Meglumine Antimonate

What it is and how it works

Meglumine antimoniate is a pentavalent antimony compound that is reduced to the trivalent form within macrophages and parasites. It inhibits Leishmania glycolytic and fatty-acid oxidation enzymes and trypanothione reductase, disrupting parasite energy metabolism and redox defence.

Indications

Treatment of cutaneous leishmaniasis (intralesional or systemic), mucocutaneous leishmaniasis and visceral leishmaniasis (kala-azar).

Dosage and administration (summary)

Systemic: 20 mg/kg/day of pentavalent antimony by deep intramuscular or slow intravenous injection for 20 days (cutaneous) or 28–30 days (visceral or mucocutaneous). Intralesional: injected into the lesion, usually once weekly, according to national protocols.

Contraindications

Significant cardiac, hepatic or renal impairment; hypersensitivity to antimony compounds.

Warnings and precautions

Cardiotoxicity with QT prolongation and arrhythmias may occur; ECG monitoring is required, especially with systemic therapy. Pancreatitis, hepatotoxicity, nephrotoxicity, musculoskeletal pain and cytopenias may occur; monitor amylase or lipase, liver and renal function and blood counts.

Pregnancy

Avoid in pregnancy; consider alternative treatment or defer treatment of cutaneous disease.

Storage and supply

Store below 30 °C, protected from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.