CLINICAL USE
Antibacterial agent:Pneumocystis treatment and prophylaxis Visceral leishmaniasis Cutaneous leishmaniasis Trypanosomiasis
DOSE IN NORMAL RENAL FUNCTION
Pneumocystis: Treatment: Nebuliser: 600 mg daily for —3 weeks; IV: 4 mg/kg/day for at least 14 days Prophylaxis: 300 mg monthly or —150 mg every 2 weeksVisceral leishmaniasis: 3–4 mg/kg on alternate days to a maximum of 10 doses (deep IM)Cutaneous leishmaniasis: 3–4 mg/kg once or twice weekly (deep IM)Trypanosomiasis: 4 mg/kg daily, or alternate days to a total of 7–10 doses (deep IM or IV)
PHARMACOKINETICS
DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
ADMINISTRATION
Reconstition
IV: 300 mg with 3–5 mL water for injection IM: 300 mg with 3 mL water for injection Inhalation: 600 mg with 6 mL water for injection
Route
IV, IM, nebulised
Rate of Administration
Over at least 1 hour
Comments
Dilute calculated dose in 50–250 mL sodium chloride 0.9% or glucose 5%Pentamidine isetionate.570 PEnTAMidinE isETionATE
OTHER INFORMATION
Monitor patients closely Patient must be lying down when drug is administeredIf given by
IV infusion
, patient should be monitored closely: heart rate, blood pressure, blood glucoseIV prophylaxis (unlicensed): 4–5 mg/kg over a minimum of 1 hour every 4 weeksNebulise over 20 minutes using Respigard II or other suitable nebuliser, oxygen flow rate 6–10 L/minute5 mg nebulised salbutamol may be given prior to pentamidine nebulisation to reduce risk of bronchospasm. Do not mix together in nebuliserMay produce reversible impairment of renal functionRenal clearance accounts for <5% of the plasma clearance of pentamidine.