Meglumine Antimoniate Injection

What is Meglumine Antimoniate Injection?
Meglumine Antimoniate is a pentavalent antimonial ($Sb^V$) compound used as a primary antiparasitic agent. It is specifically indicated for the treatment of Leishmaniasis—a disease caused by protozoan parasites transmitted by the bite of infected sandflies. It remains one of the most vital medications in tropical medicine, particularly in regions where visceral and cutaneous leishmaniasis are endemic.
 
Uses of Meglumine Antimoniate Injection
Visceral Leishmaniasis (Kala-azar): Treatment of the systemic form of the disease which affects internal organs like the liver, spleen, and bone marrow.
Cutaneous Leishmaniasis: Management of skin lesions and ulcers caused by the parasite.
 
Mucocutaneous Leishmaniasis: Treatment of infections that affect the mucous membranes of the nose, mouth, and throat.
Post-Kala-azar Dermal Leishmaniasis (PKDL): Used to treat the skin manifestations that sometimes follow the systemic infection.
How Does Meglumine Antimoniate Work?
The exact mechanism is still being studied, but it is widely believed that Meglumine Antimoniate acts as a prodrug. Once injected, the pentavalent antimony ($Sb^V$) is reduced to the more toxic trivalent antimony ($Sb^{III}$) within the parasite. This trivalent form interferes with the parasite's energy metabolism by inhibiting glycolysis and fatty acid oxidation, and it induces oxidative stress, ultimately leading to the death of the Leishmania amastigotes.
 
FAQs on Meglumine Antimoniate Injection
1. How is this medication administered?
It is usually administered via deep intramuscular (IM) injection or slow intravenous (IV) infusion. The dosage is typically calculated based on the patient's body weight and the specific type of leishmaniasis being treated. Treatment cycles often last between 20 to 28 consecutive days.
 
2. What are the common side effects?
Common side effects include joint and muscle pain (myalgia), nausea, and abdominal pain. Because antimony can be taxing on the body, clinicians must monitor the patient’s ECG (for QT prolongation), as well as liver and pancreatic enzyme levels throughout the treatment course.
 
3. Is there a risk of resistance?
Yes. In some geographical regions, particularly in parts of India, there have been reports of parasite resistance to pentavalent antimonials. In such cases, alternative treatments like Amphotericin B or Miltefosine may be required.
 
Therapeutic Category
Antiparasitic / Antiprotozoal (Pentavalent Antimonial)
 
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