Pentamidine (inhalation route)


    Brand Name

    US Brand Name

    Nebupent


    Description

    Pentamidine is used to try to prevent Pneumocystis carinii pneumonia (PCP), a very serious type of pneumonia. This type of pneumonia occurs commonly in patients whose immune systems are not working normally, such as patients with acquired immune deficiency syndrome (AIDS). Inhaled pentamidine does not prevent illness in parts of the body outside the lungs. This medicine may also be used for other conditions as determined by your doctor.

    Pentamidine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Powder for Solution

    Before Using

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

    Allergies

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

    Pediatric

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

    Geriatric

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

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    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 know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of 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
    • Bedaquiline
    • Bretylium
    • Buprenorphine
    • Buserelin
    • Ceritinib
    • Chloral Hydrate
    • Chloroquine
    • Chlorpromazine
    • Cidofovir
    • Citalopram
    • Clarithromycin
    • Clofazimine
    • Clothiapine
    • Clozapine
    • Crizotinib
    • Dabrafenib
    • Dasatinib
    • Degarelix
    • Delamanid
    • Desipramine
    • Deslorelin

    Other Interactions

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

    Other Medical Problems

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

    • Asthma—Patients with asthma may have an increase in coughing or difficulty in breathing while receiving pentamidine inhalation

    Proper Use

    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.


    Precautions

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

    A bitter or metallic taste may occur during use of this medicine. Sucking on a hard candy after each treatment can help reduce this problem.

    Cigarette smoking can increase the chance of coughing and difficulty in breathing during pentamidine inhalation therapy.


    Side Effects

    On rare occasions, pneumocystis infections have occurred in parts of the body outside the lungs in patients receiving pentamidine inhalation therapy. You should discuss this possible problem with your doctor.

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Burning pain, dryness, or sensation of lump in throat
    • chest pain or congestion
    • coughing
    • difficulty in breathing
    • difficulty in swallowing
    • skin rash
    • wheezing

    Rare

    • Nausea and vomiting
    • pain in upper abdomen, possibly radiating to the back
    • pain in side of chest (severe)
    • shortness of breath (sudden and severe)

    Rare

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






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