36
Azoles (Oral)
All azoles GI symptoms (eg, nausea,
vomiting, abdominal pain);
headache; hepatotoxicity
Baseline and weekly assessment
of hepatic function (eg,
aminotransferase levels).
More frequent and/or additional
types of monitoring (eg, ECG,
CBC) may be indicated or
prudent for some patients.
Fluconazole
(Oral)
See above.
Also: reversible hair loss and
agranulocytosis
See above.
Ketoconazole
k
(Oral)
See above.
Risk for severe hepatoxicity (fatal
or requiring transplantation) may
be higher than with other azoles
and may occur regardless of dose/
duration of therapy.
k
Highdose therapy may be
associated with decreased secretion
of adrenal corticosteroids and/
or reversible decreases in serum
testosterone levels.
See above.
Others
Miltefosine
k
(Oral)
GI symptoms (nausea/vomiting
> diarrhea), mainly early in
treatment course; dizziness/
motion sickness; scrotal pain
(decreased/absent ejaculate);
nephrotoxicity and/or
hepatoxicity
Baseline and weekly assessment of
renal function.
Also (particularly, if VL)
monitor hepatic function
(aminotransferase and bilirubin
levels) and CBC (platelet count).
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
