Sodium Stibogluconate
Sodium Antimony Gluconate
Also known as: Pentostam · Sodium antimony gluconate · stiboglucat-natrium · natriumstibogluconat-9-wasser · solusurmin · sodio stibogluconato · natrii stibogluconas · Stibogluconate sodium
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treatment of cutaneous leishmaniasis | 30-50 mg/kg IV or SC daily | IV/SC | q24h | 3-4 weeks | 🌎 NA |
| Treatment of visceral leishmaniasis | 30-50 mg/kg IV or SC q24h | IV/SC | q24h | one month | 🌎 NA |
- Treatment of visceral leishmaniasis: Has severe side effects and may not be obtainable in the USA; allopurinol alone is usually used initially.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Sodium stibogluconate is a pentavalent antimonial compound primarily utilized as an antileishmanial agent in both human and veterinary medicine.
- It is considered a traditional mainstay for the treatment of both cutaneous and visceral leishmaniasis in dogs.
- The drug is known for having a narrow therapeutic index, with a high potential for serious adverse effects.
Clinical Pearl: In the United States, this drug is not commercially available. It must be obtained directly from the Centers for Disease Control and Prevention (CDC) under specific protocols, and it may or may not be released for use in domestic animals.
Mechanism of action
The exact mechanism of action of sodium stibogluconate remains incompletely elucidated.
- Prodrug Hypothesis: It is widely hypothesized to act as a prodrug, where the pentavalent antimony (SbV) is reduced to the more toxic trivalent antimony (SbIII) within the host macrophage or the parasite itself.
- Bioenergetic Disruption: It is believed to interfere with the parasite's bioenergetics by reducing ATP and GTP synthesis in susceptible Leishmania amastigotes, ultimately leading to parasite death.
Safety & warnings
Contraindications
- Pre-existing cardiac arrhythmias
- Significantly impaired renal function
- Previous serious adverse reaction to a dose of stibogluconate
- Severe renal impairment
- Severe hepatic impairment
Adverse effects
- Increased AST levels
- Pain on injection
- Musculoskeletal pain
- Hemolytic anemia
- Leukopenia
- Vomiting
- Diarrhea
- Pancreatitis
- Myocardial injury and arrhythmias
- Renal toxicity
- Shock
- Sudden death
- Thrombophlebitis (with IV administration)
- Nephrotoxicity
- Hepatotoxicity
- Injection site pain
- Lethargy
- Anorexia
- Myalgia/Arthralgia
- Cardiac arrhythmias (rare)
Precautions
Contraindicated in patients with pre-existing cardiac arrhythmias or significantly impaired renal function.
- Duration Warning: The incidence of adverse effects reportedly increases significantly if the drug is administered for longer than 2 months.
- Pregnancy: Has not been shown to cause fetal harm, but should be withheld during pregnancy unless the benefits clearly outweigh the risks.
- Nursing: Controversial; the manufacturer states it should not be used in nursing mothers, though some human pediatric guidelines consider it compatible.
Drug interactions
Increased risk of nephrotoxicity
Synergistic antileishmanial effect (often used together clinically)
Monitoring
- CBC
- Liver enzymes (especially AST)
- Renal function tests
- ECG (for myocardial injury/arrhythmias)
- Bone marrow cultures for Leishmania
- Clinical efficacy
- Renal function (BUN, Creatinine, SDMA, Urinalysis)
- Hepatic enzymes (ALT, AST, ALP)
- Pancreatic enzymes (cPLI, Lipase)
- ECG (for arrhythmias)
Pharmacokinetics
Half-life
Absorption
Well absorbed following intramuscular or subcutaneous injection.
Distribution
In dogs, steady-state volume of distribution is 0.25 L/kg.
Metabolism
Pentavalent antimony is partially reduced to the more toxic and active trivalent antimony in vivo.
Elimination
The main route of excretion is via the kidneys; glomerular filtration rate determines the excretion rate. Clearance in dogs is 1.71 L/kg/hr.
Overdose
In the unlikely event of a parenterally administered overdose, it is suggested to immediately contact an animal poison control center.
- Chelation Therapy: Potentially, antimony toxicity can be managed by chelating agents such as dimercaptosuccinic acid (DMSA) or d-penicillamine to enhance excretion.
Available products
Formulations
- Injection: 100 mg (of antimony)/mL
- Injectable: 100 mg/ml solution
Human-labeled
- Sodium Stibogluconate (sodium antimony gluconate) 100 mg (of antimony)/mL for injection in 6 mL and 100 mL (Pentostam)
- Pentostam 100 mg/ml solution for injection
Regulatory status
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store at temperatures below 25°C (76°F) and protect from freezing and exposure to light. After removing the first dose, the vial should not be used after one month.
Client information
- Public Health: Clients should understand the potential zoonotic and public health implications of leishmaniasis in dogs, which is highly dependent on the country and local vectors.
- Prognosis: The prognosis for dogs with leishmaniasis remains guarded, even with aggressive treatment. Relapses are common.
- Risks & Costs: Treatment carries a risk of severe side effects and can be financially demanding. Close monitoring by your veterinarian is essential.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.