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Miltefosine Disease Interactions

There are 4 disease interactions with miltefosine:

Major

Miltefosine (Includes Miltefosine) ↔ Sjogren-Larsson Syndrome

Severe Potential Hazard, High plausibility

Applies to: Sjogren-Larsson Syndrome

The use of miltefosine is contraindicated in patients with Sjogren-Larsson syndrome. Miltefosine undergoes metabolic cleavage in hepatocytes to release choline. The fatty alcohol-containing fragment of miltefosine is then oxidized to palmitic acid, which enters the metabolism of fatty acids. However, this oxidation is blocked in patients with Sjogren-Larsson syndrome, who have a genetic defect in fatty aldehyde dehydrogenase activity.

Moderate

Miltefosine (Includes Miltefosine) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Elevations in liver transaminases (ALT, AST) and bilirubin were observed in clinical trials of miltefosine for the treatment of visceral leishmaniasis. Therapy with miltefosine should be administered cautiously in patients with liver disease, as the pharmacokinetics of miltefosine have not been studied in this population. Patients with serum ALT or AST levels 3 times or higher than the upper limit of normal and bilirubin levels 2 times or higher than the upper limit of normal were excluded from clinical trials. Liver transaminases and bilirubin should be monitored regularly during therapy.

Moderate

Miltefosine (Includes Miltefosine) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Elevations in serum creatinine were observed in clinical trials of miltefosine for the treatment of cutaneous, mucosal, and visceral leishmaniasis. Therapy with miltefosine should be administered cautiously in patients with renal impairment, as the pharmacokinetics of miltefosine have not been studied in this population. Patients with serum creatinine or BUN levels 1.5 times or higher than the upper limit of normal were excluded from clinical trials. Renal function should be monitored weekly during therapy and for 4 weeks after completion of therapy. Miltefosine may commonly cause gastrointestinal adverse reactions. Patients should be advised to drink plenty of fluids to help prevent dehydration and kidney injury if they experience diarrhea or vomiting, and to seek medical attention if it is persistent or severe.

Moderate

Miltefosine (Includes Miltefosine) ↔ Thrombocytopenia

Moderate Potential Hazard, Moderate plausibility

Applies to: Thrombocytopenia

Thrombocytopenia was observed in clinical trials of miltefosine for the treatment of visceral leishmaniasis. Therapy with miltefosine should be administered cautiously in patients with preexisting thrombocytopenia. Platelet counts should be monitored regularly during therapy.

miltefosine drug Interactions

There are 23 drug interactions with miltefosine

miltefosine alcohol/food Interactions

There is 1 alcohol/food interaction with miltefosine

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. 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.

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