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Miltefosine



Miltefosine
Systematic (IUPAC) name
2-(hexadecoxy-oxido-phosphoryl)oxyethyl-trimethyl-azanium
Identifiers
CAS number 58066-85-6
ATC code L01XX09
PubChem 3599
Chemical data
Formula C21H46NO4P 
Mol. mass 407.568 g/mol
Pharmacokinetic data
Bioavailability High
Metabolism  ?
Half life 6 to 8 days
Excretion  ?
Therapeutic considerations
Pregnancy cat.

?

Legal status
Routes Oral

Miltefosine (INN, trade names Impavido and Miltex) is an antiprotozoal drug. Originally developed as an antineoplastic, it is finding use as an antiprotozoal drug. It can be administered orally and intravenously.

Contents

Current antiprotozoal and antifungal applications

Leishmania: Miltefosine is registered and used by Zentaris GmbH in India, Colombia and Germany for the treatment of visceral and cutaneous leishmaniasis, and is undergoing clinical trials for this use in several other countries, such as Brazil[1] and Guatemala.[2] It is currently the only effective oral treatment for leishmaniasis.

Miltefosine is one of the few orally administered drugs that is effective against Leishmania [3]


Investigatory antiprotozoal and antifungal usage

Miltefosine is being investigated by researchers interested in finding treatments for infections which have become resistant to existing drugs. Animal and in-vitro studies suggest it may have broad anti-protozoal and anti-fungal properties:

  • Animal studies suggest miltefosine may also be effective against Trypanosoma cruzi, the parasite responsible for Chagas' disease. [4]
  • Several studies have found the drug to be effective against Cryptococcus neoformans, Candida, Aspergillus and Fusarium.[5]
  • An in-vitro study found that Miltefosine is effective against metronidazole-resistant variants of Trichomonas vaginalis, a sexually transmitted protozoal disease.[6]


Side effects

The main side effects reported with miltefosine treatment are nausea and vomiting. Miltefosine has exhibited teratogenicity, and should not be administered to pregnant women.


References

  1. ^ Cristina, Márcia; Pedrosa, Robert. "Hospital de Doenças Tropicais testa droga contra calazar", Sapiência, Fundação de Amparo à Pesquisa do Estado do Piauí, September 2005. Retrieved on 2006-09-01. (Portuguese) 
  2. ^ Soto J, Berman J (2006). "Treatment of New World cutaneous leishmaniasis with miltefosine.". Trans R Soc Trop Med Hyg. PMID 16930649.
  3. ^ Berman J (2005). "Clinical status of agents being developed for leishmaniasis". Expert opinion on investigational drugs 14 (11): 1337–46. doi:10.1517/13543784.14.11.1337. PMID 16255674.
  4. ^ Saraiva V, Gibaldi D, Previato J, Mendonça-Previato L, Bozza M, Freire-De-Lima C, Heise N (2002). "Proinflammatory and cytotoxic effects of hexadecylphosphocholine (miltefosine) against drug-resistant strains of Trypanosoma cruzi.". Antimicrob Agents Chemother 46 (11): 3472-7. PMID 12384352.
  5. ^ Widmer F, Wright L, Obando D, Handke R, Ganendren R, Ellis D, Sorrell T (2006). "Hexadecylphosphocholine (miltefosine) has broad-spectrum fungicidal activity and is efficacious in a mouse model of cryptococcosis.". Antimicrob Agents Chemother 50 (2): 414-21. PMID 16436691.
  6. ^ Blaha C, Duchêne M, Aspöck H, Walochnik J (2006). "In vitro activity of hexadecylphosphocholine (miltefosine) against metronidazole-resistant and -susceptible strains of Trichomonas vaginalis". J. Antimicrob. Chemother. 57 (2): 273–8. doi:10.1093/jac/dki417. PMID 16344287.
  7. ^ Choubey V, Maity P, Guha M, Kumar S, Shrivastava K, Puri SK, Bandyopadhyay U (2006). "Inhibition of Plasmodium falciparum choline kinase by hexadecyltrimethylammonium bromide: A possible antimalarial mechanism of hexadecyltrimethylammonium bromide.". Antimicrob Agents Chemother. PMID 17145794.
 
This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Miltefosine". A list of authors is available in Wikipedia.
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