26
Treatment
Table 3b. Approach to Syndromic Treatment of Mucosal
Leishmaniasis (ML) in North America
1,2
Treatment
Classification
Generic (Brand)
Source and Availability Regimen
Treatment of
choice
ere is no treatment of choice; choice should be individualized.
Alternatives Amphotericin B deoxycholate
(Fungizone
®
)
Bristol Myers Squibb
0.5–1.0 mg/kg per dose
daily IV or every other
day for cumulative total of
~20–45 mg/kg
Liposomal amphotericin B
(AmBisome
®
)
Astellas
~3 mg/kg/day IV for
cumulative total of
~20–60 mg/kg
Miltefosine (Impavido
®
)
• In US: Knight Therapeutics, via
Profounda, the US marketer.
• In Canada: via Special Access
Program
FDA- approved regimen:
• 30–44 kg : 50 mg bid PO
for 28 days
• ≥45 kg : 50 mg tid PO for
28 days
Pentavalent antimonials
4
Sodium stibogluconate
(Pentostam
®
)
GlaxoSmithKline
• via CDC Drug Service or
USAMMDA for military health
care beneficiaries
13
20 mg Sb
V
/kg/day for 28
days IV, IM (IV preferred in
North America
1
)
Meglumine antimoniate
(Glucantime
®
)
Sanofi
• via Special Access Program in
Canada
As per Pentostam
®
Lesser
alternative
Pentamidine isethionate
(Pentam 300
®
)
APP Pharmaceuticals
2–4 mg/kg every other day
or 3 times per week for ≥15
doses IV, IM (IV preferred
in North America
1
)
