II. Indications
- Intralesional injection- Simple Cutaneous Leishmaniasis
 
- Intravenous or Intramuscular- Complex or Diffuse Cutaneous Leishmaniasis
- Mucosal Leishmaniasis
- Leishmania braziliensis
- Visceral Leishmaniasis in high resistance regions (esp. East Africa)
- Visceral Leishmaniasis (alternative to first-line agents)
 
III. Mechanism
- Pentavalent antimony (Sb) based Antiprotozoal with activity against Leishmaniasis- Other antimony compound (Stibogluconate) for Leishmaniasis is no longer available
 
- Prodrug, reduced from pentavalent to trivalent form, interferes with Protozoal metabolic pathways- Interacts with Protozoal trypanothione (thiol group) critical for its Redox Reactions
- Disrupts cellular processes resulting in cellular death
 
IV. Medications
- Injection solution: 1.5 g/5 ml in 5 ml ampules (Antimony 0.405 g/5 ml)
- Dosing is based on Antimony component (every 75 mg Meglumine Antimoniate contains 20 mg Antimony)
V. Dosing: Intralesional Injection
- Inject undiluted solution intralesionally (up to 20 mg/kg total or 850 mg of antimony component) weekly for 5-10 weeks
- May be combined with Cryotherapy
VI. Dosing: IV or IM
- Precautions- Dilute intravenous doses in 50 ml D5W or NS prior to administration
- Administer over >=10 minutes
 
- Meglumine Antimoniate 20 mg/kg/day up to 850 mg (of antimony component) IV or IM
- Duration- Mucosal or Visceral Leishmaniasis: 28 days
- Cutaneous Leishmaniasis: 20 days
 
VII. Adverse Effects
VIII. Safety
- Pregnancy- Avoid in pregnancy (suspected to be Teratogenic)
 
- 
                          Lactation
                          - Likely safe in Lactation given low milk concentrations
- Consider avoiding Breast Feeding young infants (age <2 months) while taking Meglumine Antimoniate
 
- Monitoring: Baseline and weekly labs
IX. Resources
- Glucantime Drug Profile (ASTMH)
X. References
- Freedman (2025) Sanford Guide, accessed 7/13/2025 on IOS
