pentamidine isetionate at a glance
Medicine class
Antiprotozoal and antiparasitic agent.
How it is given
By intravenous infusion, intramuscular injection or inhalation through a suitable nebuliser, depending on the indication.
Where it is given
Administration is supervised by healthcare professionals; nebulised treatment requires measures to prevent unintended aerosol exposure.
What is pentamidine isetionate used for?
The selected UK product is licensed in adults and children for:
Prevention and treatment of Pneumocystis jirovecii pneumonia.
Treatment of visceral and cutaneous leishmaniasis.
Treatment of first-stage human African trypanosomiasis caused by Trypanosoma brucei gambiense.
How does pentamidine isetionate work?
Pentamidine interacts with pathogen DNA and disrupts folate metabolism and the production of RNA and proteins. These effects interfere with survival and replication of susceptible protozoa and Pneumocystis organisms.
pentamidine isetionate preparations and strengths
Injection
Route: Parenteral
Strengths: 300 mg
How to take pentamidine isetionate
Pentamidine is prepared and administered by trained healthcare professionals. The route depends on the infection: it may be infused into a vein, injected into a muscle or inhaled as a mist from a suitable nebuliser.
Remain lying down for injection or infusion because blood pressure can fall suddenly.
Nebulised pentamidine should be used in a suitable, well-ventilated treatment area that limits aerosol exposure to other people.
An inhaled bronchodilator may be given beforehand to reduce coughing and bronchospasm.
Tell staff immediately if you become wheezy, faint, dizzy or unwell during administration.
pentamidine isetionate side effects
Common or expected effects
- With inhalation: cough, wheezing, breathlessness or bronchospasm, altered taste and nausea.
- With injection or infusion: nausea, vomiting, altered taste, dizziness, blood-pressure changes, rash and blood-test abnormalities affecting blood cells, glucose, electrolytes, liver or kidneys.
- Pain, swelling or inflammation can occur at an intramuscular injection site.
Get urgent medical advice
- Severe allergic reaction, including anaphylaxis or angioedema.
- Severe bronchospasm or worsening breathlessness.
- Fainting, severe hypotension, QT prolongation or a dangerous heart rhythm.
- Severe low blood sugar, pancreatitis or acute kidney injury.
- Serious blood-cell disorders or severe skin reactions such as Stevens–Johnson syndrome.
pentamidine isetionate in pregnancy
Experience during pregnancy is very limited, and reproductive toxicity has been seen in animals. The UK product information advises using pentamidine only when the woman's clinical condition requires it; anyone pregnant, planning pregnancy or who may be pregnant should discuss this with the specialist team before treatment. Pregnant bystanders should avoid exposure to nebulised pentamidine aerosol.
pentamidine isetionate while breastfeeding
It is unknown whether pentamidine or its metabolites enter breast milk. The UK product information advises stopping breastfeeding during treatment, so specialist advice is needed before therapy begins. Breastfeeding bystanders should also avoid exposure to nebuliser aerosol.
pentamidine isetionate interactions
Check the complete medication list before systemic or inhaled pentamidine, particularly for medicines affecting the kidneys, pancreas, electrolytes or heart rhythm.
Didanosine
Concurrent use increases the risk of pancreatitis.
Foscarnet
The combination may cause severe kidney impairment and low blood calcium.
Amphotericin B
Systemic co-administration is associated with severe kidney impairment.
QT-prolonging medicines
Common questions about pentamidine isetionate
Answers are fully visible for fast scanning and source review.
What is pentamidine isetionate used for?
It is licensed to prevent or treat Pneumocystis jirovecii pneumonia and to treat visceral or cutaneous leishmaniasis and first-stage West African sleeping sickness.
Why is pentamidine isetionate inhaled through a nebuliser?
The nebuliser creates a fine mist that carries pentamidine into the air sacs of the lungs, where Pneumocystis organisms are found.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.