Infectious Disease Compendium

Pentamadine (Pentam®)

Dosing

CrCl Formula

CrCl > 80: 4 mg/kg iv q 24 h. Inhaled for PJP prophylaxis is 300 mg q 3 - 4 weeks.

CrCl 80-50: 4 mg/kg iv q 24 h.

CrCl 50-10: 4 mg/kg iv q 24 h.

CrCl < 10: 4 mg/kg iv q 24 h.

Hemodialysis:

Peritoneal dialysis:

Important side effects

Renal failure. Poisons islet cells, so get hypoglycemia followed by hyperglycemia. acute pancreatitis, anorexia, nausea, bronchospasm, cough, dyspnea (inhalation only), cardiac arrhythmias, elevated liver function tests, extravasation; ulceration, tissue necrosis, sloughing, hypotension, leukopenia, thrombocytopenia, rash.

Important drug interactions

Antipsychotics, arsenic trioxide, astemizole, bepridil, chloral hydrate, chloroquine, cidofovir, cisapride, clarithromycin, class i antiarrhythmic agents, class ia antiarrhythmic agents, class iii antiarrhythmic agents, cotrimoxazole, dolasetron, droperidol, enflurane, erythromycin, erythromycin/sulfisoxazole, fluconazole, fluoxetine, foscarnet, gemifloxacin, grepafloxacin, halofantrine, halothane, isoflurane, isradipine, levomethadyl, lidoflazine, mefloquine, mesoridazine, octreotide, phenothiazines, pimozide, probucol, sparfloxacin, spiramycin, sulfamethoxazole, telithromycin, terfenadine, thioridazine, tricyclic antidepressants, trimethoprim, vasopressin, venlafaxine, zalcitabine, ziprasidone, zolmitriptan.

Rants and Screeds

Pearls

Treatment of choice

Use for

PJP treatment and prophylaxis. Acanthamoeba meningoencephalitis, Babesia, Leishmania, Trypanosoma.

Don't use for

Class