How Do Antileishmaniasis Agents Work?

Antileishmaniasis agents are a class of drugs that are used to treat an infection called leishmaniasis. Leishmaniasis is a parasitic infection caused by protozoan parasites which are transmitted by the bite of infected female phlebotomine sandflies. This disease particularly affects some of the poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and a lack of financial resources.

Leishmaniasis is a tropical disease categorized into the following three types:

• Visceral leishmaniasis: It is also known as ‘kala azar’ and is the most severe form of the disease, affecting the internal organs.
• Cutaneous leishmaniasis: It is the most commonly seen type of disease affecting the skin.
• Mucosal leishmaniasis: It affects the nose, mouth, and throat.
• Antileishmaniasis agents are administered via the oral and intravenous or intramuscular routes. Oral medication is taken twice or thrice daily with food for 28 consecutive days.

Antileishmaniasis agents work in the following ways:

• They work by stopping the growth of the parasites.
• They bind to the thiol groups in the parasite and inhibit the formation of adenosine triphosphate and guanosine triphosphate.
• This causes a decrease in the parasite’s DNA, RNA protein, and purine nucleoside triphosphate levels which further stops their macromolecular synthesis.

Antileishmaniasis agents are used in conditions such as:

Leishmaniasis (infection with Leishmania parasites which causes skin sores and affects several internal organs usually the spleen, liver, and bone marrow)

• Visceral leishmaniasis due to Leishmania donovani
  • Cutaneous leishmaniasis due to Leishmania braziliensis, Leishmania guyanensis, and Leishmania panamensis
  • Mucosal leishmaniasis due to Leishmania braziliensis
• Acute Myeloid Leukemia (a type of cancer that starts in the blood-forming cells of the bone marrow)

Some of the common side effects include:

• Nausea
• Headache
• Vomiting 
• Diarrhea 
• Abdominal pain
• Decreased appetite 
• Joint/muscle pain
• Sleepiness
• Fatigue (tiredness)
• Elevated serum amylase (amylase is a digestive enzyme that helps the body break down carbohydrates)
• Loss of appetite
• Pruritis (itching)
• Other rare side effects include:
• Dizziness (feeling faint, weak, or unsteady)
• Testicular pain and absent or decreased ejaculation
• Increased serum creatinine
• Asthenia (abnormal physical weakness or lack of energy)
• Decreased platelets 
• Yellowing of skin and eyes (jaundice)
• Rash
• Raised liver enzymes
• Pancreatitis (inflammation of the pancreas)
• Liver damage
• Vertigo (a sensation of feeling off-balance)
• Fever
• Bleeding from nose or gums
• Pain and thrombosis (formation of a blood clot) on intravenous administration or intramuscular injection

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Drug names of antileishmaniasis agents include:

• Impavido
• Miltefosine
• Pentostam
• Sodium stibogluconate
• Stibogluconate sodium