Indications
Miltefos is a leishmaniacide used in adults and adolescents aged 12 and older who weigh at least 30 kg (66 lbs). It is prescribed to treat visceral leishmaniasis caused by *Leishmania donovani*; cutaneous leishmaniasis caused by *Leishmania braziliensis*, *Leishmania guyanensis*, or *Leishmania panamensis*; and mucosal leishmaniasis caused by *Leishmania braziliensis*.
⚠️ Always consult a registered physician before taking any medicine.
Pharmacology
Miltefosine is active against Leishmania parasites and against neoplastic cells, mainly because of its effects on apoptosis and its disturbance of lipid-dependent cell signalling pathways. Several ways in which it might kill Leishmania have been proposed, but none has been identified with certainty. Inside the mitochondria, miltefosine inhibits cytochrome-c oxidase, which leads to mitochondrial dysfunction and apoptosis-like cell death.
Its antineoplastic actions are linked to the same targets that matter in leishmaniasis. They include inhibition of phosphatidylcholine biosynthesis and inhibition of Akt (also called protein kinase B). Akt is an important protein in the PI3K/Akt/mTOR intracellular signalling pathway, which helps regulate the cell cycle.
Animal studies also suggest that miltefosine may work against Trypanosome cruzi (the organism that causes Chagas' disease) and against metronidazole-resistant strains of Trichonomas vaginalis. It may also have broad-spectrum anti-fungal activity.
Pregnancy & Breastfeeding
Pregnancy: Miltefosine should not be used during pregnancy. A urine or serum pregnancy test should be obtained in females of reproductive potential before prescribing.
Nursing Mothers: Depending on how important the drug is to the mother, either the drug or nursing should be discontinued. Breastfeeding should be avoided for 5 months after finishing Miltefosine therapy.
Females and Males of Reproductive Potential: Females should be advised to use effective contraception during therapy and for 5 months afterward. Patients should also be advised of the reproductive toxicities seen in animals, and that the potential for impaired fertility in humans has not been adequately evaluated.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Dosage Reference
⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.