32
Table 4. Drugs Used in North America for Systemic
a
Antileishmanial Therapy: Adverse Events,
Monitoring for Toxicity, and Mitigation Approaches
b
Drug
c
(Route(s) of
Administration) Adverse Events
d,e
Laboratory Monitoring for
Toxicity
d,f
Parenteral
Amphotericin B formulations
Amphotericin
B deoxycholate
(IV)
Infusion-related reactions
i
(eg, fever, rigors, headache,
nausea, vomiting, hypotension,
tachypnea), electrolyte
abnormalities (eg, hypokalemia,
hypomagnesemia),
nephrotoxicity, anemia
Baseline and frequent (eg, once
or twice weekly) serum chemistry
values and CBC. More frequent
and/or additional testing
(eg, ECG, urinalysis) may be
indicated or prudent for some
patients.
Liposomal
amphotericin
B (also other
lipid-associated
formulations of
amphotericin
B) (IV)
Usually better tolerated than
amphotericin B deoxycholate
but similar types of toxicity (eg,
renal). Infusion-related reactions
to liposomal amphotericin B
also can be caused by liposome-
induced complement activation-
related pseudoallerg y (CARPA;
see Recs. 51-54).
See above.
Treatment
