Sodium stibogluconate, also known by the brand name Pentostam, is a synthetic, pentavalent antimonial agent used primarily to treat leishmaniasis, a parasitic disease caused by sandfly bites. This includes cutaneous, visceral, and mucosal forms of leishmaniasis. It's considered the drug of choice in the United States, available through the Centers for Disease Control (CDC). However, combination therapy with other drugs like miltefosine, paromomycin, and liposomal amphotericin B may be considered due to increasing resistance. 

 

While the exact mechanism of action is not fully understood, it's believed that sodium stibogluconate may work by binding to thiol groups within the parasite and inhibiting the formation of high-energy phosphates like ATP and GTP. This potentially leads to decreased synthesis of essential macromolecules and ultimately reduces parasite viability. 

 

Sodium stibogluconate is administered parenterally, meaning not through the digestive system. This can be done either through intramuscular injection or slow intravenous infusion. Typical dosage regimens for treating leishmaniasis involve 20 mg/kg/day of pentavalent antimony. For cutaneous leishmaniasis, treatment may last 20 days, while visceral and mucosal leishmaniasis may require 28 days of treatment. 

 

Sodium stibogluconate can cause a range of side effects, some of which are common and others more serious. 

 

Sodium stibogluconate is contraindicated in individuals with known hypersensitivity to the drug. It should be used with caution in patients with pre-existing heart disease (especially arrhythmias), renal failure, severe liver disease, severe malnutrition, or advanced HIV infection. Pregnancy is also a contraindication unless the potential benefits outweigh the risks. 

 

Sodium stibogluconate can interact with other medications, particularly those affecting cardiac rhythm (like beta-blockers or other antiarrhythmics) or those with hepatotoxic potential. Inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements, to avoid harmful interactions.