34
Pentavalent antimonial (Sb
V
) compounds
Sodium
stibogluconate
(Pentostam®)
and meglumine
antimoniate
(Glucantime®)
(IV, IMa)
Various symptoms (eg, myalgia,
large- joint arthralgia, headache,
malaise, fatigue, anorexia,
nausea) commonly noted as
treatment course progresses.
Laboratory abnormalities
usually reversible (during or
aer treatment), including
elevated aminotransferase,
lipase, and amylase values (see
Recs. comments). Also, ECG
abnormalities (eg, nonspecific
ST-T-wave changes. Less
oen, clinically relevant QTc
prolongation) and cytopenias
(in VL, pretreatment cytopenias
typically improve during
therapy).
Baseline and weekly serum
chemistry values (eg,
aminotransferase s, lipase/
amylase, potassium, creatinine,
BUN, glucose), CBC, and ECG.
More frequent monitoring may
be indicated or prudent for some
patients (see Recs. 78-79).
Others
Pentamidine
Isethionate (IV,
IM)
Various symptoms (eg, nausea,
vomiting, dysgeusia, headache);
hypo/hyperglycemia, insulin-
dependent diabetes mellitus
(may be diagnosed up to
several months posttreatment),
pancreatitis, hypotension, QTc
prolongation, nephrotoxicity,
hyperkalemia, hypocalcemia,
hepatoxicity, cytopenias
(leukopenia/thrombocytopenia
> anemia), rhabdomyolysis.
If IM: also pain and sterile
abscesses at injection sites.
Assess before, during, and aer
therapy: serum chemistry values,
CBC, and ECG. Monitor fasting
glucose level (and urinalysis)
before each dose and ~3 weeks
and ~2–3 months post-treatment.
If indicated (if potential for
rhabdomyolysis), check or
monitor CPK level.
Table 4. Drugs Used in North America for Systemic
a
Antileishmanial Therapy: Adverse Events, Monitoring
for Toxicity, and Mitigation Approaches
b
(cont'd)
Drug
c
(Route(s) of
Administration) Adverse Events
d,e
Laboratory Monitoring for
Toxicity
d,f
Treatment
