Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Antiprotozoal, Antiparasitic
Original Date: 
August 2005
Revised Date: 
April 2014
  • Treatment and prevention of Pneumocystis carinii infections in immunocompromised patients who cannot tolerate or who fail to respond to co-trimoxazole 
Reconstitution and Stability: 




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

- Solutions Compatible: D5W, NS

- Additive/Above Cassette Compatible: no information

- Y-site Compatible: zidovudine

Incompatible: cefazolin, cefotaxime, ceftazidime, ceftriaxone, fluconazole, foscarnet


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IM YES, IV route preferred
IV Direct


IV Intermittent Infusion

YES, blood pressure monitoring
LARGE VOLUME PUMP ONLY. Don't use a minibag smaller than 50 mL
Usual dilution: 1-2.5 mg/mL
Infusion time: 1-2 hours (preferrably 2-3 hours)

IV Continuous Infusion NO

(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


  • 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                                      
  • 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

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