Pentamidine
General Information
Non-formulary antimicrobial.
- Use as per Haem-Onc or Transplant guidelines below or following recommendation by Micro/ID Consultant or registrar
- Use of IV for PCP prophylaxis is off-label use.
- Intravenous pentamidine must be ordered via Baxter® as per OUH SOP for obtaining aseptically-prepared non-cancer medicines via Pharmacy.
- Nebulised pentamidine must only be administered in a room with a scavenger unit. In the absence of this equipment nebulised pentamidine must not be used.
For all information regarding contra-indications, interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).
Dosing
BMT patient treatment or prophylaxis: See PJP prophylaxis (formerly PCP) Discuss dosing with specialist teams
Transplant patient: See PJP prophylaxis (formerly PCP) Discuss dosing with specialist teams
Other patients:
|
By inhalation of nebulised solution |
IV |
|
|
Prophylaxis of Pneumocystis jirovecii pneumonia |
150mg every 2 weeks OR 300mg once a Month
(Note IV is off-label use) |
4mg/kg once a Month |
|
|
IV |
|
Treatment of Pneumocystis jirovecii pneumonia |
4mg/kg OD |
Other uses: Discuss dosing with Micro/ID
Renal and hepatic impairment
|
eGFR (mL/min/1.73m2) |
Intravenous Treatment Dose |
|
10 or more |
Dose as in normal renal function |
|
Depending on severity of infection. For severe/life threatening PJP infection: 4mg/kg/day IV for 7–10 days, then on alternate days to complete a minimum of 14 doses. For less severe PJP infection: 4 mg/kg on alternate days to complete a minimum of 14 doses. |
|
|
HD/PD |
Not dialysed. Dose as in eGFR less than 10 mL/min/1.73m2 |
|
HDF/High flux |
Unknown dialysability. Dose as in eGFR less than 10 mL/min/1.73m2 |
Hepatic impairment
No specific dosage recommendations. Manufacturer recommend use with caution.
In patients with a decrease in hepatic function, the benefits of continuation of therapy should outweigh the potential risk.
References
References
- Tillomed Laboratories Ltd. Pentamidine isetionate Tillomed 300 mg powder for solution for injection/infusion summary of product characteristics. Electronic Medicines Compendium. Last revision of the text 27/6/23. Available at: https://www.medicines.org.uk/emc Accessed 7/10/26
- British National Formulary. Pentamidine Isetionate. BNF online accessed via via: www.medicinescomplete.com Accessed 7/10/26.
- The Renal Drug Database. Pentamidine Isetionate. Last updated 23/9/24. Available at: https://www.renaldrugdatabase.com Accessed 7/10/26.
- Sanford guide [online]. Pentamidine. Last updated 30/6/26. Accessed via https://webedition.sanfordguide.com Accessed 7/10/26.