II. Indications
- Leishmaniasis
- Ameba Infection (off-label)
- Naegleria fowleri
- Balamuthia mandrillaris
- Acanthamoeba
III. Contraindications
- Pregnancy
- Lactation
- Age under 12 years old
- Sjogren-Larsson Syndrome
IV. Mechanism
- Alkyl-phosphocholine affects cellular membranes, interferes with cell mitosis and acts as an immunomodulator
V. Medications
- Capsules 50 mg in Blister packs
VI. Dosing: Adults and Children (age >12 years)
-
General
- Take with food
-
Leishmaniasis (Visceral, cutaneous or mucosal)
- Weight 30 to 44 kg: Miltefosine 50 mg orally twice daily for 28 days
- Weight >=45 kg: Miltefosine 50 mg orally three times daily for 28 days
- Ameba infections (Naegleria fowleri, Balamuthia mandrillaris, Acanthamoeba)
- See CDC and other references for dosing
VII. Adverse Effects
-
Serum Creatinine Increase
- Monitor Serum Creatinine weekly for 4 weeks
- Increased Liver Function Tests
- Monitor transaminases and Serum Bilirubin
- Decreased Platelet Count (in Visceral Leishmaniasis)
- Monitor Platelet Count
- Common
VIII. Safety
- Avoid in Lactation for 5 months after last use
- Pregnancy Category D (avoid)
- Use reliable Contraception while taking Miltefosine and for 5 months after use
IX. Drug Interactions
X. Resources
XI. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia