Pentamidine (Inhalation)

Pentamidine is used to help prevent Pneumocystis carinii pneumonia (PCP), which is a very serious type of pneumonia. This type of pneumonia often affects patients with weakened immune systems, such as those with acquired immune deficiency syndrome (AIDS). Inhaled pentamidine does not protect against illness in areas of the body outside the lungs. Your doctor may also prescribe this medicine for other conditions.

Pentamidine is available only with your doctor's prescription.

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

You may experience a bitter or metallic taste while using this medicine. Sucking on a hard candy after each treatment can help with this issue.

Cigarette smoking can increase the risk of coughing and trouble breathing during pentamidine inhalation therapy.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine compared to the benefits it may provide. For this medicine, think about the following:

Allergies

Inform your doctor if you have ever had any strange or allergic reaction to this medicine or any other medicines. Also let your healthcare professional know if you have other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

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

Geriatric

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

Breast Feeding

There are no adequate studies in women to determine 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

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction could happen. In these situations, your doctor may want to adjust 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 necessary in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both 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

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating food or certain types of food because interactions may occur. Using alcohol or tobacco with some medicines may also lead to interactions. Talk with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect how you can use this medicine. Be sure to tell your doctor if you have any other medical problems, especially:

• Asthma—Patients with asthma may have more coughing or trouble breathing while using pentamidine inhalation.

On rare occasions, pneumocystis infections have happened in parts of the body outside the lungs in patients receiving pentamidine (inhalation) therapy. You should talk to your doctor about this possible issue.

Along with its necessary effects, a medicine may cause some unwanted effects. Not everyone will experience these side effects, but if they do occur, they might need medical attention.

Check with your doctor right away if any of the following side effects happen:

More common

• Burning pain, dryness, or feeling of a lump in the throat
• Chest pain or congestion
• Coughing
• Difficulty breathing
• Difficulty swallowing
• Skin rash
• Wheezing

Rare

• Nausea and vomiting
• Pain in the upper abdomen, possibly spreading to the back
• Severe pain in the side of the chest
• Sudden and severe shortness of breath

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 can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nebupent

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antiprotozoal

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 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 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 this medicine, 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.