Infectious Disease Compendium

Pentamidine (Pentam®)

Dosing

CrCl Formula

CrCl > 80: 4 mg/kg iv q 24 h. Inhaled for PJP prophylaxis is 300 mg q 3 - 4 weeks.

CrCl 80-50: 4 mg/kg iv q 24 h.

CrCl 50-10: 4 mg/kg iv q 24 h.

CrCl < 10: 4 mg/kg iv q 24 h.

Hemodialysis:

Peritoneal dialysis:

Important side effects

Renal failure. Poisons islet cells, so get hypoglycemia followed by hyperglycemia. acute pancreatitis, anorexia, nausea, bronchospasm, cough, dyspnea (inhalation only), cardiac arrhythmias, elevated liver function tests, extravasation; ulceration, tissue necrosis, sloughing, hypotension, leukopenia, thrombocytopenia, rash.

Important drug interactions

Antipsychotics, arsenic trioxide, astemizole, bepridil, chloral hydrate, chloroquine, cidofovir, cisapride, clarithromycin, class i antiarrhythmic agents, class ia antiarrhythmic agents, class iii antiarrhythmic agents, cotrimoxazole, dolasetron, droperidol, enflurane, erythromycin, erythromycin/sulfisoxazole, fluconazole, fluoxetine, foscarnet, gemifloxacin, grepafloxacin, halofantrine, halothane, isoflurane, isradipine, levomethadyl, lidoflazine, mefloquine, mesoridazine, octreotide, phenothiazines, pimozide, probucol, sparfloxacin, spiramycin, sulfamethoxazole, telithromycin, terfenadine, thioridazine, tricyclic antidepressants, trimethoprim, vasopressin, venlafaxine, zalcitabine, ziprasidone, zolmitriptan.

Rants and Screeds

Pearls

Treatment of choice

Use for

PJP treatment and prophylaxis.

Acanthamoeba meningoencephalitis, Babesia, Leishmania, Trypanosoma.

Don't use for

Class

Last update 11/30/19