sodium antimony gluconate

Action and Spectrum

Actions and spectrum: 

sodium antimony gluconate is a medication used primarily to treat leishmaniasis, a parasitic infection caused by protozoa of the Leishmania genus. It is part of a class of drugs known as antiprotozoal agents and is specifically used to combat visceral leishmaniasis (kala-azar) and cutaneous leishmaniasis. 

The spectrum of action for sodium antimony gluconate is limited to treating infections caused by Leishmania parasites. It is not effective against other types of parasitic infections or unrelated microbial pathogens. 

sodium antimony gluconate is administered intravenously and works by disrupting the growth and replication of Leishmania parasites in the body. It is considered the treatment of choice for visceral leishmaniasis and is used in specific regions where this parasitic infection is prevalent. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Nausea 

injection site Pain 

Loss of appetite 

Abdominal pain 

ECG changes 

Vomiting 

Myalgia 

Cough 

Headache 

Tiredness 

Anaphylactic shock 

Diarrhoea 

Black Box Warning

Black Box Warning: 

there is no specific black box warning associated with sodium antimony gluconate. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity: Patients who have a known hypersensitivity or allergy to sodium antimony gluconate or any of its components should not use this medication. 
• Pregnancy and Breastfeeding: The safety of sodium antimony gluconate during pregnancy and breastfeeding is not well-established. It should be used with caution in pregnant or breastfeeding women, and the potential benefits should be carefully weighed against the risks. 
• Electrolyte Imbalance: sodium antimony gluconate can lead to electrolyte imbalances, such as changes in sodium and potassium levels. Patients should be monitored for signs of electrolyte disturbances, and any pre-existing imbalances should be corrected before starting treatment.

Caution: 

• Cardiac Conditions: sodium antimony gluconate may affect the electrical activity of the heart. Patients with pre-existing cardiac conditions or a history of arrhythmias should use this medication with caution. 
• Pediatric Use: The safety and efficacy of sodium antimony gluconate in pediatric populations have not been well-established. It is not recommended for use in children unless the potential benefits outweigh the risks, and the healthcare provider deems it necessary. 
• Elderly Patients: Special caution may be required in elderly patients, as they may be more susceptible to the side effects and complications of this medication.

Comorbidities: 

• Hepatic Impairment: Patients with pre-existing liver disease or impaired liver function may have difficulty metabolizing sodium antimony gluconate. The medication can further impact liver function, so careful monitoring and potential dose adjustments are needed in such cases. 
• Renal Impairment: Kidney function is essential for the elimination of drugs from the body. sodium antimony gluconate can affect renal function, and individuals with pre-existing kidney problems may require dose adjustments or more frequent monitoring. 
• Immunosuppression: Individuals who are immunosuppressed due to medical conditions or medications may be at increased risk of leishmaniasis and may have different responses to treatment. The impact of sodium antimony gluconate in immunosuppressed patients should be studied carefully. 

Pregnancy / Lactation

Pregnancy consideration:  

pregnancy category: not assigned 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• <b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

sodium antimony gluconate is a medication used to treat leishmaniasis, a parasitic infection. Its pharmacology revolves around its antimonial properties, as it contains pentavalent antimony. This compound interferes with the parasites’ ability to reproduce and survive in the human body. sodium antimony gluconate is administered intravenously and distributed throughout the body.

It primarily accumulates in the liver and spleen, where it exerts its antileishmanial effects. While its exact mechanism of action is not fully understood, it is believed to inhibit enzymes essential for the parasite’s survival. The drug is eliminated primarily through the kidneys. It can have side effects and requires careful monitoring due to potential toxicities, especially in the liver and kidneys.  

Pharmacodynamics: 

• Inhibition of Enzymes: SAG contains pentavalent antimony, which is toxic to Leishmania parasites. It interferes with the parasites’ metabolic pathways, primarily through the inhibition of enzymes involved in essential biochemical processes. This disrupts the parasites’ ability to reproduce and survive in the human host. 
• Amastigote Transformation: In the human body, Leishmania parasites exist in two forms, promastigotes (the infective form) and amastigotes (the replicative form). SAG is particularly effective against amastigotes, where it interferes with their replication and survival. 
• Immune System Modulation: SAG may also modulate the host’s immune response. By affecting the parasites and reducing their numbers, it can help the host’s immune system regain control and eliminate the infection more effectively.

Pharmacokinetics: 

Absorption: 

• Absorption Route: SAG is typically administered via intravenous injection or infusion. This route ensures rapid and complete absorption into the bloodstream. 

Distribution: 

• Distribution in Tissues: After absorption, SAG is distributed throughout the body, where it targets the Leishmania parasites responsible for leishmaniasis. It has an affinity for the cells where these parasites reside. 
• Tissue Penetration: SAG is known to penetrate cells, including macrophages, which are the primary host cells for Leishmania parasites. 

Metabolism: 

• Metabolic Pathways: SAG itself is not significantly metabolized in the body. It acts directly on the parasites by interfering with their metabolic pathways. 

Excretion: 

• Excretion Route: SAG and its metabolites are primarily eliminated via the renal route (through the kidneys). Renal clearance is an important process for the removal of SAG from the body. 
• Elimination Half-Life: The half-life of SAG in the body is short, which means it is eliminated within a few hours after administration. 

Adminstartion

Administration: 

• Intravenous Administration: SAG is usually administered via intravenous (IV) injection or infusion. This ensures that the medication is delivered directly into the bloodstream for rapid and effective action. 
• Dosage: The dosage of SAG is determined by the healthcare provider based on factors such as the patient’s weight, the severity of the infection, and the specific type of leishmaniasis being treated. 
• Frequency: The frequency of administration may vary depending on the treatment protocol, but it is typically administered daily for several days to weeks.  
• Monitoring: Patients receiving SAG therapy are closely monitored for adverse effects or signs of toxicity. Regular blood tests and kidney function tests are often conducted to ensure the drug is being tolerated well and that it is effectively treating the infection. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: sodium antimony gluconate 

Pronounced: (soh-dee-uhm an-tee-muh-nee gloo-coh-nayt)  

Why do we use sodium antimony gluconate? 

SAG is a key treatment option for visceral leishmaniasis, also known as kala-azar. It is an intravenous medication used to combat the parasite causing this disease. Visceral leishmaniasis is of particular concern in HIV-positive individuals who may have weakened immune systems.

SAG may be used in the treatment of visceral leishmaniasis in these patients. While SAG is not typically the first-line treatment for cutaneous leishmaniasis (a form of leishmaniasis that affects the skin), it may be considered when other treatments are not effective or in cases of severe disease.