Alternate Name(s):
PENTAM-300
Classification:
Antiprotozoal, Antiparasitic
Original Date:
August 2005
Revised Date:
April 2014
Indications:
- Treatment and prevention of Pneumocystis carinii infections in immunocompromised patients who cannot tolerate or who fail to respond to co-trimoxazole
Reconstitution and Stability:
|
VIAL SIZE |
STERILE WATER for INJECTION REQUIRED |
FINAL CONCENTRATION |
|
300 mg |
3 mL |
100 mg/mL |
- Store unopened vials at room temperature
- Protect vials from light - in original container
- Reconstituted solution stable for 48 hrs at room temperature, protected from light
- Diluted solutions (1-2.5 mg/mL) stable 24 hrs at room temperature in D5W or NS
Compatibility:
- Solutions Compatible: D5W, NS
- Additive/Above Cassette Compatible: no information
- Y-site Compatible: zidovudine
Incompatible: cefazolin, cefotaxime, ceftazidime, ceftriaxone, fluconazole, foscarnet
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | YES, IV route preferred |
| IV Direct |
NO |
| IV Intermittent Infusion |
YES, blood pressure monitoring |
| IV Continuous Infusion | NO |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- Treatment: 4 mg/kg/day IM/IV once daily for 14-21 days
- Prevention: 4 mg/kg/dose IM/IV, every 2-4 weeks
DOSING ADJUSTMENT IN RENAL IMPAIRMENT:
- CrCl 10-30 mL/minute: Administer normal dose once every 36 hours
- CrCl <10 mL/minute: Administer normal dose once every 48 hours
Potential hazards of parenteral administration:
- Hypotension, especially with rapid IV administration
- Tachycardia, cardiac arrhythmias
- Nephrotoxicity
- Nausea, vomiting, dizziness, syncope, flushing, rash
- Phlebitis can occur after IV injection
- IM injections associated with pain, tenderness, erythema, induration and sterile abscess formation at the site of injection.
- Neutropenia, leukopenia and thrombocytopenia
- Hypocalcemia, hyperkalemia, hypoglycemia, hyperglycemia
- Elevated BUN and serum creatinine
Notes:
- Patients should be in a supine position and blood pressure should be monitored closely during and after IV or IM administration until vital signs stable
- Monitor liver function tests, renal function tests, blood pressure, blood glucose, serum potassium and calcium, CBC with differential and platelet count, EKG
- Hypoglycemia can occur any time or up to several days after the drug is discontinued
- Hyperglycemia and diabetes mellitus sometimes can occur several months after therapy
- Aminoglycosides, amphotericin B, cisplatin and vancomycin may increase nephrotoxicity
- IM injections should be reserved for patients with adequate muscle mass and limited to those situations where IV administration is not possible