|
| Drug | Properties and administration | Comments | Reactions in patients with CL/VL |
|
| Pentavalent antimonials | Polymeric organometallic complexes, intravenous, or intramuscular | For VL and CL. Drug resistance in Bihar, India. Variable response in different forms of CL. Generic sodium stibogluconate (SSG) has made treatment cheaper | Pain, erythema, oedema, abdominal pain, nausea, and thrombocytopenia |
|
Amphotericin B
fungizone | Polyene antibiotic, Fermentation product of Streptomyces nodus, intravenous | For VL, CL, and complex forms of CL, for example, MCL. first-line drug for VL in India where there is antimonial resistance | Infusion related, azotemia, anemia, or hypokalemia |
|
Amphotericin B
ambisome | Unilamellar liposome, intravenous | Most effective lipid formulation for VL and available at $18/50 mg ampoule via WHO used for complex forms, such as PKDL and MCL |
Hypotension,anorexia,nausea,vomiting, and headache generalized weakness. |
|
| Miltefosine | Hexadecylphosphocholine, oral | First oral drug for VL. Effective against some forms of CL
contraindicated in pregnancy | Nausea, vomiting and/or diarrhea, raised creatinine, and raised LFT's |
|
Amphotericin B
formulations | Lipidic formulations, intravenous | Other lipid formulations, including Abelcet, Amphocil, Amphomul, and multilamellar liposomes have been in clinical studies, mainly for VL | Shaking chills, nausea, hypotension,anorexia,headache, and vomiting, |
|
| Paromomycin | Aminoglycoside (also known as aminosidine or monomycin), fermentation product of Streptomyces rimosus. Supplied as sulphate. Intramuscular for VL and topical for CL | Registered for VL in India, completed Phase III trials for VL in East Africa where less effective in Sudan. Topical formulation (12%) with methyl benzethonium chloride available for CL. Topical with gentamicin and surfactants in Phase III trial | Pain, erythema, oedema, blisters, and ototoxicity |
|
| Pentamidine | Diamidine, as isethionate salt, intramuscular | For specific forms of CL in South America only | Nausea, vomiting, diarrhea, hyperglycemia, and cardiotoxicity |
|
| Sitamaquine | 8-aminoquinoline analog, orally active | Tested in VL patients in Kenya and Brazil with limited success | Abdominal pain, headache, vomiting, dyspepsia, and cyanosis |
|
