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Miltefosine Disease Interactions

There are 4 disease interactions with miltefosine.

Major

Miltefosine (applies to miltefosine) Sjogren-Larsson syndrome

Major Potential Hazard, High plausibility.

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.

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Moderate

Miltefosine (applies to miltefosine) liver disease

Moderate Potential Hazard, High plausibility.

Elevations in liver transaminases (ALT, AST) and bilirubin were observed in clinical trials of miltefosine for the treatment of visceral leishmaniasis. Patients with serum ALT or AST levels at least 3 times the upper limit of normal and bilirubin levels at least 2 times the upper limit of normal were excluded from clinical trials. The pharmacokinetics of miltefosine have not been studied in patients with liver dysfunction; caution is recommended. Liver transaminases (ALT, AST) and bilirubin should be monitored during therapy.

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Moderate

Miltefosine (applies to miltefosine) renal dysfunction

Moderate Potential Hazard, High plausibility. Applicable conditions: Dehydration

Elevations in serum creatinine were observed in clinical trials of miltefosine for the treatment of cutaneous, mucosal, and visceral leishmaniasis. Patients with serum creatinine or BUN levels at least 1.5 times the upper limit of normal were excluded from clinical trials. The pharmacokinetics of miltefosine have not been studied in patients with renal dysfunction; caution is recommended. Renal function should be monitored weekly during therapy and for 4 weeks after completion of therapy. Abdominal pain, nausea, vomiting, and diarrhea are common side effects of miltefosine; patients should be advised to drink plenty of fluids to avoid dehydration (and, thus, the risk of kidney injury) and to seek medical attention if these gastrointestinal side effects are persistent or severe.

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Moderate

Miltefosine (applies to miltefosine) thrombocytopenia

Moderate Potential Hazard, Moderate plausibility.

Thrombocytopenia has been reported during treatment of visceral leishmaniasis, including with miltefosine. Therapy with miltefosine should be administered cautiously in patients with preexisting thrombocytopenia. Platelet counts should be monitored during therapy for visceral leishmaniasis.

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Miltefosine drug interactions

There are 6 drug interactions with miltefosine.

Miltefosine alcohol/food interactions

There is 1 alcohol/food interaction with miltefosine.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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