• Kala-azar Drugs available in India

• Sodium Stibogluconate (indigenous manufacture, registered for use & sale)

• Pentamidine Isethionate: (imported, registered for use)
• Amphotericin B: (indigenous manufacture, registered for use and sale)
• Liposomal Amphotericin B: (indigenous manufacture & import, registered for use and sale)
• Miltefosine (imported/ registered for use & sale)
• Drug Policy under Kala-azar Elimination Programme as per recommendations of Expert Committee (2000) – (This drug policy is under review)

• First Line Drugs

      A.  Short Term

• Areas with SSG sensitivity >90%

                    -  SSG IM/IV 20mg/kg/day X 30 days

• Areas with SSG sensitivity <90%

                    -  Amphotericin B 1mg/kg b.w. IV infusion daily or alternate day for 15-20 infusions. Dose can be increased

                        in patients with incomplete response with 30 injections

      B.  Long Term

• Areas with high level of SSG resistance (>20%)

                   -   Miltefosine 100 mg daily x 4 weeks (after phase III studies completed with proven safety & efficacy)

• Areas with SSG sensitivity >80%

                   -   SSG IM/IV 20mg/kg/day X 30 days

                   -   Miltefosine 100 mg daily x 4 weeks (after phase III studies completed with proven safety & efficacy)

• Second Line Drugs

      A. SSG Failures

                  -   Amphotericin B 1mg/kg b.w. IV infusion daily or alternate day for 15-20 infusions. Dose can be increased in patients

                      with incomplete response with 30 injections

     B.  SSG and Miltefosine Failures

                        -    Liposomal Amphotericin B (when final results are available with proven efficacy and safety)

Treatment of PKDL

•  SSG in usual dosages for KA could be given up to 120 days

• Repeated 3-4 courses of Amphotericin B can be given in patients failing SSG treatment