Meglumine Antimoniate: veterinary dose and monograph

At a glance

Drug class

Antiparasitic

Also known as

Glucantime, Meglumine antimonate, N-methylglucamine antimoniate

Species with doses

Dogs

General dose range

75–100 mg/kg SC q12–24h SC (per protocol) — check the species tables for the indication

Routes

SC

Last reviewed

1 October 2026

Indications

• Canine leishmaniasis (visceral/cutaneous, Leishmania infantum) — reduce parasite load and clinical signs
• Leishmaniasis management combined with allopurinol (standard) ± other agents (miltefosine)

Meglumine Antimoniate dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Leishmaniasis (with allopurinol): Plumb’s p.774: first line 75–100 mg/kg SC once daily for 4–8 weeks with allopurinol 10 mg/kg PO q12h for at least 6–12 months (Solano-Gallego 2009); at least 100 mg/kg SC daily for 3–4 weeks, better with 4–6 weeks (Noli & Auxilia). Doses refer to the meglumine antimoniate salt (the 300 mg/mL injection contains about 81–85 mg/mL pentavalent antimony). Stage and monitor renal function (nephrotoxic); injection-site reactions common. Not in Papich 5e.

Contraindications

Significant renal impairment (nephrotoxic — leishmaniasis often already causes renal disease; assess/stage first). Significant cardiac disease (antimony cardiotoxicity/QT). Pancreatitis. Pregnancy. Known hypersensitivity. Regulatory restrictions on veterinary antimonial use (verify locally). Rapid IV administration.

Species-specific warnings

Dogs: Leishmaniasis is ZOONOTIC — handle infected dogs and the drug appropriately, notify per local rules, and stage renal function before/throughout treatment (nephrotoxic drug in a renally-affected disease).

Adverse effects

• Nephrotoxicity (worsening of leishmaniasis-associated renal disease)
• Injection-site pain/swelling/abscess (SC/IM)
• GI upset, lethargy, myalgia
• Cardiotoxicity / QT prolongation; pancreatitis; hepatic effects

Drug interactions

• Allopurinol: standard synergistic partner (combined and continued long-term)
• Other nephrotoxic/QT-prolonging drugs: additive toxicity
• Amphotericin B / miltefosine: alternative/second-line anti-leishmanials (sequential, not usually concurrent)

Pregnancy and lactation

Avoid in pregnancy (antimony toxicity).

Monitoring

• Renal function (creatinine, SDMA, urine protein:creatinine, IRIS stage) before and during therapy — the key monitor
• Clinical response and antibody/parasite load (e.g. quantitative serology/PCR)
• ECG (cardiotoxicity) in at-risk dogs; injection sites
• Continue allopurinol long-term (relapse suppression)

Toxicity and overdose

Dose-/duration-related NEPHROTOXICITY (a major concern because leishmaniasis itself causes immune-complex glomerulonephritis/renal disease), cardiotoxicity (QT prolongation, arrhythmia), pancreatitis, hepatic effects, and injection-site reactions. Renal staging (IRIS) and monitoring throughout treatment are essential; some dogs need dose reduction or alternative therapy.

Management: No specific antidote (chelators like dimercaprol have been used for antimony toxicity). Discontinue; supportive care with IV fluids and renal support, ECG monitoring for arrhythmia, and management of pancreatitis/hepatic effects. Monitor renal values closely.

Clinical pearls

• First-line for canine leishmaniasis — but it CONTROLS rather than cures, so ALWAYS pair it with long-term allopurinol and expect possible relapses
• Stage and monitor the KIDNEYS: leishmaniasis causes renal disease and the drug is nephrotoxic — this drives dosing/duration decisions (IRIS staging)
• A zoonotic, notifiable disease in many areas and a One-Health/stewardship issue (antimonials are vital human anti-leishmanials) — treat within local regulations
• Alternatives/adjuncts include miltefosine and amphotericin B (with allopurinol); combine with vector control (sandfly repellents) and prevention

Mechanism of action

A pentavalent antimonial pro-drug: the Sb5+ is reduced within the parasite/macrophage to the active trivalent antimony (Sb3+), which inhibits Leishmania glycolysis and fatty-acid β-oxidation (and trypanothione/thiol redox metabolism), depleting ATP and killing amastigotes inside macrophages. It reduces parasite burden but seldom sterilises the infection — hence the need for prolonged allopurinol to suppress relapse.

Formulations and products

• Injection 300 mg/mL (≈85 mg/mL pentavalent antimony, Glucantime)
• Glucantime (Boehringer Ingelheim (Merial)) — 300 mg/mL (≈85 mg/mL Sb5+), SC/IM injection
• Glucantime (human antileishmanial) — 300 mg/mL, Injection (human-label)

Storage

Injection: 15–30 °C, protect from light; do not freeze.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other antiparasitics

• Levamisole + Oxyclozanide
• Lotilaner
• Lufenuron
• Mebendazole
• Melarsomine
• Milbemycin oxime
• Monensin
• Monepantel

Frequently asked questions