Pentam (Injection)

Pentamidine is used to treat Pneumocystis carinii pneumonia (PCP), a very serious type of pneumonia. This pneumonia often affects patients with weakened immune systems, such as those with cancer, those who have had transplants, and those with acquired immune deficiency syndrome (AIDS). Your doctor may also prescribe pentamidine for other medical issues caused by protozoa. This medicine may be used for other conditions as determined by your doctor.

Pentamidine can lead to some serious side effects. Before starting treatment with pentamidine, you and your doctor should discuss the benefits of this medicine as well as the risks involved.

Pentamidine must be given only by or under the close supervision of your doctor.

Some patients may experience sudden, severe low blood pressure after receiving a dose of pentamidine. Therefore, you should lie down while you are getting this medicine. Your doctor may also want to check your blood pressure during the pentamidine injection and several times afterward until your blood pressure is stable.

Pentamidine can reduce the number of white blood cells in your blood, which increases your risk of getting certain infections. It can also lower the number of platelets, which are important for proper blood clotting. If these issues happen, there are specific precautions you can take to lower the risk of infection or bleeding:

• Contact your doctor right away if you think you are getting a cold or any other infection.
• Contact your doctor right away if you notice any unusual bleeding or bruising.
• Be careful when using regular toothbrushes, dental floss, or toothpicks. Your doctor, dentist, or nurse may suggest other methods for cleaning your teeth and gums. Talk to your health care professional before having any dental work done.
• Avoid using a safety razor. Use an electric shaver instead. Also, be cautious when using fingernail or toenail clippers.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the benefits. This is a decision you and your doctor will make. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, inform your healthcare professional about any other allergies you may have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Although pentamidine has not been widely used in children, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Geriatric

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

Breast Feeding

There are no adequate studies in women determining the risk to infants 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 this medicine, it is especially important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Using this medicine 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.

• Bepridil
• Cisapride
• Dronedarone
• Grepafloxacin
• Levoketoconazole
• Levomethadyl
• Mesoridazine
• Pimozide
• Piperaquine
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Using this medicine 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
• Adagrasib
• Ajmaline
• Amiodarone
• Amisulpride
• Amitriptyline
• Amoxapine
• Anagrelide
• Apomorphine
• Aprindine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Artemether
• Astemizole
• Atazanavir
• Azimilide
• Azithromycin
• Bretylium
• Buprenorphine
• Buserelin
• Ceritinib
• Chloral Hydrate
• Chloroquine
• Chlorpromazine
• Cidofovir
• Citalopram
• Clarithromycin
• Clofazimine
• Clothiapine
• Clozapine
• Crizotinib
• Dabrafenib
• Dasatinib
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Dibenzepin
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxepin
• Droperidol
• Efavirenz
• Encainide
• Encorafenib
• Enflurane
• Entrectinib
• Erythromycin
• Escitalopram
• Ethopropazine
• Etrasimod
• Fexinidazole
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fluphenazine
• Formoterol
• Fostemsavir
• Gemifloxacin
• Gepirone
• Glasdegib
• Gonadorelin
• Goserelin
• Halofantrine
• Haloperidol
• Halothane
• Histrelin
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Imipramine
• Inotuzumab Ozogamicin
• Isoflurane
• Isradipine
• Ivabradine
• Ivosidenib
• Ketoconazole
• Lefamulin
• Lenvatinib
• Leuprolide
• Levofloxacin
• Lidoflazine
• Lofexidine
• Lorcainide
• Lumefantrine
• Macimorelin
• Mefloquine
• Methadone
• Methotrimeprazine
• Metronidazole
• Mirtazapine
• Mobocertinib
• Moxifloxacin
• Nafarelin
• Nilotinib
• Nortriptyline
• Octreotide
• Olanzapine
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Ozanimod
• Pacritinib
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Perphenazine
• Phenobarbital
• Pimavanserin
• Pipotiazine
• Pirmenol
• Pitolisant
• Ponesimod
• Posaconazole
• Prajmaline
• Primidone
• Probucol
• Procainamide
• Prochlorperazine
• Promazine
• Promethazine
• Propafenone
• Propiomazine
• Protriptyline
• Quetiapine
• Quinidine
• Quizartinib
• Relugolix
• Ribociclib
• Risperidone
• Selpercatinib
• Sematilide
• Sertindole
• Sertraline
• Sevoflurane
• Siponimod
• Solifenacin
• Sotalol
• Spiramycin
• Sulfamethoxazole
• Sulpiride
• Sultopride
• Sunitinib
• Tacrolimus
• Tedisamil
• Telithromycin
• Thiethylperazine
• Trazodone
• Triclabendazole
• Trifluoperazine
• Triflupromazine
• Trimeprazine
• Trimethoprim
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Vilanterol
• Vinflunine
• Voclosporin
• Zolmitriptan
• Zotepine
• Zuclopenthixol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Zalcitabine

Interactions with Food/Tobacco/Alcohol

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

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to tell your doctor if you have any other medical problems, especially:

• Anemia or
• Bleeding disorders (history of) or
• Heart disease or
• Hypotension (low blood pressure) or
• Kidney disease or
• Liver disease—Pentamidine may make these conditions worse

• Diabetes mellitus (sugar diabetes) or
• Hypoglycemia (low blood sugar)—Pentamidine may increase or decrease blood sugar levels and may disturb control of sugar diabetes

Pentamidine can lead to serious side effects, including heart issues, low blood pressure, low or high blood sugar, and other blood-related problems. You should talk with your doctor about the benefits of this medicine and the risks associated with it.

While a medicine can be helpful, it may also cause some unwanted effects. Not all side effects will happen, but if they do, they may require medical attention.

Contact your doctor right away if you experience any of the following side effects:

More common

• Decrease in urination
• Sore throat and fever
• Unusual bleeding or bruising

Signs of diabetes mellitus or high blood sugar:

• Drowsiness
• Flushed, dry skin
• Fruit-like breath odor
• Increased thirst
• Increased urination
• Loss of appetite

Signs of low blood sugar:

• Anxiety
• Chills
• Cold sweats
• Cool, pale skin
• Headache
• Increased hunger
• Nausea
• Nervousness
• Shakiness

Signs of low blood pressure:

• Blurred vision
• Confusion
• Dizziness
• Fainting or lightheadedness
• Unusual tiredness or weakness

Less common

• Fast or irregular pulse
• Fever
• Nausea and vomiting
• Pain in upper abdomen
• Pain, redness, and/or hardness at the injection site
• Skin rash, redness, or itching

Note: Signs of diabetes mellitus or high blood sugar, or signs of low blood sugar may also appear up to several months after you stop taking this medicine.

Some side effects may happen that usually do not need medical attention. These side effects may go away as your body gets used to the medicine. Your health care professional may also have ways to help prevent or lessen some of these side effects. Talk to your health care professional if any of the following side effects continue, become bothersome, or if you have any questions about them:

More common

• Diarrhea
• Loss of appetite
• Nausea and vomiting

Stomach issues like nausea and vomiting or loss of appetite are common mild side effects of pentamidine treatment. However, if you experience these issues along with sharp pain in the upper abdomen or a noticeable decrease in urination, contact your doctor immediately.

Pentamidine may also cause an unpleasant metallic taste, which is expected and does not need medical attention.

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

Reach out to your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Pentam

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antiprotozoal

To help clear up your infection completely, pentamidine must be given for the full time of treatment, even if you begin to feel better after a few days. Also, this medicine works best when there is a constant amount in the blood. To help keep the amount constant, pentamidine must be given on a regular schedule.

Make certain your health care professional knows if you are on a low-sodium, low-sugar, or any other special diet. Since most medicines contain more than their active ingredient, some products may have to be avoided.

Dosing

The dose of this medicine 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 this medicine. 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 injection dosage form: For Pneumocystis carinii pneumonia (PCP): Adults and children—Dose is based on body weight and must be determined by your doctor. The usual dose is 4 milligrams (mg) per kilogram (kg) (1.8 mg per pound) of body weight given once a day for fourteen to twenty-one days. This dose is injected slowly into a vein over a one- to two-hour period of time.