Glucantime

Meglumine [6284-40-8] antimonate [133-51 -7] C H NO HO Sb, (Glucantime) is a pentavalent antimonial used for the treatment of leishmania sis in Latin America (207) and in the French-speaking areas of Europe and Africa (206). It is adrxiinistered by deep intramuscular injection. Although relatively safe and usually well tolerated, numerous side effects have been observed. It is not available in the United States. 

The conditions described above were used by Figad re, Alami and coworkers" to prepare analogues of meglumine antimonate (Glucantime ), a product used in chemotherapy, from chloroenynes or chlorodienes (Scheme 21). The reaction was further extended to various chloroenynes (Scheme 22). 

Since the early study, a number of papers have appeared in the literature dealing with the use of antimony-based drugs [Glucantime, Triostib] that have been used in several tropical diseases, such as schistosomiasis and leishmaniasis, but not without side effects such as arthralgia or possible antimony intoxication. Many of these articles are based on... 

Allopurinol and meglumine antimoniate (Glucantime) have been evaluated in a randomized controlled trial in 150 patients with cutaneous leishmaniasis (2). They received oral allopurinol (15 mg/kg/day) for 3 weeks or intramuscular meglumine antimoniate (30 mg/kg/day, corresponding to 8 mg/kg/day of pentavalent antimony, for 2 weeks), or combined therapy. There were a few adverse effects in those who used allopurinol nausea, heartburn (n = 3), and mild increases in transaminases (n = 2). These symptoms subsided on drug withdrawal. 

Esfandiarpour I, Alavi A. Evaluating the efficacy of allopurinol and meglumine antimoniate (Glucantime) in the treatment of cutaneous leishmaniasis. Int J Dermatol 2002 41(8) 521. ... 

Leishmaniasis Leishmania donovani, L tropica, L. mexicana, L. brasiliensis Pentostam, glucantime, urea stibamine, pentamidine, WR-6026, al-lopurinol, allopurinol riboside, amphotericin B... 

Antimonate, C7I 1 lBNOaSb, RP 2168, Glucantim, Gtucan time, Protostib. Powder. Soly in water about 35% ww. Practically insol in alcohol, ether, chloroform. pH of aq solns 6-7. 

This has been translated into clinical benefits. There have been several reports of the efficacy of allopurinol in visceral leishmaniasis and one study using allopurinol riboside in cutaneous leishmaniasis. More recently, a controlled study in Colombia has documented the efficacy of allopurinol in cutaneous leishmaniasis (20). In this study the cure rate of allopurinol was 80% compared to 74% using allopurinol and glucantime together. The cure rate of glucantime alone was 36%. A similar study of the efficacy of allopurinol in chronic asymptomatic Chagas disease showed that allopurinol in doses of 600 or 900 mg day was equal efficacy to nifurotimox or benznidazole (21). 

Ezzine Sebai N, Mrabet N, Khaled A, Zeglaoui F, Kharfi M, Fazaa B, Kamoun MR. Les effets indesirables du Glucantime par voie generale, dans le traitement de la leishmaniose cutanee a propos de 15 cas. [Side effects of meglumine antimoniate in cutaneous leishmaniasis 15 cases.] Tunis Med 2010 88(1) 9-11. 

---