**4.3 Adverse events**

The most serious side effects are cardiotoxicity and nephrotoxicity. Most patients on antimony will develop pancreatitis (either subclinical or severe abdominal pain). The dose-dependent side effects include pain at the injection site, myalgia, hepatitis, bone marrow suppression, QT prolongation, headache, fatigue, rash, and nausea, vomiting, metallic taste. These problems resolve with a reduction in the dose of antimonial. Other side-effects include sterile abscess, stiffness in the injected muscle, mental symptoms.

**Relative contraindication:** >60% resistance is seen in species in India and Nepal, hence not used as a first-line drug.
