This drug is an orally bio-available chemical that was originally studied as an antitumor agent. Subsequent to the serendipitous laboratory finding that miltefosine was active against Leishmania in vitro, it was tested in dogs in vivo and found to be an effective agent at eliminating parasitemia. The advantage of this drug is that its direct anti-parasitic activity is not dependent on a functional immune system.
Recently registered for the oral treatment of canine leishmaniasis in several European countries, miltefosine has been used in combination with marbofloxacin and/or allopurinol, with good efficacy even when used as a stand-alone therapy. However, clearance of the parasite, as evidence by PCR testing of L. infantum antigens is rarely complete when used alone.
Recommended dose rate in dogs is 2 mg/kg orally once daily for 28 days in conjunction with allopurinol at 10 mg/kg orally twice daily for 7 months to potentiate the efficacy of both drugs and limit drug resistance.
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