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Leishmaniasis

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38 Footnotes for Table 4 a. See Table 3 and text (eg, XIV and Recs. 38–39 & 78–79) regarding nonsystemic drug therapies, including treatment with intralesional Sb V and topical paromomycin. b. To help ensure safe and effective therapy, see full prescribing information for additional details, including potential drug interactions. Expert consultation also is encouraged regarding such issues as whether to start, continue, or interrupt therapy with a particular antileishmanial agent; to adjust the dosage regimen; or to select a different agent if the patient has or develops laboratory abnormalities or comorbid conditions. On principle, minimize the use of other medications/supplements and avoid alcohol. c. In general, drugs are listed alphabetically in the parenteral and oral categories and in the subcategories (eg, azoles); however, "pentavalent antimonial compounds" are listed before "pentamidine isethionate." d. Not all-inclusive. e. Selected examples are provided (eg, comparatively common or noteworthy adverse events); potential dermatologic effects and phlebitis (if IV) are not addressed. In general, symptoms are listed first. The types and rates of adverse events associated with a particular drug may vary, depending on interrelated factors such as the leishmanial syndrome, dosage regimen, and host characteristics (eg, immunologic status, comorbid conditions, concomitant/recent use of other medications). f. Should be individualized. g. Use during pregnancy only if clearly indicated (see Recs. 78–79); expert consultation encouraged. h. The potential for risk to breastfeeding infants cannot be excluded; expert consultation encouraged. i. Some of the examples (eg, headache, GI symptoms) are not necessarily just infusion related. j. Reproduction studies in animals have not demonstrated fetal risk. However, data from adequate, controlled studies in pregnant women are not available. k. See boxed warning (also known as "black box warning") in prescribing information. Treatment

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