Anti-leishmanial Drug Discovery: Rising to the Challenges of a Highly Neglected Disease

Table 2

Anti-leishmanial Treatments

Drug	Primary Use	Comments
Pentavalent antimony (sodium stibogluconate, meglumine antimoniate)	Cutaneous, Muco-cutaneous, Visceral	Adverse effects include cardiotoxicity, pain, nausea. Will no longer be manufactured by GlaxoSmith Kline, UK after 2012.
Amphotericin B formulations (polyene antibiotic)	Muco-cutaneous, Visceral, Cutaneous	Impacts cell membrane integrity. No known MOA. Adverse effects include painful administration, anemia, hypokalemia, renal toxicity. Multiple formulations.
Pentamidine (diamidine)	Cutaneous, Muco-cutaneous, Visceral	No known MOA. Rare adverse effects but include pain, nausea, vomiting.
Fluconazole	Cutaneous	Effects ergosterol biosynthesis. Rare adverse effects but include pain, nausea, diarrhea.
Itracanazole	Cutaneous	Effects ergosterol biosynthesis. Adverse effects include pain, nausea, diarrhea.
Allopurinol	Cutaneous	Inhibits xanthine oxidase. Adverse effects include pain, nausea, rash, diarrhea.
Paromomycin (aminosidine, monomycin)	Visceral, Cutaneous	Impacts protein synthesis. Adverse effects include pain, nausea, diarrhea, liver toxicity, erythema, mild edema.
Ketoconazole	Cutaneous	Effects ergosterol biosynthesis. Adverse effects include hepatotoxicity, endocrine dysfunction.
Miltefosine (hexadecylphosphocholine)	Visceral	Impacts cell membrane integrity. No known MOA. Adverse effects include nausea, vomiting, diarrhea.