PENTAMIDINE ISETHIONATE

Antileishmaniasis and antipneumocystis medicine

Dosage Forms

Powder for Injection

300 mg

Uses

  • Pneumocystis carinii pneumonia (PCP)
  • Leishmaniasis
  • Human African trypanosomiasis

Dose and Duration

Visceral leishmaniasis (unresponsive to, or intolerant of antimonial compounds)

Adult and child: by deep IM injection or by IV infusion, 4 mg/kg 3 times a week for 5–25 weeks or longer, until consecutive splenic aspirates taken 14 days apart are negative

Cutaneous leishmaniasis (infections caused by L. aethiopica or L. guyanensis)

Adult and child: by deep IM injection or by IV infusion, 3–4 mg/kg once or twice a week until the lesion is no longer visible

Diffuse cutaneous leishmaniasis (infections caused by L. aethiopica)

Adult and child: by deep IM injection or by IV infusion, 3–4 mg/kg once a week, continued for at least 4 months after parasites are no longer detectable in slit-skin smears

Mucocutaneous leishmaniasis unresponsive to antimonial compounds

Adult and child: by deep IM injection or by IV infusion, 4 mg/kg 3 times a week for 5–25 weeks or longer, until lesion is no longer visible

Treatment of pneumocystis carinii pneumonia

Adult and child: by slow IV infusion or by deep IM injection, 4 mg/kg daily for at least 14 days

Prophylaxis of P.carinii pneumonia

Adult and child: 4 mg/kg once every 4 weeks

Treatment of haemolymphatic stage of T. brucei gambiense infection

Adult and child: by IM injection, 4 mg/kg daily or on alternate days for a total of 7–10 doses

Treatment of meningoencephalitic stage of T. brucei gambiense (prior to melarsoprol)

Adult and child: by IM injection, 4 mg/kg daily on day 1 and day 2

Preparation

  • Reconstitute according to manufacturer’s instructions

Contraindications

  • Severe renal impairment

Side Effects

  • Thrombocytopenia, leucopoenia, anaemia, azotemia
  • Nephrotoxicity, pancreatitis
  • Hypoglycaemia, hyperglycaemia, hyperkalaemia, hypocalcaemia
  • Nausea, vomiting, taste disturbance, abdominal pain
  • Confusion, hallucinations
  • Arrhythmias
  • Rash, Stevens-Johnson syndrome
  • Acute hypotension with dizziness, headache, breathlessness, tachycardia and syncope after rapid IV injection

Pregnancy

  • Do not use

Breast-feeding

  • Do not use

⚠️ Caution

  • Establish baseline blood pressure before administration and administer when patient is lying down due to risk of severe hypotension. Monitor blood pressure during administration and during treatment
  • Interrupt or discontinue treatment if severe deterioration in bone marrow, renal or pancreatic function develop
  • Can be used to treat in potentially fatal visceral leishmaniasis in pregnancy and breast feeding