1 What is Impavido?

Brand: Impavido

Generic: Miltefosine

Impavido is used to treat leishmaniasis, a skin disease that causes the formation of open ulcers that does not heal on its own.

Leishmaniasis is caused by the protozoan parasite Leishmania, which is transmitted by bites from sandflies.

Leishmaniasis is very common in developing countries, especially tropic and subtropical areas, and it is a public health concern. Aside from causing open, painful and slow-healing ulcers in the skin, leishmaniasis also affects the mucous membranes of the mouth and nose, and in worst cases, infect vital organs such as the liver, spleen and bone marrow (visceral leishmaniasis).

Miltefosine is approved to treat all forms of leishmaniasis. Up to the time of writing, Miltefosine is the only oral drug for treatment of leishmaniasis in the United States.

2 What to Know Before Using

Your doctor will inform you of what you need to know before using Impavido.

The doctor will consider the following before prescribing miltefosine:

Miltefosine is highly contraindicated for pregnant patients. It is known that miltefosine can cause birth defects or death in fetuses. Do not take Miltefosine if you are or planning to get pregnant. The doctor may request you to have a pregnancy test first before starting Miltefosine treatment.

Miltefosine is also contraindicated in individuals with Sjogren-Larsson syndrome, a very rare genetic disease that causes dry scaly skin, paralysis in the legs and intellectual impairment.

Tell your doctor if you have or have a history of liver problems. Miltefosine may elevate liver enzymes, which can increase the risk of damage to the liver. The doctor may require regular liver tests during Miltefosine treatment.

Tell your doctor if you have or have a history of kidney disease. Miltefosine may increase levels of creatinine in the bloodstream, which may increase the risk of kidney damage in individuals with previous kidney issues.

The effect of Miltefosine on small nursing babies is not yet known. Because many drugs are expressed through breast milk, you have to stop breastfeeding while taking Miltefosine.

Note that Miltefosine may reduce effects of birth control pills. If you have vomiting and diarrhea due to taking the drug, you may have to use barrier birth control methods (condom, diaphragm with spermicide). You also need to continue using effective birth control for 5 months after the end of treatment. Ask your doctor if you have any questions.

Patients less than 12 years of age cannot use Miltefosine.

Tell your doctor if you have previous allergic reactions to Miltefosine. You also have to tell your allergies on food, other medications, and animal products as well.

3 Proper Usage

To use Impavido properly, you must follow all instructions given by your doctor.

Miltefosine is usually taken for 28 days. The doctor will determine the right dose of Miltefosine based on your current body weight. Always take the exact amount prescribed by the doctor.

Miltefosine must be taken with food to prevent stomach upset. Swallow the capsule whole. Do not bite, chew or break the capsule. Consume plenty of fluids throughout treatment to prevent dehydration and reduce risk to the kidneys.

Monitor changes on body weight and reports it to your doctor because Miltefosine doses are based on your body weight. This ensures the effectiveness of the drug.

4 Precautions to Take

Before using Impavido, there are some precautions you must take.

During Miltefosine treatment, the doctor will order regular blood tests to check the health of your liver and kidneys. These tests may continue for some time after the treatment. Stick to scheduled tests and visits.

Do not get pregnant or breastfeed during and for at least 5 months after Miltefosine treatment. If you get pregnant during treatment, call your doctor at once.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Impavido.

Miltefosine may cause serious side effects. Call your doctor at once if you experienced the following:

  • Severe nausea, vomiting or diarrhea
  • In men, having retrograde ejaculation or ‘dry orgasm.'
  • Bleeding tendencies, bruising or bleeding gums
  • Signs of kidney problems such as reduced urination, painful urination, shortness of breath, swelling of feet and ankles
  • Signs of liver problems such as nausea, upper stomach pain, yellowing of skin and eyes, dark colored urine and passing out clay-colored stools
  • Having severe reaction to the drug such as fever, sore throat, burning pain in the eyes, appearance of rashes, having pain, blistering and peeling of the skin

Miltefosine may cause other side effects that do not require immediate medical attention:

  • Itching
  • Nausea and vomiting
  • Loss of appetite
  • Stomach discomfort
  • Diarrhea

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