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Pentamidine

    Brands

    DEA Class; Rx

    Common Brand Names; NebuPent, Pentam

    • Antipneumocystis Agents

    Oral inhalation/IM/IV antifungal agent
    Used for Pneumocystis jiroveci (Pneumocystis carinii) pneumonia treatment and prophylaxis 
    Parenteral administration is associated with several major ADRs

    Indicated for the treatment of Pneumocystis pneumonia (PCP).
    For pneumocystis pneumonia (PCP) prophylaxis.
    For the treatment of leishmaniasis.
    For the treatment of African trypanosomiasis (sleeping sickness) due to Trypanosoma brucei gambiense without CNS involvement (first stage or hemolymphatic stage).
     

    Hypersensitivity

    Injection

    • Increased SCr (23%)

    • IM site reactions (11%)

    • Leukopenia (10.3%)

    Nebulizer

    • Cough (1-63%)

    • Wheezing (32%)

    • Fever (51%)

    • Decreased appetite (50%)

    • Bronchospasm (48%)

    • Fatigue (66%)

    • Infection (15%)

    Hypotension, QT prolongation, and Stevens-Johnson syndrome reported with use

    Use caution in patients with history of pancreatitis, hyperglycemia, hypoglycemia, hypocalcemia, leukopenia, thrombocytopenia, anemia, hepatic/renal dysfunction

    Risk of nephrotoxicity with parenteral administration

    Risk of sudden, severe hypotension with parentera administration-keep patient supine

    Pregnancy Category: C

    There are no adequate and well controlled studies of aerosolized pentamidine in pregnant women; a literature report indicated that pentamidine 4 mg/kg/day IV administered to pregnant rats was embryolethal; teratogenicity was not observed in this study. It is unknown whether aerosolized pentamidine crosses the placenta at clinically significant concentrations

    Lactation: Not known if distributed in breast milk, discontinue drug or do not nurse

    Adults

    4 mg/kg IM or IV daily; 300 mg nebulized once every 4 weeks.

    Geriatric

    4 mg/kg IM or IV daily; 300 mg nebulized once every 4 weeks.

    Adolescents

    >= 17 years: 4 mg/kg IM or IV daily; 300 mg nebulized once every 4 weeks.
    < 17 years: 4 mg/kg IM or IV daily; safety and efficacy of nebulized solution not established, but 300 mg nebulized  once every 4 weeks has been recommended.

    Children

    >= 5 years: 4 mg/kg IM or IV daily; safety and efficacy of nebulized solution not established, but 300 mg nebulized  once every 4 weeks has been recommended..
    < 5 years: 4 mg/kg IM or IV daily; safety and efficacy of nebulized solution not established.

    Infants

    > 4 months: 4 mg/kg IM or IV daily; safety and efficacy of nebulized solution not established. 
    <= 4 months: Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Pentamidine isethionate

    powder for injection

    • 300mg

    powder for nebulizer solution

    • 300mg