanistan
  • Algeria
  • Saudi Arabia
  • Peru
  • Brazil
  • Nepal
  • Iran
  • Bolivia
  • Sudan
  • Syria
  • Ethiopia
  • Bangladesh
  • Colombia
  • Southern Europe

Travelers to these regions are generally advised to exercise precautions for preventing insect bites, by:

  • Using an insect repellant
  • Wearing long-sleeved clothing
  • Investing in a mosquito net

These precautions should be taken at all times, but especially during the evening time when sand flies are most active. It should also be noted that not all sand flies are infected with Leishman parasites. Infected sand flies generally acquire these parasites by biting into an infected party' be it a human or animal.

Infected patients may develop sores or ulcers on the skin. This type of Leishmaniasis is called cutaneous leishmaniasis. However, there are other less common forms, such as visceral leishmaniasis, which targets the organs; or mucocutaneous, which generally affects the nose and other parts of the body.

Leishmaniasis may hide quietly in the body for years, without any visible symptoms. The development of ulcers and sores is often triggered by a suppressed immune system. These are slow-healing, meaning sores, ulcers, and plaques may take months or up to a year to heal. As a result, medical intervention is typically required with Meglumine Antimoniate.

Not only are the open sores on the skin due to subcutaneous Leishmaniasis painful for patients, these sores also leave unsightly scars. There is also a stigma associated with Leishmaniasis because in many cases, it looks like Leprosy.

Subcutaneous Leishmaniasis is less serious than visceral types, which when left untreated, it could lead to death. The primary concerns for Visceral Leishmaniasis is preventing damage to the spleen or liver. Fortunately, Meglumine Antimoniate can help.

Meglumine Antimoniate has been used as a first line of treatment for Leishmaniasis for more than 70 years. It is also included in the List of Essential Medicines by the World Health Organization.

It is sold under the following brand names:

  • Glucantime
  • Glucantim

Conditions Treated?

  • Leishmaniasis

Type Of Medicine?

  • Antiprotozoal, Antimony Compound

Side Effects

The most common side effects of Meglumine Antimoniate include:

  • Feeling sleepy
  • Feeling sick or uncomfortable
  • A headache
  • Appetite loss
  • Pain in the muscles
  • Pain in the abdomen
  • Coughing

In rare cases, Meglumine Antimoniate may cause the following adverse reactions:

  • Skin discoloration
  • Voice changes
  • Low urinary output
  • Labored breathing
  • Syncope
  • Swelling
  • Itching and skin rashes
  • Lethargy
  • An irregular heartbeat
  • Kidney issues

Dosage

Meglumine Antimoniate is administered as an injection vs. in pill form due its poor absorption rating. In addition, medical studies have shown that oral administration adversely affects the GI tract.

Dose amounts for Meglumine Antimoniate varies from one patient to another and is generally based on the patient's weight, as well as:

  • Age
  • Medication strength
  • Timeline for treatment
  • Intervals per day required

The average doses, however, are listed below, based on the type of therapy:

Types of Therapy

  • For subcutaneous Leishmaniasis' where the condition only affects the skin, the injection is administered into the base of the impacted area¬†' the ulcers and sores.
  • For visceral Leishmaniasis' the primary care physician generally injects Meglumine Antimoniate into a muscle.

Local Therapy Doses

Inject 1-3 ml | Every Day or Other Day

Systemic Therapy Doses

  • Children: 20 mg of Pentavalent Antimony in Meglumine Antimoniate | per kg of Body Weight | 1X Daily | for 20-28 Days
  • Adults: 20 mg of Pentavalent Antimony in Meglumine Antimoniate | per kg of Body Weight | 1X Daily | for 20-28 Days

Treatment may extend beyond this four-week window if the patient isn't fully recovered from Leishmaniasis. Repeat treatments are recommended as soon as a relapse is noticed.

Within a 20-day timeframe, however, the dose amount should not exceed 850 mg.

Interactions

Limited data is available for how Meglumine Antimoniate interacts with other medicines. Patients, however, are advised to list all current medications and underlying conditions, including any use of vitamins, herbs, or supplements. You should also tell your doctor if you have a history of allergic reactions to any medicines, or foods, dyes, and/or preservatives' before starting treatment with Meglumine Antimoniate.

Warnings

Both patients and physicians are advised to read and discuss the warnings listed for Meglumine Antimoniate. An informed decision can be made on whether to proceed with treatment after completing a risk-benefit evaluation.

Preexisting Conditions

The presence of certain underlying ailments complicates treatment with Meglumine Antimoniate injections. For instance, contraindications have been found when this medicine is used in patients with heart, liver, or kidney disorders. Meglumine Antimoniate should also be used with caution in people with Pancreatitis.

Full round of treatment required

To adequately cure Leishmaniasis, the full course of treatment with Meglumine Antimoniate is required. Patients should therefore keep all appointments for treatment. Additionally, patients are advised to attend all progress checks to determine if there are any signs of improvement.

How can doctors tell if a patient has been infected with the parasite causing Leishmaniasis?

Repeat tests known as splenic aspirates are performed to pinpoint if the underlying cause of a skin ulcer or sore is the Leishmania parasite. Following treatment, healthcare providers generally follow-up with the patient every two weeks to repeat this test and verify that the patient is fully cured.

To lower the risk of side effects, patients' heart, liver, and kidneys are generally monitored throughout the course of treatment.

Relapse

There is a chance that patients' Leishmaniasis may relapse after receiving the full course of treatment with Meglumine Antimoniate. In this event, multiple therapies may be necessary to fully clear up the infection. If patients are unresponsive to this treatment, other drugs may be prescribed.

Dietary changes

In some cases, Meglumine Antimoniate may cause iron or protein deficiencies. As a result, supplements may be given before starting the therapy. Moreover, patients are advised to eat foods that are rich in protein to prevent this side effect of Meglumine Antimoniate.

Pregnant and nursing mothers

Meglumine Antimoniate injections are not recommended for women who are pregnant or nursing. If you are pregnant, nursing, or plan to be, inform your healthcare provider before starting treatment with this drug.

When to call a doctor

Seek emergency medical help immediately if you experience the following side effects:

  • An abnormal heartbeat
  • A high temperature
  • Abdominal pain
  • Back pain
  • Vomiting
  • Queasiness
  • A metallic taste

Storage

Store Meglumine Antimoniate in the original vials.

Healthcare workers are advised to verify the expiration date before use, as the efficiency generally denigrates with age.

Summary

Meglumine Antimoniate is an antiprotozoal agent that is suggested for the treatment of Leishmaniasis. The condition is generally characterized by large ulcers and sores on the skin. However, Leishmaniasis can additionally affect the organs. The infection is caused by a parasite living in sand flies. It is most prevalent in tropical and subtropical regions of the world.

Since the 1940s, Meglumine Antimoniate was developed as a first line of treatment for Leishmaniasis. Today, it is widely recognized as a vital medicine, and has also been listed on the World Health Organization's list of essential medicines.

To ensure the infection is completely cleared, patients are advised to check in at their doctor and to keep all follow-up appointments scheduled. If a relapse is detected following the initial round of treatment, a repeat dose is administered immediately ' for 20-28 days.

Patients who are using Meglumine Antimoniate may experience sleepiness, coughing, voice changes, a loss of appetite, or stomach pain. Most of these symptoms generally subside with time. However, there are some cases where medical help is required, including when patients develop trouble breathing, an abnormal heartbeat, or severe back pain. These are signs of a severe adverse reaction to the medicine, in which case, emergency medical help is required.

All the dose amounts for Meglumine Antimoniate are weight-based. The injections are further localized to the affected area, if Leishmaniasis only affects the skin alone. However, systemic therapy may be required if Leishmaniasis affects organs and other areas of the body.

Meglumine Antimoniate is not suggested for individuals with heart, liver, or kidney disease. Additionally, this drug should not be prescribed to pregnant or nursing mothers, as it may cause serious harm to unborn babies and infants. All patients should be closely monitored for adverse side effects.