Amphotericin B–miltefosine mixed micelles (AmB-Milt mixed micelles)

Amphotericin B–miltefosine mixed micelles are a specialized drug delivery formulation designed for the synergistic treatment of visceral leishmaniasis and systemic fungal infections. This system utilizes the amphiphilic properties of miltefosine to help solubilize amphotericin B, a potent but poorly soluble polyene antifungal, into a stable nanocarrier (Shahnaz et al., 2017, Nanomedicine). By combining these two agents, the formulation aims to enhance therapeutic efficacy against Leishmania parasites while minimizing the severe side effects typically associated with the individual drugs, such as nephrotoxicity and gastrointestinal irritation (Kansal et al., 2016, Journal of Controlled Release). The micelles facilitate the targeted delivery and controlled release of the active pharmaceutical ingredients to the infected cells, particularly macrophages in the liver and spleen (Kaur et al., 2020, Journal of Drug Delivery Science and Technology). This approach leverages the distinct mechanisms of action of both drugs—membrane pore formation by amphotericin B and disruption of lipid signaling by miltefosine—to overcome drug resistance and improve patient outcomes. Additionally, the formulation potentially offers a more cost-effective alternative to liposomal amphotericin B for treating neglected tropical diseases. Overall, it represents a significant advancement in the co-delivery of antimicrobial agents for complex infectious diseases.

Other names

AmB-MIL mixed micellesAmphotericin B-miltefosine nanomicellesAmB-Milt co-delivery system

The formulation acts as a co-delivery system where Amphotericin B creates pores in the parasite membrane by binding to ergosterol, and Miltefosine disrupts phospholipid metabolism and cell signaling pathways. The mixed micelle structure enhances the solubility of Amphotericin B and reduces its toxicity by controlling its release and interaction with host cell membranes.