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miltefosine

Generic Name: miltefosine (MIL te FOE seen)
Brand Name: Impavido

What is miltefosine?

Miltefosine is an anti-parasitic drug used to treat leishmaniasis, a disease caused by an infection with parasites that enter the body through the bite of an infected sand fly.

Miltefosine is used to treat leishmaniasis affecting the skin, internal organs (such as the liver, spleen or bone marrow), and mucous membranes (nose, mouth, and throat).

Miltefosine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about miltefosine?

In animal studies, miltefosine has caused birth defects and death of unborn offspring. It is not known whether these effects would occur in people. You should not use miltefosine if you are pregnant.

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You may need to have a negative pregnancy test before starting this treatment. Use effective birth control while you are taking miltefosine and for at least 5 months after your treatment ends.

What should I discuss with my healthcare provider before taking miltefosine?

You should not use miltefosine if you are allergic to it, or if you have:

  • a rare genetic skin and nerve disorder called Sjogren-Larsson syndrome; or

  • if you are pregnant.

To make sure miltefosine is safe for you, tell your doctor if you have:

  • liver or kidney disease.

In animal studies, miltefosine caused birth defects and death of unborn offspring, and also affected fertility in male and female adults. It is not known whether these effects would occur in people using miltefosine. Ask your doctor about your risk.

FDA pregnancy category D. You should not use miltefosine if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use effective birth control while you are taking miltefosine and for at least 5 months after your treatment ends.

Vomiting or diarrhea caused by miltefosine can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy if you have vomiting and/or diarrhea while taking miltefosine.

If you become pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of miltefosine on the baby.

It is not known whether miltefosine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine, and for at least 5 months after your treatment ends.

Miltefosine should not be given to a child younger than 12 years old.

How should I take miltefosine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take with food to lessen upset stomach.

Do not crush, chew, break, or dissolve a miltefosine tablet. Swallow it whole.

Tell your doctor if you have any changes in weight. Miltefosine doses are based on weight (especially in children and teenagers), and any changes may affect the dose.

Vomiting or diarrhea can cause you to become dehydrated. This can lead to kidney failure while you are taking miltefosine. Drink plenty of water each day while you are taking this medicine.

While using miltefosine, you may need frequent blood tests. Your kidney function will need to be checked during treatment and for 4 weeks after you stop using miltefosine.

Miltefosine is usually taken for 28 days in a row. Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared.

Store at room temperature away from moisture and heat. Keep each tablet in its blister pack until you are ready to take it.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking miltefosine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Miltefosine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe or ongoing stomach problems (nausea, vomiting, diarrhea);

  • (in men) pain in the scrotum or testicles, abnormal ejaculation;

  • easy bruising or bleeding (nosebleeds, bleeding gums);

  • signs of a kidney problem--little or no urinating; painful or difficult urination; swelling in your feet or ankles; feeling tired or short of breath;

  • liver problems--nausea, upper stomach pain, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • nausea, vomiting, stomach pain, loss of appetite;

  • diarrhea;

  • headache, dizziness, drowsiness; or

  • itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Miltefosine dosing information

Usual Adult Dose for Leishmaniasis:

30 kg to 44 kg: 50 mg orally twice a day with food
45 kg or greater: 50 mg orally three times a day with food
Duration of therapy: 28 consecutive days

What other drugs will affect miltefosine?

Other drugs may interact with miltefosine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about miltefosine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02. Revision Date: 2014-04-29, 3:20:06 PM.

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