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Pentamidine Coupon - Pentamidine 300mg vial

pentamidine

Generic Nebupent
Used for Pneumonia
Used for Pneumonia

Pentamidine (Nebupent) is used to help prevent a fungal infection in the lungs called Pneumocystis jirovecii pneumonia (PCP) in certain people with human immunodeficiency virus (HIV). It's typically for people with HIV who've had a PCP infection before or who have a weak immune system. Pentamidine (Nebupent) is a breathing treatment that's given as an inhalation using a nebulizer. It can cause breathing-related side effects, like a cough or airway tightening right after your dose. This page focuses on the inhalation form of pentamidine to prevent PCP. But, note that the medication is also available as an injection that's given by a healthcare provider to treat PCP.

Reviewed by:
reviewer
Christina Aungst, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on May 1, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostAlternativesImagesReferencesPricesMedicare
basics-icon

What is Pentamidine (Nebupent)?

What is Pentamidine (Nebupent) used for?

  • Prevention of Pneumocystis jirovecii pneumonia (PCP) in certain people with HIV

How Pentamidine (Nebupent) works

Pentamidine (Nebupent) is an antifungal. Experts aren't exactly sure how it works to prevent PCP. But it's thought that the medication interferes with the ability of the fungus that causes PCP to make its own genetic material and proteins. By doing so, pentamidine (Nebupent) might help stop the fungus from growing.

Drug Facts

Common BrandsNebupent, Pentam 300
Drug ClassAntifungal
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Pentamidine (Nebupent)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Cough during or right after inhaling pentamidine (Nebupent) (38%)
  • Airway tightening during or right after inhaling pentamidine (Nebupent) (15%)
  • Wheezing (1-5%)
  • Oral thrush (1-5%)
  • Bad taste in mouth (1-5%)
  • Headache (1-5%)
  • Chest pain (1-5%)
  • Respiratory infection (1-5%)

Other Side Effects

  • Night sweats
  • Diarrhea
  • Nausea
  • Herpes flare
  • Shingles
  • Flu-like symptoms

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • PCP infection: shortness of breath, fever, cough
  • Inflammation of the pancreas (pancreatitis): upper stomach pain, fever, nausea, vomiting, yellowing of the skin or eyes

Source: DailyMed

The following side effects have also been reported

Pentamidine may cause some serious side effects, including heart problems, low blood pressure, low or high blood sugar, and other blood problems. You and your doctor should discuss the good this medicine will do as well as the risks of receiving it.

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

Decrease in urination

sore throat and fever

unusual bleeding or bruising

Signs of diabetes mellitus or high blood sugar

Drowsiness

flushed, dry skin

fruit-like breath odor

increased thirst

increased urination

loss of appetite

Signs of low blood sugar

Anxiety

chills

cold sweats

cool, pale skin

headache

increased hunger

nausea

nervousness

shakiness

Signs of low blood pressure

Blurred vision

confusion

dizziness

fainting or lightheadedness

unusual tiredness or weakness

Less common

Fast or irregular pulse

fever

nausea and vomiting

pain in upper abdomen

pain, redness, and/or hardness at place of injection

skin rash, redness, or itching

Note: Signs of diabetes mellitus or high blood sugar, or signs of low blood sugar may also occur up to several months after you stop receiving this medicine.

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

loss of appetite

nausea and vomiting

Stomach problems, such as nausea and vomiting, or loss of appetite, are common minor side effects seen in pentamidine treatment. However, if you have these problems, and at the same time have sharp pain in the upper abdomen, or an unusual decrease in the amount of urine, check with your doctor immediately.

Pentamidine may also cause an unpleasant metallic taste. This side effect is to be expected and does not require medical attention.

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.

pros-and-cons

Pros and cons of Pentamidine (Nebupent)

thumbs-up

Pros

Only needs to be taken once every few weeks

Might lower your risk of PCP infection by 50% to 70%

Typically mild side effects

thumbs-down

Cons

Not a first-choice medication to prevent PCP in people with HIV

Must use a specific nebulizer machine

Takes about 30 to 45 minutes to take a full dose of medication

pharmacist-tips

Pharmacist tips for Pentamidine (Nebupent)

pharmacist

  • Make sure you know how to prepare your dose of pentamidine (Nebupent) before placing it into the nebulizer machine. Your provider will teach you how to use your Respirgard II nebulizer machine to take your dose. Ask your provider if you have any questions about how to prepare or take pentamidine (Nebupent).

    • Prepare your dose of pentamidine (Nebupent) by mixing the medication with 6 mL of sterile water. This sterile water is given to you by your provider or pharmacy.

      • It's best to use your dose of pentamidine (Nebupent) right after you prepare it. But if needed, the mixture will be okay to use for up to 48 hours when stored at room temperature in the original vial. Just be sure to keep the mixture in a dark place and away from light.

        • If you're taking other inhaled medications with a nebulizer, don't mix pentamidine (Nebupent) with them in the nebulizer machine. Only take pentamidine (Nebupent) by itself.

          • If you develop any symptoms of an infection in between doses of pentamidine (Nebupent), let your healthcare provider know. You shouldn't use pentamidine (Nebupent) if you have an active PCP infection. Symptoms to watch out for include fever, trouble breathing, and a cough.

            • If pentamidine (Nebupent) gives you a cough, your provider might prescribe a bronchodilator for you to use before your pentamidine (Nebupent) dose. It can help open your airways and lessen bothersome airway symptoms from your pentamidine (Nebupent) treatment. If your provider wants you to use a bronchodilator beforehand, don't use your pentamidine (Nebupent) nebulizer to administer the bronchodilator.

              faqs

              Frequently asked questions about Pentamidine (Nebupent)

              Can the intravenous (IV) version of pentamidine be used in my nebulizer?
              No. Don't put IV pentamidine solutions into your nebulizer. Only use the inhalation solution of pentamidine (Nebupent) in your nebulizer. Using IV solutions in your nebulizer will not only damage the machine, but they can be harmful to inhale as well. The IV solutions are only given as an injection into the veins and sometimes into the muscle by a provider in a healthcare setting.
              Is pentamidine (Nebupent) an antibiotic?
              No. Pentamidine (Nebupent) is an antifungal medication. It prevents and treats fungal infections like PCP. Antibiotics treat infections caused by bacteria.
              How do you nebulize pentamidine (Nebupent)?
              Mix 1 vial of pentamidine (Nebupent) with 6 mL of sterile water until it dissolves. Only use sterile water to mix the solution. Then, place the solution into your Respirgard II nebulizer machine. Place your lips around the mouthpiece to make a tight seal. Turn on the machine, and breathe normally through the mouthpiece. Keep the nebulizer on until the dose cup is empty. It will take about 30 to 45 minutes to take a full dose of pentamidine (Nebupent). Ask your provider if you have any questions about how to prepare pentamidine (Nebupent), use the nebulizer, and take your medication.
              It's been 45 minutes since I started my pentamidine (Nebupent) dose, and my nebulizer dose cup still isn't empty. Should I keep my nebulizer going?
              Yes. It takes about 30 to 45 minutes to inhale your full dose of pentamidine (Nebupent). If your dose cup isn't completely empty at 45 minutes, keep going. It shouldn't be much longer. It's important that you get the whole dose of pentamidine (Nebupent) to help prevent PCP as much as possible.
              Why does pentamidine (Nebupent) cause pancreatitis?
              Pentamidine (Nebupent) can be harmful to your pancreas cells. In some rare cases, this can lead to inflammation of the pancreas (pancreatitis). There have been reports that some people taking pentamidine (Nebupent) have had acute (sudden) issues with their pancreas. Make sure to tell your provider about your full medical history, especially if you have a history of pancreatic disease. If you experience really bad stomach or back pain, upset stomach, vomiting, or yellowing of the skin or eyes, get medical help right away. These can be symptoms of pancreatitis.
              Can I use pentamidine (Nebupent) if I'm pregnant?
              If you're pregnant or thinking of becoming pregnant, talk to your healthcare provider about the risks and benefits of taking pentamidine (Nebupent). This medication hasn't been studied much in pregnant women. So experts don't know if it's safe for pregnant women to take pentamidine (Nebupent). Speak with your provider about PCP prevention that's safe for you and your baby.
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              What are the risks and warnings for Pentamidine (Nebupent)?

              Pentamidine (Nebupent) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Possible PCP infection despite taking preventative medication

              Although pentamidine (Nebupent) is used to prevent Pneumocystis jirovecii pneumonia (PCP), it's possible for you to still get sick. In studies, pentamidine (Nebupent) lowered the risk of another PCP infection in people with HIV by about 50% to 70%. You shouldn't use pentamidine (Nebupent) if you have a current PCP infection because the dose used for prevention isn't appropriate for treatment. Let your healthcare provider know right away if you have any symptoms of an infection, including fever, cough, or trouble breathing.

              risk-warning

              Coughing and airway tightness

              • Risk factors: Smoking | History of asthma

                Coughing and having a feeling of tight airways after using pentamidine (Nebupent) is a very common side effect. These side effects might be more likely to happen if you smoke or have asthma. For most people, these problems are temporary and relatively mild. If you find this side effect bothersome or know it happens every time you use pentamidine (Nebupent), you can ask your healthcare provider to prescribe you a short-acting inhaler, such as albuterol, that you can take before each time you use pentamidine (Nebupent).

                risk-warning

                Might require regular blood tests and follow-up

                The active ingredient in pentamidine (Nebupent) is known to cause many serious side effects when it's given as an injection. Some of these side effects include changes in blood sugar levels, blood cell counts, and liver or kidney problems. Experts don't know if these sorts of issues happen when it's inhaled through a nebulizer during long-term treatment. To be extra cautious, it's recommended that you have regular blood tests done and follow-ups with your provider while using pentamidine (Nebupent) to make sure you stay healthy enough to use it. Be sure to get all required blood tests and follow-ups done on time.

                dosage

                Pentamidine (Nebupent) dosage forms

                Typical dosing for Pentamidine (Nebupent)

                • Prevention of PCP in people with HIV: Inhale 1 vial (300 mg) of pentamidine (Nebupent) using the Respirgard II nebulizer machine once every 4 weeks. Inhale the medication into your lungs through the mouthpiece of the nebulizer.

                • Pentamidine is also available as an injection into the veins (IV) or muscles (IM) under the brand name Pentam 300. The injection is usually given by a provider in a hospital for the treatment of PCP.

                interactions

                Interactions between Pentamidine (Nebupent) and other drugs

                Pentamidine (Nebupent) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pentamidine (Nebupent). Please note that only the generic name of each medication is listed below.

                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.

                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.

                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                • Zalcitabine
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                alternatives

                What are alternatives to Pentamidine (Nebupent)?

                There are a number of medications that your doctor can prescribe in place of Pentamidine (Nebupent). Compare a few possible alternatives below.
                Pentamidine (Nebupent)
                Used for:

                • Prevention of Pneumocystis jirovecii pneumonia (PCP) in certain people with HIV

                $175.74 Lowest GoodRx priceView Prices
                Atovaquone (Mepron)
                Used for:

                • Treatment and prevention of pneumonia caused by the Pneumocystis jirovecii fungus. This medication is used when people cannot tolerate the first-choice medication, trimethoprim-sulfamethoxazole.

                $173.90 Lowest GoodRx priceView Prices
                Sulfamethoxazole/trimethoprim
                Used for:
                $8.67 Lowest GoodRx priceView Prices
                images

                Pentamidine (Nebupent) images

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                This medicine is White Vial.white - Pentamidine Isethionate 300mg Powder for Inhalation Solution
                white - Pentamidine Isethionate 300mg Powder for Inhalation Solution
                This medicine is White Vial.white - Pentamidine Isethionate 300mg Powder for Inhalation Solution
                white - Pentamidine 300mg Powder for Injection
                This medicine is White Vial.white - Pentamidine 300mg Powder for Injection

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                References

                Best studies we found

                Centers for Disease Control and Prevention. (2021). Pneumocystis pneumonia.

                Clinical Info HIV.gov. (2023). Pneumocystis pneumonia.

                Fresenius Kabi USA, LLC. (2022). Pentam 300- pentamidine isethionate injection, powder, lyophilized, for solution [package insert]. DailyMed.

                View All References (6)

                Hafiz, S., et al. (2023). Pentamidine. StatPearls.

                Hung, W. Y., et al. (2014). Contemporary review of drug-induced pancreatitis: A different perspective. World Journal of Gastrointestinal Pathophysiology.

                MedlinePlus. (2022). How to use a nebulizer.

                National Heart, Lung, and Blood Institute. (2021). How to use a nebulizer fact sheet.

                XGen Pharmaceuticals DJB, Inc. (2023). Pentamidine isethionate inhalant [package insert]. DailyMed.

                XGen Pharmaceuticals DJB, Inc. (2023). Pentamidine isethionate injection, powder, lyophilized, for solution [package insert]. DailyMed.

                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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