PENTAMIDINE injectable

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    Prescription under medical supervision

     

    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.