Drug Characteristics
  • Formulation

    Injection: 300 mg

    Nebulizer solution: 300 mg

    Ready made nebulizer solution not always available. Use IV preparation

  • Dose

    PCP treatment

    4 mg/kg IV once a day for 21 days

    PCP prophylaxis

    300 mg nebulised via Respirgard II every 4 weeks

    Less effective in subjects with CD4<100 and provides no cross prophylaxis cover against other OIs

  • Side Effects

    Intravenous: Nephrotoxicity; postural hypotension; SIADH; hypocalcaemia; hypoglycaemia; hyperglycaemia; pancreatitis; facial flushing; nausea and vomiting; tachycardia; abnormal LFTs; dizziness; rash; leukopenia

    Caution: Dysglycaemias may occur some time (14 days) after drug is stopped

    Blood glucose, HR and BP should be monitored regularly throughout the treatment period and for up to 1 week after stopping

    Inhaled: bronchospasm; cough; taste disturbances

    An inhaled beta-2-agonist should be administered prior to inhaled pentamidine

  • Interactions

    Other nephrotoxic drugs e.g. aminoglycosides, amphotericin, foscarnet, cidofovir (contraindicated)

    Caution –hypocalcaemia especially with foscarnet

  • Renal

    Dose in renal impairment GFR (ml/min);

    20–50: Dose as in normal renal function;

    10–20: Dose as in normal renal function;

    <10: 4 mg/kg on alternate days to complete 14 doses

  • Hepatic

    No data available on dosage reduction in patients with hepatic dysfunction

    Use with caution with possible dose reduction

  • Pregnancy

    Compatible – Maternal Benefit >> Embryo-Foetal Risk

  • Other Information