Miltefosine

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Generic Name of Miltefosine - Learn More

Miltefosine

Miltefosine Precaution - What You Need to Know

Before initiating treatment with Miltefosine, it is crucial that patients consult their healthcare provider to discuss any potential risks and considerations, as this medication requires careful monitoring and may have specific safety concerns. Key precautions include:
- Pregnancy: Miltefosine is contraindicated during pregnancy, as it has been shown to cause fetal harm and birth defects in animal studies. Women of childbearing age should be on reliable contraception during treatment and for at least 5 months after treatment.
- Breastfeeding: The safety of Miltefosine in breastfeeding is not well established. It should be used with caution in lactating women, and alternative therapies may be considered.
- Liver and Kidney Function: Patients with pre-existing liver or kidney issues should be monitored closely, as Miltefosine is metabolized in the liver and excreted through the kidneys. Adjustments may be needed for individuals with impaired liver or renal function.
- Hematological Effects: Miltefosine can cause hematological changes, such as low red blood cell counts (anemia) or low white blood cell counts (leukopenia). Regular blood tests to monitor hemoglobin and white blood cell count are recommended during treatment.
- Gastrointestinal Disturbances: It may cause nausea, vomiting, and other gastrointestinal symptoms, so patients should be informed of these potential side effects.
- Alcohol Use: Alcohol consumption should be avoided during treatment with Miltefosine due to potential liver toxicity and the possibility of exacerbating gastrointestinal side effects.

Miltefosine Indication - Uses and Benefits

Miltefosine is primarily used in the treatment of leishmaniasis, a parasitic disease caused by Leishmania species. It is especially indicated in the following conditions:
- Visceral Leishmaniasis (Kala-azar): Miltefosine is effective in treating visceral leishmaniasis, which is caused by Leishmania donovani. It is used as an alternative treatment to intravenous liposomal amphotericin B and other first-line agents.
- Cutaneous Leishmaniasis: It is also used for cutaneous leishmaniasis, caused by different Leishmania species. In this case, Miltefosine can be used in patients with localized lesions, especially in regions where other treatments may not be as accessible.
- Mucocutaneous Leishmaniasis: Miltefosine is sometimes used in mucocutaneous leishmaniasis, although other therapies may be preferred in certain severe cases.

Miltefosine Contraindications - Important Warnings

Miltefosine should not be used in the following situations due to safety concerns:
- Pregnancy: Miltefosine is contraindicated in pregnant women, as it has shown teratogenic effects (birth defects) in animal studies.
- Hypersensitivity: Any patient with a known hypersensitivity or allergic reaction to Miltefosine or its components should avoid its use.
- Severe Liver or Kidney Disease: For individuals with severe hepatic (liver) or renal (kidney) impairment, the use of Miltefosine may be contraindicated, as it can worsen liver and kidney function.
- Breastfeeding: As it is not known whether Miltefosine passes into breast milk, it should be avoided in lactating women unless absolutely necessary, and alternative therapies should be considered.

Miltefosine Side Effects - What to Expect

Common side effects associated with Miltefosine treatment include:
- Gastrointestinal Disturbances: Nausea, vomiting, diarrhea, and abdominal pain are among the most common side effects. These symptoms are typically mild to moderate in severity.
- Liver Toxicity: Miltefosine can lead to liver enzyme abnormalities (elevated ALT, AST), which may indicate liver toxicity. Regular liver function tests should be performed during treatment.
- Fatigue: Some patients report feeling unusually tired or weak while undergoing Miltefosine therapy.
- Headache and Dizziness: Mild to moderate headaches or dizziness may occur.
- Dermatological Reactions: Rash or skin irritation may develop, especially with long-term use.
- Teratogenic Effects (Pregnancy): As mentioned earlier, Miltefosine is teratogenic and should not be used during pregnancy due to potential birth defects in the developing fetus.
- Hematological Effects: Rarely, patients may develop low blood counts (anemia, leukopenia, thrombocytopenia), requiring regular blood tests to monitor for potential blood-related complications.
- Other Serious Effects: Severe allergic reactions, including anaphylaxis, are rare but possible and require immediate medical attention.

Miltefosine Pregnancy Category ID - Safety Information

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Miltefosine Mode of Action - How It Works

Miltefosine is a phospholipid that works by inhibiting parasite cell membrane function in Leishmania species. Its exact mechanism of action is not fully understood, but it is believed to exert its effects through:
- Inhibition of Lipid Metabolism: Miltefosine is incorporated into the membrane lipids of Leishmania parasites, disrupting the lipid metabolism essential for parasite survival.
- Induction of Apoptosis: It triggers cell death in the parasite by interfering with the synthesis of key lipids that are important for membrane integrity, leading to apoptosis (programmed cell death) in the parasites.
- Disruption of Cellular Functions: This ultimately leads to parasite death and the resolution of the infection.

Miltefosine Drug Interactions - What to Avoid

Miltefosine may interact with various other medications and substances, influencing its safety and efficacy:
- Anticancer Drugs: There are concerns about potential interactions with chemotherapy agents, as Miltefosine may alter the metabolism of certain chemotherapy drugs, particularly alkylating agents. Careful monitoring is required if used in combination.
- Cytochrome P450: Miltefosine is metabolized in the liver by cytochrome P450 enzymes. Medications that affect the P450 system may alter the efficacy or toxicity of Miltefosine. Drugs that induce or inhibit these enzymes should be used with caution.
- Other Hepatotoxic Drugs: Concurrent use with other hepatotoxic drugs (such as certain antibiotics and antifungals) may increase the risk of liver damage.
- Alcohol: Consumption of alcohol during Miltefosine treatment should be avoided, as it can enhance the risk of liver damage and gastrointestinal side effects.
- HIV Medications: When combined with antiretroviral therapy used in HIV treatment, there may be pharmacokinetic interactions. Patients on HIV drugs should be carefully monitored for adverse effects.

Miltefosine Adult Dose - Recommended Dosage

The recommended adult dose for Miltefosine for the treatment of leishmaniasis varies based on the specific form of the disease:
- Visceral Leishmaniasis (Kala-azar): The usual dosage is 2.5 mg/kg orally, once daily, for 28 days.
- Cutaneous Leishmaniasis: The recommended dosage is 2.5 mg/kg orally, once daily, for 28 days.
- Mucocutaneous Leishmaniasis: In cases of mucocutaneous disease, a prolonged treatment duration or an alternative therapy may be necessary.

Miltefosine Child Dose - Dosage for Children

Miltefosine is generally not recommended for children under 12 years old, as its safety and efficacy in pediatric populations have not been fully established. The medication should only be prescribed to children under close medical supervision and after careful consideration of potential risks. If used, the dosing should be adjusted based on body weight and clinical condition. However, there are no established pediatric guidelines at this time.

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Important Note:
Always consult your healthcare provider before starting Miltefosine therapy. This medication requires proper medical supervision to minimize risks and ensure efficacy. Regular monitoring of liver function, kidney function, and blood cell counts is essential during treatment.

Miltefosine Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, dose adjustments may be necessary, although specific dose adjustments are not well-established. Miltefosine should be used with caution in patients with kidney problems, and close monitoring of renal function is recommended. Dosage reduction might be required in cases of severe renal impairment. Patients should consult their healthcare provider for more information on individual dosing regimens.