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Therapeutic action
- Antiprotozoal active against Pneumocystis jiroveci (carinii)
Indications
- Second-line treatment of pneumocystosis, in the event of contra-indication, intolerance or unresponsiveness to co-trimoxazole
Forms and strengths, route of administration
- Powder for injection, 200 mg and 300 mg vials, to be dissolved in 10 ml water for injection, for IM injection or infusion in 250 ml of 5% glucose
Dosage and duration
- Child and adult: 4 mg/kg once daily by IM injection or infusion (60 minutes minimum) for 14 to 21 days
Contra-indications, adverse effects, precautions
- Do not administer to patients with severe renal impairment.
- Reduce dosage in patients with renal impairment.
- May cause:
- aseptic abscess by IM route; venous thrombosis by IV route;
- malaise, hypotension, particularly if administered too rapidly by IV route;
- gastrointestinal disturbances; renal, hepatic and haematologic disorders; pancreatitis, arrhythmia, torsades de pointes, hypoglycaemia followed by hyperglycaemia.
- Do not combine with drugs inducing torsades de pointes: anti-arrhythmics, neuroleptics, tricyclic antidepressants, IV erythromycin, halofantrine, etc.
- Avoid combination with: mefloquine, cardiac glycosides, azole antifungals, drugs inducing hypokalaemia (diuretics, glucocorticoids, injectable amphotericin B, etc.).
- Administer on a empty stomach, keep the patient supine during injection and 30 minutes after.
- Monitor blood pressure, blood glucose level, serum creatinine level, blood counts.
- Pregnancy and breast-feeding: CONTRA-INDICATED, except if vital and there is no therapeutic alternative.
Remarks
- For the prophylaxis of pneumocystosis, pentamidine may be used by inhalation of nebulised solution using suitable equipment.
- Pentamidine is also used in the treatment of African trypanosomiasis and leishmaniasis.
Storage
– Below 25 °C
Once reconstituted, solution keeps for 24 hours maximum, between 2 °C to 8 °C.
Once reconstituted, solution keeps for 24 hours maximum, between 2 °C to 8 °C.