Pharmacokinetics in children

No studies have been carried out into the pharmacokinetic parameters of pentamidine in children

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Treatment of pneumonia caused by Pneumocystis jirovecii (PCP)
Intravenous 1 month up to 18 years [1] [5] 4 mg/kg/day in 1 dose Duration of treatment: 14-21 days Directions for administration: Slow infusion over 60 min. There is only limited scientific evidence for this application in children.

Prophylaxis for PCP in oncology patients
Intravenous 2 years up to 18 years [2] [4] [5] 4 mg/kg/dose once every 4 weeks. There is only limited scientific evidence for this application. Less effective at ages of under 2 years, particularly after bone marrow transplants.

Prophylaxis for pneumonia caused by Pneumocystis jirovecii (PCP)
Inhalation 1 month up to 18 years [1] 300 mg/dose once a month.

Renal impaiment in children > 3 months

Adjustment in renal impairment as specified:

GFR 50-80 ml/min/1.73 m2

Adjustment not necessary

GFR 30-50 ml/min/1.73 m2

100 percentage of single dose and dosing interval : 24 up to 36 uur

GFR 10-30 ml/min/1.73 m2

100 percentage of single dose and dosing interval : 24 up to 36 uur

GFR < 10 ml/min/1.73 m2

100 percentage of single dose and dosing interval : 48 uur

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects

No information is present at this moment.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications

No information available on specific contra indications in children.

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Uncommon: acute hypotension, preferably to be administered on IC. Check the blood counts, blood pressure, serum creatinine and blood glucose.

 

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

• ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS
• ANTIPROTOZOALS

AGENTS AGAINST LEISHMANIASIS AND TRYPANOSOMIASIS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

References

1. Hartwig NC, et al, Vademecum pediatrische antimicrobiele therapie, 2005
2. Milstone AM, et al, Failure of intravenous pentamidine prophylaxis to prevent pneumocystis pneumonia in a pediatric hematopoietic stem cell transplant (HSCT) patient, Pediatr Blood Cancer. , 2006 , Nov;47(6), 859-60
3. Schuval SJ, et al, Failure of pentamidine as prophylaxis for Pneumocystis carinii pneumonia in HIV-infected children, Arch Pediatr Adolesc Med, 1994, Aug;148(8), 876-9
4. Kim SY, et al, Intravenous pentamidine is effective as second line Pneumocystis pneumonia prophylaxis in pediatric oncology patients. , Pediatr Blood Cancer, 2008, Apr;50(4), 779-83
5. Prasad P, et al , Pneumocystis pneumonia in children receiving chemotherapy, Pediatr Blood Cancer, 2008, Apr;50(4), 896-8

Changes

Therapeutic Drug Monitoring

Overdose