Pentamidine


Full Generic Medicine Info
Dosage/Direction for Use

Parenteral
African trypanosomiasis
Adult: For the treatment of Trypanosoma brucei gambiense infection: 4 mg/kg daily or on alternate days to a total of 7-10 injections, given via IM inj or IV infusion over 60-120 minutes.
Reconstitution: IM: Reconstitute with 3 mL of sterile water for injection. IV: Initially, reconstitute with 3-5 mL of sterile water for injection or 5% dextrose in water. Further dilute with 50-250 mL of 5% dextrose in water or 0.9% NaCl.
Incompatibility: Incompatible with foscarnet.

Parenteral
Leishmaniasis
Adult: For cutaneous leishmaniasis: 3-4 mg/kg via IM inj or IV infusion once or twice weekly until the condition resolves.
Reconstitution: IM: Reconstitute with 3 mL of sterile water for injection. IV: Initially, reconstitute with 3-5 mL of sterile water for injection or 5% dextrose in water. Further dilute with 50-250 mL of 5% dextrose in water or 0.9% NaCl.
Incompatibility: Incompatible with foscarnet.

Parenteral
Pneumocystis (carinii) jirovecii pneumonia
Adult: 4 mg/kg daily for 14 days via slow IV infusion or IM inj.
Renal impairment:
CrCl (ml/min)Dosage Recommendation
<10In life threatening cases: 4 mg/kg once daily for 7-10 days then on alternate days for the remaining 14-dose course. In less severe cases: 4 mg/kg on alternate days for 14 doses.

Reconstitution: IM: Reconstitute with 3 mL of sterile water for injection. IV: Initially, reconstitute with 3-5 mL of sterile water for injection or 5% dextrose in water. Further dilute with 50-250 mL of 5% dextrose in water or 0.9% NaCl.
Incompatibility: Incompatible with foscarnet.

Inhalation
Prophylaxis of Pneumocystis (carinii) jirovecii pneumonia
Adult: In HIV-positive patients: 300 mg every 4 weeks or 150 mg every 2 weeks.
Reconstitution: Inhalation: Reconstitute with 6 mL of sterile water for injection.
Incompatibility: Incompatible with foscarnet.
Contraindications
Hypersensitivity.
Special Precautions
Patient with CV disease, long QT syndrome, history of ventricular arrhythmias, bradycardia, hypotension, hypertension, haematologic disorders (e.g. anaemia, leucopenia, thrombocytopenia), diabetes mellitus, hypoglycaemia, hyperglycaemia, hypocalcaemia, hypokalaemia, hypomagnesaemia, pancreatic disease, elevated amylase or lipase levels, asthma. Renal and hepatic impairment. Pregnancy and lactation. Monitoring Parameters Monitor ECG, blood pressure, LFTs, BUN, serum bilirubin, transaminases, renal function, blood glucose, serum electrolytes (e.g. K, Ca, Mg), haematologic status (e.g. CBC and platelets).
Adverse Reactions
Significant: Extravasation, ulcerations, tissue necrosis, hyperkalaemia, hypocalcaemia, hypomagnesaemia, hypertension, hypotension, ventricular tachycardia, QT prolongation, torsades de pointes, hyperglycaemia, pancreatic islet cell necrosis with hyperinsulinaemia, anaemia, leucopenia, thrombocytopenia; bronchospasm, cough, extrapulmonary infection with P. jirovecii. Gastrointestinal disorders: Nausea, vomiting, dysgeusia. General disorders and administration site conditions: Discomfort and pain to indurations, abcess formation, muscle necrosis. Metabolism and nutrition disorders: Anorexia. Nervous system disorders: Dizziness, syncope. Renal and urinary disorders: Renal insufficiency, azotaemia. Reproductive system and breast disorders: Shortness of breath, wheezing. Skin and subcutaneous tissue disorders: Rash. Vascular disorders: Flushing.
Potentially Fatal: Severe hypotension, hypoglycaemia, acute pancreatitis, cardiac arrhythmia.
Drug Interactions
Increased risk of arrhythmias with medicines that prolong QT interval (e.g. erythromycin, amiodarone, terfenadine, fluoroquinolones, phenothiazines, TCAs). Increased risk of hypocalcaemia with foscarnet. Increased risk of pancreatitis with didanosine, stavudine, zalcitabine. Increased risk of hyperkalaemia with K sparing diuretics.
Action
Pentamidine, an aromatic diamidine derivative, antiprotozoal agent that acts by inhibition of oxidative phospohorylation and/or interference with the incorporation of nucleotides and nucleic acid into RNA and DNA.
Absorption: Well absorbed (IM); Limited systemic absorption (inhalation).
Distribution: Widely distributed in the body with high concentrations specifically in liver, kidney, adrenals, spleen, lungs, and pancreas.
Excretion: Via urine (as unchanged drug). Elimination half-life: 5-8 hours (IV); 7-11 hours (IM).
Storage
Inhalation: Store between 20-25°C. Protect from light. Parenteral: Store between 20-25°C. Protect from light.
CIMS Class
Other Antiprotozoal Agents
Disclaimer: This information is independently developed by CIMS based on pentamidine from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in