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 has demonstrated activity against Leishmania parasites and neoplastic cells primarily due to its effects on apoptosis and disturbance of lipid-dependent cell signalling pathways. Several potential antileishmanial mechanisms of action have been proposed, however no mechanism has been identified definitely. Within the mitochondria, miltefosine inhibits cytochrome-c oxidase leading to mitochondrial dysfunction and apoptosis-like cell death. Antineoplastic mechanisms of action are related to antileishmanial targets and include inhibition of phosphatidylcholine biosynthesis and inhibition of Akt (also known as protein kinase B), which is a crucial protein within the PI3K/Akt/mTOR intracellular signalling pathway involved in regulating the cell cycle. Animal studies also suggest it may be effective against Trypanosome cruzi (the organism responsible for Chagas' disease), metronidazole-resistant strains of Trichonomas vaginalis, and it may 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.