Sunday, October 23, 2016

Pentamidine


Generic Name: pentamidine (pen TAM e deen)

Brand Names: Nebupent, Pentam 300


What is pentamidine?

Pentamidine is a type of antibiotic that fights protozoa in the body.


Pentamidine is used to prevent and treat serious infections such as Pneumocystis pneumonia.


Pentamidine may also be used for purposes other than those listed in this medication guide.


What is the most important information I should know about pentamidine?


Pentamidine may affect blood sugar levels. Contact your doctor if you experience any low blood sugar symptoms including



  • increased appetite;




  • headache;




  • chills, pale skin, shakes, cold sweats; or




  • anxiety.



Pentamidine may affect blood sugar levels. Contact your doctor if you experience any high blood sugar symptoms including



  • increased thirst;




  • loss of appetite;




  • increase in amount or frequency or urination;




  • fruity smelling breath; or




  • drowsiness.



Your doctor may want you to have regular blood, heart function, and blood sugar evaluations during treatment with pentamidine to monitor progress and side effects.


What should I discuss with my healthcare provider before taking pentamidine?


Before taking this medication, tell your doctor if you have:



  • diabetes;




  • heart problems




  • blood pressure or circulation problems;




  • kidney disease;




  • pancreatitis;




  • asthma;




  • recent radiation therapy or treatment with chemotherapy;




  • a history of dehydration; or




  • special dietary restrictions.



You may not be able to take pentamidine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.


Pentamidine may affect blood sugar levels. Contact your doctor if you experience any low blood sugar symptoms including



  • increased appetite;




  • headache;




  • chills, pale skin, shakes, cold sweats; or




  • anxiety.



Pentamidine may affect blood sugar levels. Contact your doctor if you experience any high blood sugar symptoms including



  • increased thirst;




  • loss of appetite;




  • increase in amount or frequency or urination;




  • fruity smelling breath; or




  • drowsiness.



Your doctor may want you to have regular blood, heart function, and blood sugar evaluations during treatment with pentamidine to monitor progress and side effects.


Talk to your doctor if you develop an infection of any kind.


Pentamidine is in the FDA pregnancy category C. This means that it is not known whether pentamidine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. It is not known whether pentamidine passes into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take pentamidine?


Injectable pentamidine can be administered as an injection into a muscle or by slow infusion. The injection should be administered in a clinical setting where a healthcare provider can monitor blood pressure other vital signs and where an emergency situation can be handled properly.


Your healthcare provider will store injectable pentamidine as directed by the manufacturer.


Pentamidine for inhalation may be administered via the Respigard II nebulizer as part of a home health regimen by a nurse, respiratory therapist or other healthcare practitioner.


Store the prepared solution for inhalation at room temperature, away from light. The solution should be used within 48 hours and any unused portion should be thrown away.


What happens if I miss a dose?


Since the medication will be administered by a healthcare provider, missing a dose should not occur. If you have any questions contact your doctor.


What happens if I overdose?


If an overdose of pentamidine is suspected, seek emergency medical attention or contact your healthcare provider immediately.

Pentamidine should be administered in a clinical setting where a healthcare provider can monitor vital signs (blood pressure, heart rates) and where an emergency situation can be handled immediately.


What should I avoid while taking pentamidine?


Tell your doctor if you drink alcohol or caffeine drinks regularly, if you are a smoker or if you use illegal drugs. These factors can affect the way pentamidine works in your body.


Pentamidine side effects


Side effects with pentamidine are not common. Serious side effects include:

  • an allergic reaction (shortness of breath; closing of the throat; hives; swelling of the lips, face, or tongue; rash; or fainting);




  • blurred vision;




  • chest pain or irregular heart beat;




  • difficulty breathing;




  • dizziness, confusion, fainting spells or excessive tiredness;




  • drastic appetite changes;




  • pain or irritation at the injection site;




  • mouth ulcers or irritations;




  • severe stomach pain;




  • bleeding or bruising;




  • severe headache;




  • chills;




  • increased thirst; or




  • seizures.



Other, less serious side effects may be more likely to occur. Talk to your doctor if you experience



  • taste changes;




  • diarrhea; or




  • nausea or vomiting.



Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.


Pentamidine Dosing Information


Usual Adult Dose for Pneumocystis Pneumonia:

Manufacturer recommendation: 4 mg/kg IM or IV once a day for 14 to 21 days
Centers for Disease Control and Prevention (CDC) recommendation: 3 to 4 mg/kg IV once a day for 21 days

Usual Adult Dose for Pneumocystis Pneumonia Prophylaxis:

300 mg administered via the Respirgard(R) II nebulizer every 4 weeks
Prophylactic therapy should be continued as long as the patient is at risk for Pneumocystis jiroveci pneumonia.

Usual Adult Dose for Leishmaniasis:

Cutaneous leishmaniasis:
CDC recommendation: 2 to 3 mg/kg IM or IV once a day or every second day for 4 to 7 doses

The following regimens have been recommended for visceral leishmaniasis: 2 to 4 mg/kg IM or IV once a day or every other day for up to 15 doses
or
4 mg/kg IM or IV 3 times a week for 5 to 25 weeks or longer, depending on response
or
4 mg/kg IM or IV once every 2 or 3 days for up to 15 doses

Pentamidine was considered a second-line agent for visceral leishmaniasis; however, due to suboptimal efficacy and toxicity, it is rarely used. Stibogluconate sodium, amphotericin B, and amphotericin B liposomal are considered first-line agents.

Usual Adult Dose for Trypanosomiasis:

First (hemolymphatic) stage infection due to Trypanosoma brucei gambiense or T brucei rhodesiense:
CDC recommendation: 4 mg/kg IM or IV once a day for 7 to 10 days

Pentamidine is a second-line agent for African trypanosomiasis caused by T brucei rhodesiense. Suramin is the first-line agent.

Usual Pediatric Dose for Pneumocystis Pneumonia:

5 months or older:
Manufacturer recommendation: 4 mg/kg IM or IV once a day for 14 to 21 days
CDC recommendation: 3 to 4 mg/kg IM or IV once a day for 21 days

Usual Pediatric Dose for Pneumocystis Pneumonia Prophylaxis:

5 years or older:
CDC recommendation: 300 mg administered via the Respirgard(R) II nebulizer once a month
Prophylactic therapy should be continued as long as the patient is at risk for Pneumocystis jiroveci pneumonia.

Usual Pediatric Dose for Leishmaniasis:

Cutaneous leishmaniasis:
CDC recommendation: 2 to 3 mg/kg IM or IV once a day or every second day for 4 to 7 doses

Usual Pediatric Dose for Trypanosomiasis:

First (hemolymphatic) stage infection due to T brucei gambiense or T brucei rhodesiense:
CDC recommendation: 4 mg/kg IM or IV once a day for 7 to 10 days

Pentamidine is a second-line agent for African trypanosomiasis caused by T brucei rhodesiense. Suramin is the first-line agent.


What other drugs will affect pentamidine?


Before taking pentamidine, tell your doctor if you are taking any of the following medicines:



  • azathioprine (Imuran);




  • carbamazepine (Tegretol, Epitol, Carbatrol);




  • antibiotics;




  • anti-inflammatory drugs (ibuprofen (Advil), naproxen (Aleve), others)




  • cisplatin (Platinol)




  • didanosine (Videx)




  • zidovudine (Retrovir)




  • birth control pills;




  • ganciclovir (Cytovene)




  • blood pressure medications;




  • medication for diabetes;




  • valproic acid (Depakote);




  • medication for mental problems; or




  • metoclopramide (Reglan).



You may not be able to take pentamidine, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.


Drugs other than those listed here may also interact with pentamidine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines including vitamins, minerals, and herbal products. .



More pentamidine resources


  • Pentamidine Side Effects (in more detail)
  • Pentamidine Use in Pregnancy & Breastfeeding
  • Pentamidine Drug Interactions
  • Pentamidine Support Group
  • 0 Reviews for Pentamidine - Add your own review/rating


  • pentamidine Inhalation, oral/nebulization Advanced Consumer (Micromedex) - Includes Dosage Information

  • Pentamidine MedFacts Consumer Leaflet (Wolters Kluwer)

  • NebuPent Prescribing Information (FDA)

  • Nebupent Solution MedFacts Consumer Leaflet (Wolters Kluwer)

  • Pentamidine Isethionate Monograph (AHFS DI)



Compare pentamidine with other medications


  • Leishmaniasis
  • Pneumocystis Pneumonia
  • Pneumocystis Pneumonia Prophylaxis
  • Trypanosomiasis


Where can I get more information?


  • Your pharmacist has additional information about pentamidine written for health professionals that you may read.

See also: pentamidine side effects (in more detail)



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