IMG-20261029-WA0000.jpg
Make me understand this Also tell me medicine name to show pharmasist also tell me doses
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"liposomal amphotericin B" AND "visceral leishmaniasis"
What this screenshot is
It's a dosing page from a drug-reference app. The top of the page is cut off, so the drug name isn't visible. The doses match liposomal amphotericin B (brand AmBisome). It is an antifungal and anti-leishmania drug given by IV drip in hospital. Please confirm the name on the top of the page or on your prescription.
What each line means
| Line in screenshot | Plain meaning |
|---|---|
| Test dose 1 mg over 10 min | The first tiny dose checks for a severe reaction before the full dose. |
| Empiric therapy: 3 mg/kg/day | The doctor starts this dose when a fungal infection is suspected but not yet proven. |
| Systemic fungal infections (Aspergillus, Candida, Cryptococcus): 3 to 5 mg/kg/day | This is the dose for proven deep fungal infections. |
| Cryptococcal meningitis in HIV: 6 mg/kg/day | Brain-lining infection needs the highest dose. |
| Visceral leishmaniasis (kala-azar), immunocompetent: 3 mg/kg/day on days 1 to 5, then days 14 and 21 | The total is 5 daily doses, then one dose each on day 14 and day 21. A repeat course is given if the parasite isn't cleared. |
| Visceral leishmaniasis, immunocompromised: 4 mg/kg/day on days 1 to 5, then days 10, 17, 24, 31, 38 | Weaker immunity needs a higher dose and more doses. |
"mg/kg" means the dose depends on body weight. For example, 3 mg/kg for a 60 kg adult is 180 mg per day. I can't tell which line applies to you. That depends on the diagnosis, your weight and your immune status, and only your doctor can decide it.
Advice to patient (the part visible)
- Contact your doctor if you get chest pain, palpitations, skin rash, chills or nervous system symptoms such as confusion, seizures or severe headache.
- The line "shake bottle of oral suspension" is probably generic app text. This drug is not an oral suspension. It is given only through a vein, usually in a hospital or day-care unit.
What to show the pharmacist
Show the name "Liposomal Amphotericin B" (for example AmBisome). Make sure you get the liposomal form.
Conventional amphotericin B (deoxycholate) is a different product with different dosing, usually 0.5 to 1 mg/kg/day. It is more toxic to the kidneys. Mixing up the two is a known and dangerous error. The screenshot's first line mentions the deoxycholate form, so it is a real risk.
Safety points
- It can cause fever and chills during the infusion, low potassium and magnesium, and kidney strain. Doctors usually check blood tests during treatment.
- Do not start, stop or change the dose yourself. The pharmacist should dispense only against a written prescription that states the dose in mg and the number of days.
Sources
The library search returned only bibliography entries, so the dosing above comes from your screenshot and my own knowledge, not from a textbook passage. A PubMed check of the last two years found nothing that contradicts these regimens. One of the results is a 2026 meta-analysis on liposomal amphotericin B in post-kala-azar dermal leishmaniasis, which is a different condition.
If you tell me the diagnosis and the weight, I can show how the dose is calculated. If you can send the top of the page or the prescription, I can confirm the drug name.
IMG-20261028-WA0007.jpg
This was test
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"visceral leishmaniasis" AND "diagnosis"
What this report says
LD bodies seen means the lab saw Leishmania parasites under the microscope. This is a positive result for leishmaniasis.
- LD bodies are Leishman-Donovan bodies, the tiny oval parasite forms (amastigotes) that live inside the body's macrophage cells. They are about 3 µm across. Andrews' Diseases of the Skin describes them as nonflagellate oval organisms. (Andrews' Diseases of the Skin, Visceral Leishmaniasis section)
- "Clinical correlation is advised" is standard lab wording. It means the doctor should combine this result with the patient's symptoms and examination.
- The patient name is Zubair, male. The age and the date are blank or unreadable.
What the report does not tell us
The report does not say what sample was examined. That decides which type of leishmaniasis it is:
| Sample | Disease | Typical features |
|---|---|---|
| Bone marrow, spleen or lymph node aspirate | Visceral leishmaniasis (kala-azar) | Long fever, big spleen and liver, weight loss, anaemia, low blood counts |
| Skin lesion scraping or smear | Cutaneous leishmaniasis | Chronic skin sore or ulcer |
In visceral disease, the parasites are found in macrophages of the liver, spleen, bone marrow and lymph nodes. Specimens in descending order of usefulness are spleen pulp, bone marrow, liver tissue and lymph node fluid. (Andrews' Diseases of the Skin, Visceral Leishmaniasis; Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Histopathologic Features)
Seeing the parasite in a bone marrow or spleen aspirate confirms the diagnosis. The rK39 dipstick is the usual first test, and PCR or serology are alternatives. (Goldman-Cecil Medicine)
How this links to the dosing page you sent earlier
If this was a bone marrow or spleen sample, the diagnosis is visceral leishmaniasis, and the screenshot's regimen applies. That is liposomal amphotericin B, 3 mg/kg/day on days 1 to 5, then day 14 and day 21, for an immunocompetent patient. If the patient is immunocompromised, for example with HIV, the dose is 4 mg/kg with a longer schedule.
If this was a skin sample, the picture is different. Skin disease is often treated with other drugs, such as antimonials, or with treatment applied to the lesion. Liposomal amphotericin B is not automatically the right choice. The treating doctor should decide this.
What to do next
- Take this report with the patient to a physician, ideally an infectious disease or medicine specialist. This is a lab slip and not a treatment plan.
- Ask which sample was taken, because the report doesn't say.
- Expect blood tests: CBC, liver and kidney function, and an HIV test. Doctors usually check these before and during amphotericin treatment.
- Do not buy or start the medicine on your own. Dosing depends on body weight and diagnosis.
Recent evidence check
I found no recent evidence that contradicts the library. A 2024 meta-analysis of the rK39 test supports rK39 as a diagnostic tool for visceral leishmaniasis. A 2025 meta-analysis of a Loopamp assay also looks at diagnosis, using a molecular test.
If you tell me the patient's age, weight and symptoms, and what sample was taken, I can explain how the treatment dose is worked out.
Now tell me med and doses
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visceral leishmaniasis treatment liposomal amphotericin B single dose 10 mg/kg South Asia WHO guideline miltefosine paromomycin dose
Treatment if this is visceral leishmaniasis (kala-azar)
The report doesn't say what sample was taken. I'm assuming a bone marrow or spleen sample, as in the dosing page you sent earlier. If it was a skin sample, see the last section.
Medicine name to show the pharmacist: Liposomal Amphotericin B (L-AmB, brand AmBisome). The doctor chooses the exact regimen. These are the standard South Asia options:
| Regimen | Dose |
|---|---|
| A. Single dose (preferred where available) | L-AmB 10 mg/kg by IV infusion once, over about 2 hours |
| B. Short course | L-AmB 3 to 5 mg/kg IV once daily for 3 to 5 days, up to a total of 15 mg/kg |
| C. Single dose plus oral drug | L-AmB single dose plus miltefosine for 7 days, or plus paromomycin for 10 days |
| D. Two oral/injected drugs | Miltefosine plus paromomycin for 10 days |
The MSF guideline lists regimens A and B as first-line for South Asia. Regimen A is the Indian elimination programme's drug of choice. In an Indian trial, a single dose of L-AmB plus miltefosine or paromomycin was as effective as the old 30-day amphotericin course, with fewer side effects. (Katzung's Basic and Clinical Pharmacology, Drug Combinations Used in the Treatment of Visceral Leishmaniasis)
Example for a 60 kg adult:
- Regimen A: 10 × 60 = 600 mg, once.
- Regimen B: 3 mg/kg × 60 = 180 mg per day for 5 days, which is 900 mg in total.
Other medicines the doctor may mention
- Miltefosine (oral capsule) for 28 days. The MSF guideline gives these doses:
- Children 2 to 11 years: 2.5 mg/kg once daily.
- Age 12 and over, 25 to 50 kg: 50 mg twice daily.
- Over 50 kg: 50 mg three times daily.
- It must not be used in pregnancy. It also needs reliable contraception during treatment and for several months after it.
- Paromomycin injection: 15 mg/kg (11 mg base per kg) IM daily for 17 days in East Africa combinations. The South Asian 10-day combination dose should be confirmed with the treating doctor.
- Sodium stibogluconate (an antimony drug): 20 mg/kg daily. Resistance is widespread in India. (Goodman & Gilman's, Leishmaniasis)
Special cases
- HIV or weak immunity: higher or longer L-AmB courses, with or without miltefosine. Your earlier screenshot showed 4 mg/kg/day on days 1 to 5, then days 10, 17, 24, 31 and 38.
- Relapse after a single 10 mg/kg dose: the 2026 WHO guideline says not to repeat the same single dose. It suggests combinations, or higher L-AmB up to a 15 to 20 mg/kg total over three or four infusions. (WHO 2026 guideline summary)
If the sample was from skin (cutaneous leishmaniasis)
The treatment is different. It is usually an antimony drug, given into or around the lesion or by injection, or other local treatment. I can't give a safe dose without knowing the lesion type and the patient's details. Ask the doctor which type this is.
Before treatment
- Before treatment: CBC, kidney function, liver function, potassium and magnesium, and an HIV test.
- During infusion: fever, chills and back pain can occur. Treatment is given in a hospital or supervised setting.
- Never swap in conventional amphotericin B (deoxycholate). It is dosed differently and is more toxic to the kidneys.
- Doses depend on weight and immune status. I need the patient's age, weight and sample type to write them out exactly, and a doctor must prescribe them.
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