Not FDA‑approved in US. 

GOOGLE OVERVIEW

• Leishmaniasis: It's used to treat various forms of leishmaniasis, including visceral leishmaniasis (also known as kala-azar or black sickness), cutaneous leishmaniasis (including conditions like Bay sore, chiclero ulcer, and Oriental sore), and mucocutaneous leishmaniasis.
• World Health Organization Recommendation: It's a first-choice drug for all types of leishmaniasis, as recommended by the World Health Organization.
• Not available in the US: Meglumine antimoniate is available in Southern Europe and Latin America but not in the United States. 

• Intramuscular or Intravenous: Meglumine antimoniate is typically administered by injection, either into a muscle (intramuscularly) or into a vein (intravenously).
• Intralesional Injections: For cutaneous leishmaniasis, injections may also be administered directly into the skin lesion (intralesionally).
• Dosage and Duration: The standard daily dose is 20 milligrams (mg) of pentavalent antimony per kilogram (kg) of body weight, administered daily. The traditional treatment duration is typically 20 days for cutaneous leishmaniasis and 28 days for other forms, although this can be adjusted depending on the specific case and location. 

• Common:
  • Pain, redness, or swelling at the injection site
  • Nausea, vomiting, loss of appetite
  • Fever, headache
  • Joint and muscle pain
  • Stomach pain
  • Drowsiness, general discomfort
  • Changes in the color of the face
  • Chills, cough or hoarseness
  • Decreased urination
• Serious:
  • Irregular heartbeat, cardiotoxicity (abnormalities or damage to the heart)
  • Hepatotoxicity (liver damage or stress)
  • Pancreatitis
  • Renal toxicity (kidney damage)
  • Difficulty breathing
  • Fainting or loss of consciousness
  • Skin rash and/or itching, swelling of the face, puffiness around the eyes
  • Unusual tiredness or weakness
  • Anaphylactic shock 

• Allergy: Known hypersensitivity to meglumine antimoniate or other antimonials.
• Pre-existing Conditions: Severe heart, liver, or kidney problems.
• Pancreatitis: History of or active pancreatitis.
• Pregnancy and Breastfeeding: Safety during pregnancy is not well established and should be used with caution, if at all. Not recommended during breastfeeding. 

• Nephrotoxic drugs: Concurrent use with drugs like aminoglycosides or amphotericin B can increase the risk of kidney damage.
• Hepatotoxic drugs: Combining with drugs that can harm the liver, such as certain antiretrovirals or antifungals, can increase the risk of liver toxicity. 

• Not fully understood: The exact mechanism of action is not entirely clear, but it's believed to involve disrupting the parasite's energy metabolism by inhibiting key enzymes like ATP synthase.
• Oxidative Stress: It may also induce oxidative stress within the parasite, leading to DNA damage.
• Immune Response: The drug may also modulate the host's immune response, contributing to the elimination of the parasite.