ANTIMANIA

Important safety and use flags

• Scope boundary: this score covers the complete authorised ANTIMANIA dog label—symptomatic SC monotherapy of active canine leishmaniosis. It does not cover prophylaxis, subclinical infection, cats, human disease or the guideline-preferred antimoniate-allopurinol combination as if that combination were on-label.
• Confirm and stage disease: compatible clinical/clinicopathologic findings, exclusion of differentials, demonstration of infection and quantitative serology are required. Do not expose a merely seropositive subclinical dog to a direct anti-Leishmania drug.
• Exact label regimen: 100 mg/kg/day = 0.33 ml/kg/day SC, preferably divided as 50 mg/kg every 12 hours. Start at half the daily dose and titrate, especially with renal impairment. Initial course is 3 weeks; extend only one week for insufficient clinical improvement.
• Critical evidence conflict: 2025 WAVD guidance strongly does not recommend meglumine-antimoniate monotherapy because relapse and repeated-course resistance are frequent; it recommends antimoniate plus long-course allopurinol first-line. ANTIMANIA says not to administer with other veterinary medicines—do not silently rewrite the exact label as the combination protocol.
• Clinical remission is not parasitological cure. In a randomized monotherapy study 85.4% initially remitted but 74.3% relapsed within one year. The dog can remain infected and potentially infectious to vectors; maintain sand-fly prevention and structured long-term follow-up.
• Before and during treatment monitor clinical score, CBC, biochemistry, protein electrophoresis, urinalysis/UPC and renal function; monitor hepatic and cardiac function and use quantitative serology plus microscopy/qPCR when indicated. Stabilise diagnosed renal disease before starting.
• Do not use in hepatic or cardiac insufficiency. Stop intolerance; any lower-dose restart is veterinarian-directed. Watch for vomiting, diarrhoea, anorexia, prostration, myalgia/arthralgia, injection swelling and renal/cardiac injury, especially with longer or repeated courses.
• Do not mix with saline or another veterinary medicine; compatibility and interaction data are unavailable. The label permits pregnancy/lactation, but no robust exact-product reproductive outcomes establish zero fetal or neonatal risk—make and document a patient-specific benefit-risk decision.
• Plan volume and supplies before starting: a 20 kg dog needs 6.6 ml/day, so a three-week course uses 138.6 ml—at least 28 single-use 5 ml vials before wastage. Opened vials must be used immediately; rotate SC sites and record every dose.
• Resistance and zoonotic control: investigate absent response with adherence/dose-duration audit, repeat staging and parasitic burden—not automatic serial courses. Avoid unnecessary extension/repetition, use effective sand-fly repellency and never equate treatment with elimination of public-health transmission risk.