Miltefosine

Impavido
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris.wikipedia
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Leishmaniasis

Mucocutaneous leishmaniasisantileishmanialDum-dum fever
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris.
Some possible medications used for visceral disease include liposomal amphotericin B, a combination of pentavalent antimonials and paromomycin, and miltefosine.

Visceral leishmaniasis

kala-azarkala azarblack fever
This includes the three forms of leishmaniasis: cutaneous, visceral and mucosal. Miltefosine is primarily used for the treatment of visceral and New World cutaneous leishmaniasis, and is undergoing clinical trials for this use in several countries.
Miltefosine is the first oral treatment for this disease.

WHO Model List of Essential Medicines

World Health Organization's List of Essential MedicinesList of Essential MedicinesModel List of Essential Medicines
It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.

Naegleria fowleri

N. fowleri
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris.
Miltefosine, an antiparasitic drug which inhibits the pathogen via disrupting its cell survival signal pathway PI3K/Akt/mTOR, has been used in a few cases with mixed results.

Sodium stibogluconate

Pentostam
In 1992 a new research was reported in which the compound was highly effective in mouse against different life cycle stages of different Leishmania species, and in fact, more potent than the conventional sodium stibogluconate therapy by a factor of more than 600.
Some combination of miltefosine, paramycin and liposomal amphotericin B, however, may be recommended due to issues with resistance.

Naegleriasis

primary amoebic meningoencephalitisamoebic meningitisprimary amebic meningoencephalitis
It has orphan drug status in the United States for acanthamoeba keratitis and primary amebic meningoencephalitis (PAM).
In 2013, the two most recent successfully treated cases in the United States utilized drug combinations that included the medication miltefosine as well as targeted temperature management to manage cerebral edema that is secondary to the infection.

Leishmania donovani

L. donovaniDonovan's ''LeishmaniaLeishmania donavani
The compound was effective against Leishmania donovani amastigotes in cultured mouse peritoneal macrophages at a dose of 12.8 mg/kg/day in a five-day course.
In 1999 an anticancer drug miltefosine was demonstrated to be highly effective (95% cure rate) among Indian patients.

Protein kinase B

AktPKBAKT inhibitor
The HIV protein Tat activates pro-survival PI3K/Akt pathway in primary human macrophages.
Miltefosine is approved for leishmaniasis and under investigation for other indications including HIV.

Amoebiasis

amoebic dysenteryamebiasisdysentery
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris.

Balamuthia mandrillaris

BalamuthiaBalamuthiidae
Miltefosine, sold under the trade name Impavido among others, is a medication mainly used to treat leishmaniasis and free-living amoeba infections such as Naegleria fowleri and Balamuthia mandrillaris.

Cutaneous leishmaniasis

Oriental sorecutaneousAleppo boil
This includes the three forms of leishmaniasis: cutaneous, visceral and mucosal. Miltefosine is primarily used for the treatment of visceral and New World cutaneous leishmaniasis, and is undergoing clinical trials for this use in several countries.

Amphotericin B

amphotericinliposomal amphotericin BAbelcet
It may be used with liposomal amphotericin B or paromomycin.

Paromomycin

HumatinaminosidineParomomycin sulfate
It may be used with liposomal amphotericin B or paromomycin.

Vomiting

emeticvomitemesis
Common side effects include vomiting, abdominal pain, fever, headaches, and decreased kidney function.

Fever

pyrexiafebrileague
Common side effects include vomiting, abdominal pain, fever, headaches, and decreased kidney function.

Headache

headacheschronic headacheheadach
Common side effects include vomiting, abdominal pain, fever, headaches, and decreased kidney function.

Stevens–Johnson syndrome

Stevens-Johnson syndromeSteven Johnson syndromeStevens Johnson syndrome
More severe side effects may include Stevens-Johnson syndrome or low blood platelets.

Thrombocytopenia

low platelet countthrombocytopaenialow platelets
More severe side effects may include Stevens-Johnson syndrome or low blood platelets.

Pregnancy

pregnantfirst trimesterpregnant women
Use during pregnancy appears to cause harm to the baby and use during breastfeeding is not recommended.

Breastfeeding

breast feedingbreastfeedbreast-feeding
Use during pregnancy appears to cause harm to the baby and use during breastfeeding is not recommended.

Cancer

cancersmalignanciescancerous
Miltefosine was first made in the early 1980s and studied as a treatment for cancer.

Health system

health care systemhealthcare systemhealth systems
It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.

Developing country

developing countriesdeveloping worlddeveloping nations
In the developing world a course of treatment costs US$65 to $150.

Developed country

developed countriesdeveloped worlddeveloped
In the developed world treatment may be 10 to 50 times greater.

Clinical trial

clinical trialsclinical studiesclinical study
Miltefosine is primarily used for the treatment of visceral and New World cutaneous leishmaniasis, and is undergoing clinical trials for this use in several countries.