Pentamidine

Generic Name: Pentamidine

Pentamidine is an antifungal medication that fights infections caused by fungus.

Pentamidine is used to prevent and treat pneumonia caused by Pneumocystis jiroveci (carinii).

Pentamidine may also be used for purposes not listed in this medication guide.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

You should not use pentamidine if you are allergic to it.

To make sure pentamidine is safe for you, tell your doctor if you have:

  • high or low blood pressure;
  • a heart rhythm disorder;
  • diabetes, or low blood sugar (hypoglycemia);
  • a pancreas disorder;
  • a severe skin rash called Stevens-Johnson syndrome;
  • anemia (low red blood cells);
  • low white blood cells or low platelets in your blood;
  • low levels of calcium or high levels of potassium in your blood;
  • liver or kidney disease; or
  • a history of smoking or asthma.

FDA pregnancy category C. It is not known whether pentamidine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether pentamidine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Inhaled pentamidine should not be given to a child without the advice of a doctor.

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The mechanism seems to vary with different organisms and is not well understood. However, pentamidine is suspected to work through various methods of interference of critical functions in DNA, RNA, phospholipid and protein synthesis. Pentamidine binds to adenine-thymine-rich regions of the Trypanosoma parasite DNA, forming a cross-link between two adenines four to five base pairs apart. The drug also inhibits topoisomerase enzymes in the mitochondria of Pneumocystis jirovecii. Similarly, pentamidine inhibits type II topoisomerase in the mitochondria of the Trypanosoma parasite, resulting in breaks and unraveling its circular mitochondrial DNA.

  • Treatment of PCP caused by Pneumocystis jirovecii
  • Prevention of PCP in adults with HIV who have one or both of the following:
    • History of PCP
    • CD4+ count ≤ 200mm³
  • Treatment of leishmaniasis
  • Treatment of African trypanosomiasis caused by Trypanosoma brucei gambiense
  • Pentamidine is classified as an orphan drug by the U.S. Food and Drug Administration

On rare occasions, pneumocystis infections have occurred in parts of the body outside the lungs in patients receiving pentamidine inhalation therapy. You should discuss this possible problem with your doctor.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Burning pain, dryness, or sensation of lump in throat
  • chest pain or congestion
  • coughing
  • difficulty in breathing
  • difficulty in swallowing
  • skin rash
  • wheezing

Rare

  • Nausea and vomiting
  • pain in upper abdomen, possibly radiating to the back
  • pain in side of chest (severe)
  • shortness of breath (sudden and severe)

Rare

  • Anxiety
  • chills
  • cold sweats
  • cool, pale skin
  • decreased urination
  • headache
  • increased hunger
  • loss of appetite
  • nausea and vomiting
  • nervousness
  • shakiness
  • stomach pain
  • unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Pentamidine is given either as an injection, or as in inhaled medicine using a nebulizer. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Pentamidine is a powder medicine that must be mixed with a liquid (diluent) before using it as an injection or with a nebulizer. If you are using this medicine at home, be sure you understand how to properly mix and store the medicine. Use only the diluent provided with your medication.

To use pentamidine as an injection:

  • Pentamidine is injected into a muscle, or into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.
  • Do not use pentamidine if it has changed colors or has particles in it. Call your pharmacist for new medication.
  • Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when pentamidine is injected.
  • Use a disposable needle only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

To use pentamidine with a nebulizer:

  • After mixing your medicine with the diluent, pour all of the mixture into the chamber of the nebulizer. Attach the mouthpiece or face mask, then attach the drug chamber to the compressor.
  • Do not mix any other medicines in the nebulizer with pentamidine.
  • Sit upright in a comfortable position. Place the mouthpiece into your mouth or put on the face mask, covering your nose and mouth. Turn on the compressor.
  • Breathe in slowly and evenly until no more mist is formed by the nebulizer and the drug chamber is empty.
  • Clean the nebulizer after each use. Follow the cleaning directions that came with your nebulizer.

If you are diabetic, check your blood sugar carefully while you are receiving pentamidine. This medicine can raise or lower your blood sugar.

While using pentamidine, you may need frequent blood tests. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG).

Store unmixed medicine at room temperature away from moisture, heat, and light.

Mixed medicine must be used within a certain number of hours, depending on the diluent. Carefully follow the mixing and storage instructions provided with your medicine. Ask your pharmacist if you have questions.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amisulpride
  • Bepridil
  • Cisapride
  • Dronedarone
  • Grepafloxacin
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acetophenazine
  • Ajmaline
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Aprindine
  • Aripiprazole
  • Arsenic Trioxide
  • Artemether
  • Astemizole
  • Azimilide
  • Azithromycin
  • Bretylium
  • Buserelin
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cidofovir
  • Citalopram
  • Clarithromycin
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Efavirenz
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Ethopropazine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluphenazine
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Histrelin
  • Hydroquinidine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Leuprolide
  • Levofloxacin
  • Lidoflazine
  • Lorcainide
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Methotrimeprazine
  • Metronidazole
  • Moxifloxacin
  • Nafarelin
  • Nilotinib
  • Nortriptyline
  • Octreotide
  • Ondansetron
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Perphenazine
  • Pimavanserin
  • Pipotiazine
  • Pirmenol
  • Pitolisant
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propiomazine
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Risperidone
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sulpiride
  • Sultopride
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Thiethylperazine
  • Tizanidine
  • Trifluoperazine
  • Triflupromazine
  • Trimeprazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vasopressin
  • Vemurafenib
  • Vinflunine
  • Zolmitriptan
  • Zotepine
  • Zuclopenthixol

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

To help prevent the development or return of pneumocystis pneumonia, you must receive pentamidine inhalation on a regular basis, even if you are feeling well.

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