Pentamidine

Dosing

Cutaneous leishmaniasis 2-4 mg/kg IM/IV 1-2 times weekly

Visceral leishmaniasis 2-4 mg/kg IM/IV once daily for up to 15 doses

Trypanosomiasis 4 mg/kg IM/IV once daily x10d

Pneumocystis pneumonia 4 mg/kg IM/IV once daily x14-21d

HIV infection - Pneumocystis pneumonia 4 mg/kg IV once daily x21d

  • May be reduced to 3 mg/kg IV once daily due to toxicities

HIV infection - Pneumocystis pneumonia; Prophylaxis 300 mg via nebulizer every 4w

Pneumocystis pneumonia Age ≥4m 4 mg/kg IM/IV once daily x14-21d

HIV infection - Pneumocystis pneumonia Age ≥4m 4 mg/kg IV once daily x21d

  • May change to Atovaquone after 7-10d if clinical improvement occurs

HIV infection - Pneumocystis pneumonia; Prophylaxis Age ≥5y 300 mg via nebulizer every month

Age ≥16y 300 mg via nebulizer every 4w

CrCl 10-50CrCl <104 mg/kg IV q24h4 mg/kg IV q24-36h

General Information

Pneumocystis pneumonia HIV infection - Pneumocystis pneumonia; Prophylaxis

Monitor blood glucose levels, BUN and serum creatinine, CBC and platelet count, liver function tests and serum calcium prior to initiation, daily during therapy, and after treatment.

Monitor blood pressure and EGC prior to initiation, daily during therapy, and after treatment.

Common

  • Decrease in appetite

  • Nephrotoxicity

  • Renal impairment

  • Serum creatinine raised

  • Leukopenia

  • Bronchospasm

  • Cough

  • Dyspnea

  • Wheezing

  • Fatigue

  • Fever

Serious

  • Cardiac dysrhythmia

  • Hypotension

  • Hypoglycemia

  • Injection site necrosis

  • Peeling of skin

  • Skin ulcer

  • Stevens-Johnson syndrome

  • Pancreatitis

  • Neurologic effects

  • Azotemia

  • Pneumothorax

  • Sepsis

  • Anaphylaxis

  • Kaposi's sarcoma

Contraindications:

  • QT interval prolonging drugs

  • Grepafloxacin

  • Levomethadyl

Multiple drug-drug interactions:

  • QT prolonging agents

  • Class IA and III antiarrhythmic agents

  • Antipsychotics

  • Phenothiazines

Antimicrobial class: Antiprotozoal

Pregnancy category: C

Average serum half life: 6.4 hours (IV), 9.4 hours (IM)

Precautions: Use with caution in patients with hypertension, pre-existing hypotension, and ventricular tachycardia.

Use with caution in patients with preexisting endocrine and metabolic, hepatic, renal, hematologic and dermatologic diseases, and monitoring recommended.

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