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pentamidine (Inhalation route)

pen-TAM-i-deen

Commonly used brand name(s)

In the U.S.

  • Nebupent

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Antiprotozoal

Uses For pentamidine

Pentamidine is used to try to prevent Pneumocystis carinii pneumonia (PCP), a very serious type of pneumonia. This type of pneumonia occurs commonly in patients whose immune systems are not working normally, such as patients with acquired immune deficiency syndrome (AIDS). Inhaled pentamidine does not prevent illness in parts of the body outside the lungs. pentamidine may also be used for other conditions as determined by your doctor.

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Pentamidine is available only with your doctor's prescription.

Before Using pentamidine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pentamidine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to pentamidine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on pentamidine have been done only in adult patients, and there is no specific information comparing use of pentamidine inhalation in children with use in other age groups. However, pentamidine inhalation is recommended in children 5 years of age and older who cannot tolerate other medicines.

Geriatric

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of pentamidine inhalation in the elderly with use in other age groups.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking pentamidine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using pentamidine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Bepridil
  • Cisapride
  • Grepafloxacin
  • Levomethadyl
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using pentamidine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Acetophenazine
  • Ajmaline
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Amoxapine
  • Aprindine
  • Arsenic Trioxide
  • Artemether
  • Astemizole
  • Azimilide
  • Bretylium
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cidofovir
  • Clarithromycin
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Delamanid
  • Desipramine
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Doxepin
  • Droperidol
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Ethopropazine
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Fluphenazine
  • Foscarnet
  • Gemifloxacin
  • Halofantrine
  • Haloperidol
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lidoflazine
  • Lorcainide
  • Lumefantrine
  • Mefloquine
  • Methotrimeprazine
  • Nortriptyline
  • Octreotide
  • Ondansetron
  • Pazopanib
  • Perphenazine
  • Pipotiazine
  • Pirmenol
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promazine
  • Promethazine
  • Propafenone
  • Propiomazine
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Risperidone
  • Saquinavir
  • Sematilide
  • Sertindole
  • Sevoflurane
  • Sotalol
  • Spiramycin
  • Sulfamethoxazole
  • Sultopride
  • Tedisamil
  • Telithromycin
  • Thiethylperazine
  • Tizanidine
  • Trifluoperazine
  • Triflupromazine
  • Trimeprazine
  • Trimethoprim
  • Trimipramine
  • Vandetanib
  • Vasopressin
  • Vemurafenib
  • Vilanterol
  • Vinflunine
  • Zolmitriptan
  • Zotepine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of pentamidine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Asthma—Patients with asthma may have an increase in coughing or difficulty in breathing while receiving pentamidine inhalation

Proper Use of pentamidine

To help prevent the development or return of pneumocystis pneumonia, you must receive pentamidine inhalation on a regular basis, even if you are feeling well.

Dosing

The dose of pentamidine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pentamidine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For the inhalation dosage form:
    • For the prevention of Pneumocystis carinii pneumonia (PCP):
      • Adults and children 5 years of age and older—300 milligrams (mg) by oral inhalation once every four weeks.
      • Children younger than 5 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of pentamidine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Precautions While Using pentamidine

If you are also using the inhalation form of a bronchodilator (medicine used to help relieve breathing problems), use the pentamidine inhalation at least 5 to 10 minutes after the bronchodilator, unless otherwise directed by your doctor. This will help to reduce the possibility of side effects. Do not use the bronchodilator or any medicine other than pentamidine in the nebulizer.

A bitter or metallic taste may occur during use of pentamidine. Sucking on a hard candy after each treatment can help reduce this problem.

Cigarette smoking can increase the chance of coughing and difficulty in breathing during pentamidine inhalation therapy.

pentamidine Side Effects

On rare occasions, pneumocystis infections have occurred in parts of the body outside the lungs in patients receiving pentamidine inhalation therapy. You should discuss this possible problem with your doctor.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Burning pain, dryness, or sensation of lump in throat
  • chest pain or congestion
  • coughing
  • difficulty in breathing
  • difficulty in swallowing
  • skin rash
  • wheezing
Rare
  • Nausea and vomiting
  • pain in upper abdomen, possibly radiating to the back
  • pain in side of chest (severe)
  • shortness of breath (sudden and severe)
Rare - with daily treatment doses only
  • Anxiety
  • chills
  • cold sweats
  • cool, pale skin
  • decreased urination
  • headache
  • increased hunger
  • loss of appetite
  • nausea and vomiting
  • nervousness
  • shakiness
  • stomach pain
  • unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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