Pentamidine: Difference between revisions
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric))
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==Adult Dosing==
==Adult Dosing==
*PCP treatment, mod-severe: 4mg/kg IV/IM QD x21 days
===Indications by Disease===
**Not 1st-line agent; may consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur
{{#ask: [[Has DrugName::Pentamidine]] [[Has Population::Adult]]
 
|?Treats disease=Disease
*PCP prophylaxis: 300mg NEB q4wk
|?Has Dose=Dose
**Not 1st-line agent; use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water; do not mix with other nebulized meds
|?Has Context=Context
**Off label use
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
*PCP treatment [for >4 mo]: 4mg/kg IV/IM QD x21 days
===Indications by Disease===
**Not 1st-line agent
{{#ask: [[Has DrugName::Pentamidine]] [[Has Population::Pediatric]]
**Consider decreasing dose to 3mg/kg IV/IM QD if toxicities occur
|?Treats disease=Disease
**Switch to PO regimen to complete course if improvement after 7-10 days
|?Has Dose=Dose
 
|?Has Context=Context
*PCP prophylaxis [>5 yo]: 300mg NEB q4wk
|format=table
**Not 1st-line agent
|limit=50
**Use injectable product via nebulizer; reconstitute 1 vial with 6 mL sterile water
|mainlabel=-
**Do not mix with other nebulized meds
|headers=show
**Off label use
|sort=Treats disease
}}


==Special Populations==
==Special Populations==

Revision as of 01:52, 20 March 2026

Administration

  • Type: Antifungal Agent; Antiprotozoal
  • Routes of Administration: IM, IV
  • Common Trade Names: Pentam

Adult Dosing

Indications by Disease

DiseaseDoseContext
Pneumocystis jirovecii pneumonia4mg/kg IV daily over 60 minSevere disease

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Pneumocystis jirovecii pneumonia4mg/kg IV daily x 21 daysPediatric Severe, TMP/SMX intolerant

Special Populations

  • Pregnancy Risk Factor C

Renal Dosing

  • CrCl <10: give q24-36h
  • HD: give 750mg supplement
  • PD: no supplement

Hepatic Dosing

  • Caution advised with hepatic impairment

Contraindications

  • Allergy to class/drug
  • congenital long QT syndrome
  • electrolyte abnormalities, uncorrected
  • caution if QT prolongation

Adverse Reactions

Serious

  • extravasation/tissue damage
  • hypoglycemia
  • hyperglycemia
  • diabetes mellitus
  • pancreatitis
  • nephrotoxicity

Common

  • renal dysfunction
  • BUN, creatinine elevated
  • injection site necrosis
  • leukopenia
  • transaminitis

Pharmacology

  • Half-life: 2-4 weeks
  • Metabolism: Liver
  • Excretion: Urine

Mechanism of Action

protozocidal - interferes with nuclear metabolism

Comments

See Also

References

<Epocrates, UpToDate>

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