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      Drugs & Diseases

      pentamidine (Rx)

      Brand and Other Names:NebuPent, Pentam
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      powder for injection

      • 300mg

      powder for nebulizer solution

      • 300mg

      Pneumocystis Jiroveci Pneumonia

      Treatment: 4 mg/kg IV/IM qDay for 14-21 days  

      Prophylaxis: 4 mg/kg IV/IM q2-3Weeks OR

      Nebulized 300 mg q4Weeks

      African Trypanosomiasis (Off-label)

      4 mg/kg IM qDay x10 days

      Leishmaniasis (Off-label)

      Visceral: 2-4 mg/kg IM q24-48hr x 15-30 doses

      Cutaneous: 2 mg/kg IV/IM qODay x7 doses OR 3 mg/kg IM qODay x4 doses

      Orphan Designations

      Pancreatic cancer

      Liver and intrahepatic bile duct cancer

      Ovarian cancer

      Orphan sponsor

      • Oncozyme Pharma, Inc; 555 Rene-Levesque West - 9th Floor; Montreal, Quebec H2Z 1B1, Canada

      Renal Impairment

      CrCl >10 mL/min: No adjustment necessary

      CrCl <10 mL/min: 4 mg/kg IV/IM q24-36hr

      Other Information

      Monitor: Renal function

      Dosage Forms & Strengths

      powder for injection

      • 300mg

      powder for nebulizer solution

      • 300mg

      Pneumocystis Jiroveci Pneumonia

      <4 months

      • Safety and efficacy not established

      >4 months

      • Treatment: 4 mg/kg IV/IM qDay for 14-21 days
      • Prophylaxis: 4 mg/kg IV/IM q2-3Weeks OR
      • Nebulized 300 mg q4Weeks

      African Trypanosomiasis (Off-label)

      4 mg/kg IM qDay x10 days

      Leishmaniasis (Off-label)

      Visceral: 2-4 mg/kg IM q24-48hr x 15-30 doses

      Cutaneous: 2 mg/kg IV/IM qODay x7 doses OR 3 mg/kg IM qODay x4 doses

      Renal Impairment

      CrCl >30 mL/min: No adjustment necessary

      CrCl 10-30 mL/min: 4 mg/kg IV/IM q36hr

      CrC<10 mL/min: 4 mg/kg IV/IM q48hr

      Hemodialysis: 4 mg/kg IV/IM q48hr after dialysis on dialysis day

      Next:

      Interactions

      Interaction Checker

      and pentamidine

      No Results

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        No Interactions Found
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          Serious - Use Alternative

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                 activity indicator 

                Contraindicated (49)

                • amiodarone

                  amiodarone and pentamidine both increase QTc interval. Contraindicated.

                • amitriptyline

                  amitriptyline and pentamidine both increase QTc interval. Contraindicated.

                • amoxapine

                  amoxapine and pentamidine both increase QTc interval. Contraindicated.

                • artemether/lumefantrine

                  artemether/lumefantrine and pentamidine both increase QTc interval. Contraindicated.

                • chlorpromazine

                  chlorpromazine and pentamidine both increase QTc interval. Contraindicated.

                • clarithromycin

                  clarithromycin and pentamidine both increase QTc interval. Contraindicated.

                • clomipramine

                  clomipramine and pentamidine both increase QTc interval. Contraindicated.

                • desipramine

                  desipramine and pentamidine both increase QTc interval. Contraindicated.

                • disopyramide

                  disopyramide and pentamidine both increase QTc interval. Contraindicated.

                • dofetilide

                  dofetilide and pentamidine both increase QTc interval. Contraindicated.

                • doxepin

                  doxepin and pentamidine both increase QTc interval. Contraindicated.

                • dronedarone

                  dronedarone and pentamidine both increase QTc interval. Contraindicated.

                • droperidol

                  droperidol and pentamidine both increase QTc interval. Contraindicated.

                • epinephrine

                  epinephrine and pentamidine both increase QTc interval. Contraindicated.

                • epinephrine racemic

                  epinephrine racemic and pentamidine both increase QTc interval. Contraindicated.

                • erythromycin base

                  erythromycin base and pentamidine both increase QTc interval. Contraindicated.

                • erythromycin ethylsuccinate

                  erythromycin ethylsuccinate and pentamidine both increase QTc interval. Contraindicated.

                • erythromycin lactobionate

                  erythromycin lactobionate and pentamidine both increase QTc interval. Contraindicated.

                • erythromycin stearate

                  erythromycin stearate and pentamidine both increase QTc interval. Contraindicated.

                • fluconazole

                  fluconazole and pentamidine both increase QTc interval. Contraindicated.

                • fluphenazine

                  fluphenazine and pentamidine both increase QTc interval. Contraindicated.

                • haloperidol

                  haloperidol and pentamidine both increase QTc interval. Contraindicated.

                • ibutilide

                  ibutilide and pentamidine both increase QTc interval. Contraindicated.

                • imipramine

                  imipramine and pentamidine both increase QTc interval. Contraindicated.

                • indapamide

                  indapamide and pentamidine both increase QTc interval. Contraindicated.

                • ketoconazole

                  ketoconazole and pentamidine both increase QTc interval. Contraindicated.

                • levoketoconazole

                  levoketoconazole and pentamidine both increase QTc interval. Contraindicated.

                • lofepramine

                  lofepramine and pentamidine both increase QTc interval. Contraindicated.

                • lumefantrine

                  lumefantrine and pentamidine both increase QTc interval. Contraindicated.

                • maprotiline

                  maprotiline and pentamidine both increase QTc interval. Contraindicated.

                • moxifloxacin

                  moxifloxacin and pentamidine both increase QTc interval. Contraindicated.

                • nilotinib

                  nilotinib and pentamidine both increase QTc interval. Contraindicated.

                • nortriptyline

                  nortriptyline and pentamidine both increase QTc interval. Contraindicated.

                • octreotide

                  octreotide and pentamidine both increase QTc interval. Contraindicated.

                • octreotide (Antidote)

                  octreotide (Antidote) and pentamidine both increase QTc interval. Contraindicated.

                • perphenazine

                  perphenazine and pentamidine both increase QTc interval. Contraindicated.

                • pimozide

                  pentamidine and pimozide both increase QTc interval. Contraindicated.

                • procainamide

                  pentamidine and procainamide both increase QTc interval. Contraindicated.

                • prochlorperazine

                  prochlorperazine and pentamidine both increase QTc interval. Contraindicated.

                • promazine

                  promazine and pentamidine both increase QTc interval. Contraindicated.

                • promethazine

                  promethazine and pentamidine both increase QTc interval. Contraindicated.

                • protriptyline

                  protriptyline and pentamidine both increase QTc interval. Contraindicated.

                • quinidine

                  quinidine and pentamidine both increase QTc interval. Contraindicated.

                • sotalol

                  pentamidine and sotalol both increase QTc interval. Contraindicated.

                • thioridazine

                  thioridazine and pentamidine both increase QTc interval. Contraindicated.

                • trazodone

                  trazodone and pentamidine both increase QTc interval. Contraindicated.

                • trifluoperazine

                  trifluoperazine and pentamidine both increase QTc interval. Contraindicated.

                • trimipramine

                  trimipramine and pentamidine both increase QTc interval. Contraindicated.

                • ziprasidone

                  pentamidine and ziprasidone both increase QTc interval. Contraindicated.

                Serious - Use Alternative (91)

                • adagrasib

                  adagrasib, pentamidine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

                • alfuzosin

                  alfuzosin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • amisulpride

                  amisulpride and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

                • anagrelide

                  anagrelide and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • apalutamide

                  apalutamide will decrease the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.

                • apomorphine

                  apomorphine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • aripiprazole

                  aripiprazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • arsenic trioxide

                  arsenic trioxide and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • artemether

                  artemether and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • asenapine

                  asenapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • asenapine transdermal

                  asenapine transdermal and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • atomoxetine

                  atomoxetine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • bacitracin

                  pentamidine and bacitracin both increase nephrotoxicity and/or ototoxicity. Avoid or Use Alternate Drug. Avoid concurrent use of bacitracin with other nephrotoxic drugs

                • buprenorphine

                  buprenorphine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • buprenorphine buccal

                  buprenorphine buccal and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • buprenorphine subdermal implant

                  buprenorphine subdermal implant and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • buprenorphine transdermal

                  buprenorphine transdermal and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • buprenorphine, long-acting injection

                  buprenorphine, long-acting injection and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • ceritinib

                  ceritinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • clozapine

                  clozapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • dasatinib

                  dasatinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • degarelix

                  degarelix and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • desflurane

                  desflurane and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • dolasetron

                  dolasetron and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • donepezil

                  donepezil and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • efavirenz

                  efavirenz and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • eliglustat

                  eliglustat and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • encorafenib

                  encorafenib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • entrectinib

                  pentamidine and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

                • eribulin

                  eribulin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.

                • escitalopram

                  escitalopram increases toxicity of pentamidine by QTc interval. Avoid or Use Alternate Drug.

                • fedratinib

                  pentamidine will increase the level or effect of fedratinib by Other (see comment). Avoid or Use Alternate Drug. Avoid coadministration of fedratinib (a CYP3A4 and CYP2C19 substrate) with dual CYP3A4 and CYP2C19 inhibitor. Effect of coadministration of a dual CYP3A4 and CYP2C19 inhibitor with fedratinib has not been studied.

                • fexinidazole

                  fexinidazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels and/or prolong QT interval.

                • fingolimod

                  fingolimod and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • flecainide

                  flecainide and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • fluoxetine

                  fluoxetine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • fluvoxamine

                  fluvoxamine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • formoterol

                  formoterol and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • foscarnet

                  foscarnet and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • gemifloxacin

                  gemifloxacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • gilteritinib

                  gilteritinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • glasdegib

                  pentamidine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

                • granisetron

                  granisetron and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • hydroxychloroquine sulfate

                  hydroxychloroquine sulfate and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • iloperidone

                  iloperidone and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • inotuzumab

                  inotuzumab and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

                • isoflurane

                  isoflurane and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • itraconazole

                  itraconazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • ivosidenib

                  ivosidenib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.

                • lapatinib

                  lapatinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • lefamulin

                  lefamulin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • levofloxacin

                  levofloxacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • lithium

                  lithium and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • lonafarnib

                  pentamidine will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

                  lonafarnib will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.

                • macimorelin

                  macimorelin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

                • methadone

                  methadone and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • mirtazapine

                  mirtazapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • mobocertinib

                  mobocertinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

                • ofloxacin

                  ofloxacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • olanzapine

                  olanzapine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • ondansetron

                  pentamidine and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

                • oxaliplatin

                  oxaliplatin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • paliperidone

                  paliperidone and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • panobinostat

                  pentamidine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

                • paroxetine

                  paroxetine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • pitolisant

                  pentamidine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

                • posaconazole

                  pentamidine and posaconazole both increase QTc interval. Avoid or Use Alternate Drug.

                • primaquine

                  primaquine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • ranolazine

                  pentamidine and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.

                • ribociclib

                  ribociclib increases toxicity of pentamidine by QTc interval. Avoid or Use Alternate Drug.

                • risperidone

                  pentamidine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.

                • romidepsin

                  pentamidine and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.

                • saquinavir

                  saquinavir, pentamidine. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Increased risk of PR or QT prolongation and cardiac arrhythmias.

                • sertraline

                  sertraline and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • sevoflurane

                  sevoflurane and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • siponimod

                  siponimod and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • solifenacin

                  solifenacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • sulfamethoxazole

                  sulfamethoxazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • sunitinib

                  sunitinib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • tacrolimus

                  tacrolimus and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • telavancin

                  pentamidine and telavancin both increase QTc interval. Avoid or Use Alternate Drug.

                • tetrabenazine

                  tetrabenazine and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                • trimethoprim

                  pentamidine and trimethoprim both increase QTc interval. Avoid or Use Alternate Drug.

                • tropisetron

                  pentamidine and tropisetron both increase QTc interval. Avoid or Use Alternate Drug.

                • umeclidinium bromide/vilanterol inhaled

                  pentamidine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

                • vandetanib

                  pentamidine, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

                • vemurafenib

                  vemurafenib and pentamidine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.

                • venlafaxine

                  pentamidine and venlafaxine both increase QTc interval. Avoid or Use Alternate Drug.

                • vilanterol/fluticasone furoate inhaled

                  pentamidine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

                • voriconazole

                  pentamidine and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.

                • vorinostat

                  vorinostat and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.

                Monitor Closely (96)

                • albuterol

                  albuterol and pentamidine both increase QTc interval. Use Caution/Monitor.

                • alfuzosin

                  pentamidine and alfuzosin both increase QTc interval. Use Caution/Monitor.

                • amikacin

                  amikacin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • amphotericin B deoxycholate

                  amphotericin B deoxycholate and pentamidine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

                • atogepant

                  pentamidine will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • avapritinib

                  pentamidine will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • axitinib

                  pentamidine increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • azithromycin

                  azithromycin and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

                • bedaquiline

                  pentamidine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

                • canagliflozin

                  pentamidine and canagliflozin both increase serum potassium. Use Caution/Monitor.

                • cannabidiol

                  cannabidiol will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol.

                • carboplatin

                  carboplatin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • cenobamate

                  cenobamate will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate.

                • cidofovir

                  cidofovir and pentamidine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

                • ciprofloxacin

                  ciprofloxacin and pentamidine both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.

                • cisplatin

                  cisplatin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • citalopram

                  pentamidine and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

                • contrast media (iodinated)

                  contrast media (iodinated) and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • crizotinib

                  crizotinib and pentamidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

                • cyclosporine

                  cyclosporine and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • deutetrabenazine

                  deutetrabenazine and pentamidine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

                • elagolix

                  elagolix will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak CYP2C19 inhibitor. Caution with sensitive CYP2C19 substrates.

                • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                  pentamidine and elvitegravir/cobicistat/emtricitabine/tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • eslicarbazepine acetate

                  eslicarbazepine acetate will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

                • etravirine

                  etravirine increases levels of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Potential for increased toxicity.

                • ezogabine

                  ezogabine, pentamidine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

                • fedratinib

                  fedratinib will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary.

                • fexinidazole

                  fexinidazole will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

                • finerenone

                  pentamidine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

                • flibanserin

                  pentamidine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

                • fostemsavir

                  pentamidine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

                • gadobenate

                  gadobenate and pentamidine both increase QTc interval. Use Caution/Monitor.

                • gemtuzumab

                  pentamidine and gemtuzumab both increase QTc interval. Use Caution/Monitor.

                • glucarpidase

                  glucarpidase will decrease the level or effect of pentamidine by increasing metabolism. Modify Therapy/Monitor Closely. Leucorvorin, reduced folates, and folate antimetabolites are substrates for glucarpidase (hydrolyzes glutamate residue from folic acid and antifolates)

                • goserelin

                  goserelin increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

                • histrelin

                  histrelin increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

                • hydroxyzine

                  hydroxyzine increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

                • ifosfamide

                  ifosfamide, pentamidine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Monitor renal function.

                • indacaterol, inhaled

                  indacaterol, inhaled, pentamidine. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

                • insulin aspart

                  pentamidine, insulin aspart. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin aspart protamine/insulin aspart

                  pentamidine, insulin aspart protamine/insulin aspart. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin degludec

                  pentamidine, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Pentamidine may either increase or decrease the blood glucose lowering effect of antidiabetic agents; pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia.

                  pentamidine, insulin degludec. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin degludec/insulin aspart

                  pentamidine, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Pentamidine may either increase or decrease the blood glucose lowering effect of antidiabetic agents; pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia.

                • insulin detemir

                  pentamidine, insulin detemir. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin glargine

                  pentamidine, insulin glargine. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin glulisine

                  pentamidine, insulin glulisine. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin inhaled

                  pentamidine, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Pentamidine may either increase or decrease the blood glucose lowering effect of antidiabetic agents; pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia.

                  pentamidine, insulin inhaled. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin isophane human/insulin regular human

                  pentamidine, insulin isophane human/insulin regular human. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin lispro

                  pentamidine, insulin lispro. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin lispro protamine/insulin lispro

                  pentamidine, insulin lispro protamine/insulin lispro. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin NPH

                  pentamidine, insulin NPH. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • insulin regular human

                  pentamidine, insulin regular human. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

                • ioversol

                  ioversol and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • isavuconazonium sulfate

                  pentamidine will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • ivacaftor

                  pentamidine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

                • lemborexant

                  pentamidine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

                • lenvatinib

                  pentamidine and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

                • leuprolide

                  leuprolide increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

                • lomitapide

                  pentamidine increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

                • lumacaftor/ivacaftor

                  lumacaftor/ivacaftor, pentamidine. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .

                • mavacamten

                  pentamidine will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.

                • metformin

                  pentamidine decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.

                • midazolam intranasal

                  pentamidine will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

                • mifepristone

                  mifepristone, pentamidine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.

                • neomycin PO

                  neomycin PO and pentamidine both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.

                • olodaterol inhaled

                  pentamidine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

                • osilodrostat

                  osilodrostat and pentamidine both increase QTc interval. Use Caution/Monitor.

                • osimertinib

                  osimertinib and pentamidine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

                • oxaliplatin

                  oxaliplatin and pentamidine both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                  oxaliplatin will increase the level or effect of pentamidine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

                • ozanimod

                  ozanimod and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

                • pasireotide

                  pentamidine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

                • pazopanib

                  pazopanib and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

                • peramivir

                  pentamidine increases levels of peramivir by decreasing renal clearance. Use Caution/Monitor. Caution when peramivir coadministered with nephrotoxic drugs.

                • potassium citrate/citric acid

                  pentamidine and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.

                • quetiapine

                  quetiapine, pentamidine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

                • quinine

                  pentamidine and quinine both increase QTc interval. Use Caution/Monitor.

                • rilpivirine

                  rilpivirine increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

                • rucaparib

                  rucaparib will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.

                • selpercatinib

                  selpercatinib increases toxicity of pentamidine by QTc interval. Use Caution/Monitor.

                • sodium picosulfate/magnesium oxide/anhydrous citric acid

                  pentamidine decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

                • sorafenib

                  sorafenib and pentamidine both increase QTc interval. Use Caution/Monitor.

                • sparsentan

                  sparsentan will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates.

                • stiripentol

                  stiripentol will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.

                • streptozocin

                  pentamidine and streptozocin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • tacrolimus

                  pentamidine and tacrolimus both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • tazemetostat

                  pentamidine will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • tecovirimat

                  tecovirimat will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.

                • teicoplanin

                  pentamidine and teicoplanin both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.

                • tenofovir DF

                  pentamidine and tenofovir DF both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Combination may also increase tenofovir levels.

                • tinidazole

                  pentamidine will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                • tipranavir

                  tipranavir, pentamidine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Increased risk of PR or QT prolongation and cardiac arrhythmias.

                • triclabendazole

                  triclabendazole and pentamidine both increase QTc interval. Use Caution/Monitor.

                  triclabendazole will increase the level or effect of pentamidine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.

                • trimethoprim

                  trimethoprim and pentamidine both increase serum potassium. Use Caution/Monitor. Trimethoprim decreases urinary potassium excretion. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia.

                • triptorelin

                  triptorelin increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

                • valbenazine

                  valbenazine and pentamidine both increase QTc interval. Use Caution/Monitor.

                • voclosporin

                  voclosporin and pentamidine both increase serum potassium. Use Caution/Monitor.

                  voclosporin, pentamidine. Either increases effects of the other by QTc interval. Use Caution/Monitor.

                  voclosporin, pentamidine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.

                Minor (23)

                • acyclovir

                  acyclovir and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • adefovir

                  adefovir and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • capreomycin

                  capreomycin and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • cephaloridine

                  cephaloridine and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • chloroquine

                  chloroquine increases toxicity of pentamidine by QTc interval. Minor/Significance Unknown.

                • colistin

                  colistin and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • didanosine

                  didanosine, pentamidine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Enhanced risk of pancreatitis.

                • entecavir

                  pentamidine, entecavir. Either increases effects of the other by decreasing renal clearance. Minor/Significance Unknown. Coadministration with drugs that reduce renal function or compete for active tubular secretion may increase serum concentrations of either entecavir or the coadministered drug.

                • folic acid

                  pentamidine decreases levels of folic acid by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • foscarnet

                  foscarnet and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                  foscarnet, pentamidine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of severe hypocalcemia.

                • ganciclovir

                  ganciclovir increases toxicity of pentamidine by pharmacodynamic synergism. Minor/Significance Unknown.

                • gentamicin

                  gentamicin and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • L-methylfolate

                  pentamidine decreases levels of L-methylfolate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

                • methoxyflurane

                  methoxyflurane and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • paromomycin

                  paromomycin and pentamidine both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • polymyxin B

                  pentamidine and polymyxin B both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • ruxolitinib

                  pentamidine will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • ruxolitinib topical

                  pentamidine will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

                • streptomycin

                  pentamidine and streptomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • tobramycin

                  pentamidine and tobramycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • valganciclovir

                  valganciclovir increases toxicity of pentamidine by pharmacodynamic synergism. Minor/Significance Unknown.

                • vancomycin

                  pentamidine and vancomycin both increase nephrotoxicity and/or ototoxicity. Minor/Significance Unknown.

                • zidovudine

                  zidovudine increases toxicity of pentamidine by pharmacodynamic synergism. Minor/Significance Unknown.

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                Adverse Effects

                >10%

                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%)

                1-10%

                Injection

                • Anemia
                • Confusion/hallucinations
                • Hypoglycemia
                • Hypotension
                • Elevated LFT's
                • Fever
                • BUN increased
                • Azotemia
                • Anorexia/Nausea/Vomiting
                • Rash
                • Thrombocytopenia

                Nebulizer

                • Bitter/metallic taste
                • Headache
                • Diarrhea
                • Nausea
                • Oral Candida
                • Anemia
                • Pharyngitis
                • Night sweats
                • Upper respiratory tract infection

                <1%

                Anxiety

                Arthralgia

                Blepharitis

                Dizziness

                Neuralgia

                Anemia

                Bronchitis

                Chest tightness

                Colitis

                Blurred vision

                Neutropenia

                Pleuritis

                Rales

                Thrombocytopenia

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                Warnings

                Contraindications

                Hypersensitivity

                Cautions

                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

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                Pregnancy & Lactation

                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

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Inhibits synthesis of DNA, RNA, phospholipids, protein by inhibiting oxidative phosphorylation and/or interfering with incorporation of nucleotides and nucleic acids into RNA and DNA

                Pharmacokinetics

                Half-Life: 5.8 hr (IV); 7-11 hr (IM)

                Metabolism: Liver

                Vdss: 286-1356 L (IV); 1658-3790 (IM)

                Excretion: Urine (12%)

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                Administration

                IV Incompatibilities

                Y-site: aldesleukin, cefazolin, cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftriaxone, fluconazole, foscarnet, linezolid

                IV Compatibilities

                Solution: D5W, NS

                Y-site: diltiazem, gatifloxacin, zidovudine

                IV Preparation

                Reconstitute w/ 3-5 mL SWI or D5W (do not use NS)

                Reconstituted solutions (60-100 mg/mL) stable for 48 hr at room temp; keep between 22-30°C to prevent crystallization

                For IV infusion, dilute in 50-250 mL D5W (stable at room temp for 24 hr)

                IV/IM Administration

                IM: deep IM using Z-track technique

                IV: Slow infusion over 60-120 min

                Pts should be in supine position

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                pentamidine injection
                -
                		300 mg vial
                Nebupent inhalation
                -
                		300 mg nebulizer soln
                Pentam injection
                -
                		300 mg vial

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Select a drug:
                Patient Education
                pentamidine injection

                PENTAMIDINE ISETHIONATE - INJECTION

                (pen-TAM-ih-deen eye-seh-THIGH-oh-nate)

                COMMON BRAND NAME(S): Pentam 300

                USES: Pentamidine is used to treat a serious lung infection (Pneumocystis pneumonia-PCP) in people with immune system problems, including people with acquired immunodeficiency syndrome (AIDS). Pentamidine belongs to a class of drugs known as antiprotozoals. It works by killing the organism that causes the infection.

                HOW TO USE: This medication is given by injection into a vein or muscle as directed by your doctor, usually once a day. If it is given by injection into a vein, it is slowly injected over 1 to 2 hours. Tell your doctor right away if you notice leakage, redness, or pain during an injection into your vein. If this medication is given by injection into a muscle, it is usually injected into the buttock/hip area.The dosage is based on your medical condition, weight, and response to treatment.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Tell your doctor if your condition does not improve or if it worsens.

                SIDE EFFECTS: Nausea, vomiting, loss of appetite, unusual taste/dryness in the mouth, dizziness, diarrhea, or redness/pain/leakage at the injection site may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.People using this medication may have serious side effects. However, you have been prescribed this drug because your doctor has judged that the benefit to you is greater than the risk of side effects. Careful monitoring by your doctor may decrease your risk.Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, mental/mood changes (such as confusion, hallucinations), signs of kidney problems (such as change in the amount of urine), signs of anemia (such as severe tiredness, pale skin, bluish skin/nails), signs of low blood sugar (such as sudden sweating, shaking, hunger), signs of another infection (such as sore throat that doesn't go away, increased fever, chills), abdominal pain, signs of high blood sugar (such as unusual increase in thirst or urination).Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, severe dizziness, fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using pentamidine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding/blood disorders, heart problems, high or low blood pressure, diabetes, kidney disease, liver problems, pancreatitis.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Pentamidine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using pentamidine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using pentamidine safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Because breast milk can transmit HIV, do not breast-feed if you have HIV infection. Consult your doctor for details.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Many drugs besides pentamidine may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, pimozide, procainamide, quinidine, saquinavir, sotalol, macrolide antibiotics (such as erythromycin), among others.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Lab and/or medical tests (such as kidney/liver function, blood pressure, blood sugar, complete blood counts, EKGs) should be done before you start using this medication, while you are using it, and after your treatment. Keep all medical and lab appointments. Consult your doctor for more details.

                MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

                STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Create Your List of Plans

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                View explanations for tiers and restrictions
                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.
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