Pentamidine Inhaled (NebuPent): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Inhaled pentamidine is used to prevent a type of pneumonia called pneumocystis pneumonia (PCP). Common side effects include coughing, wheezing, and a bad taste in your mouth. Call your health care provider right away if you get new or worsening breathing problems, cough, fever, severe stomach pain, or nausea. Get emergency help if you have trouble breathing or chest pain.

Uses

What is inhaled pentamidine used for?

Inhaled pentamidine is used to prevent Pneumocystis jirovecii pneumonia (PJP) in certain people, which is also known as pneumocystis pneumonia (PCP).

Inhaled pentamidine may also be used for other conditions as determined by your health care provider.

Pentamidine is also available in an injectable form. See Pentamidine (Pentam) for more information.

How does inhaled pentamidine work (mechanism of action)?

Inhaled pentamidine kills the invasive fungus that causes PJP by stopping it from making important cellular parts like DNA or proteins, preventing it from causing an infection.

How is inhaled pentamidine supplied (dosage forms)?

Brands and other names

NebuPent

Dosage forms and strengths

300 mg per vial for inhalation solution

How should I store inhaled pentamidine?

Inhaled pentamidine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light.

Side Effects

What are the most common side effects of inhaled pentamidine?

The most common side effects of inhaled pentamidine are listed below. Tell your health care provider if you have any of these side effects that bother you.

Night sweats
Diarrhea
Nausea
Anemia
Infection, including nose, throat, and mouth infection
Headache
Breathing problems (see below)
Bad taste in your mouth

There may be other side effects of inhaled pentamidine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of inhaled pentamidine?

While less common, the most serious side effects of inhaled pentamidine are described below, along with what to do if they happen.

Severe Allergic Reactions. Inhaled pentamidine may cause allergic reactions, which can be serious. Stop using inhaled pentamidine and get help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Breathing Problems. Inhaled pentamidine may cause the muscles around the airways to tighten (bronchospasm) instead of relaxing, which can be serious. Talk to your health care provider about using a bronchodilator medicine before each dose of inhaled pentamidine. Stop using inhaled pentamidine and get emergency help if you have trouble breathing.

Inflammation of the Pancreas (Pancreatitis). Inhaled pentamidine may cause inflammation of the pancreas, which is called pancreatitis. Stop using inhaled pentamidine and call your health care provider right away if you have symptoms of pancreatitis, including vomiting or severe pain in the upper part of your belly that travels to your back.

Low Blood Pressure (Hypotension). Inhaled pentamidine may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

Dizziness, feeling lightheaded, or fainting
Confusion
Feeling weak or tired

Low Blood Sugar (Hypoglycemia). Inhaled pentamidine can cause low blood sugar, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Call your health care provider right away if you have any of the following symptoms of hypoglycemia.

Headache
Crankiness or anxiety
Hunger
Dizziness or confusion
Blurry vision
Slurred speech
Sweating
Feeling jittery or shakiness
Fast heartbeat
Seizures

High Blood Sugar. Inhaled pentamidine may increase your blood sugar levels. This may occur with or without a preceding episode of low blood sugar. High blood sugar may also occur several months after the treatment ends. Talk to your health care provider about how to maintain healthy blood sugar levels. Keep all appointments with your health care provider to check your blood tests. Call your health care provider if you have the following symptoms of high blood sugar.

Thirstier than usual
Peeing more than usual
Increase in hunger
Tiredness
Feeling sick to your stomach
Confusion
Fruity-smelling breath

Abnormal Heart Rhythm (Arrhythmia). Inhaled pentamidine may cause an abnormal heart rhythm (arrhythmia). Call your health care provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you feel your heartbeat more than usual.

Kidney Damage. Kidney damage can happen when using inhaled pentamidine. Call your health care provider right away if you have any of the following symptoms of kidney damage.

Reduced need to pee
Swelling in your feet, ankles, or legs
Weakness or unusual tiredness
Difficulty catching your breath or chest pain/pressure
Confusion
Nausea
Seizures

Warnings & Precautions

Who should not use inhaled pentamidine?

Allergies to Ingredients. People who are allergic to any of the following should not use inhaled pentamidine.

NebuPent
Pentamidine
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific inhaled pentamidine products they stock.

What should I know about inhaled pentamidine before using it?

Do not use inhaled pentamidine unless it has been prescribed to you by a health care provider. Use it as prescribed. Consider using a calendar to help you remember when to use inhaled pentamidine.

Do not share inhaled pentamidine with other people, even if they have the same condition as you. It may harm them.

Keep inhaled pentamidine out of the reach of children.

Only use inhaled pentamidine with the nebulizer device specified by your health care provider or the product label. Do not dissolve the inhaled pentamidine powder in any other liquid than the one specified by your health care provider or the product label. Make sure that you or a caregiver understands how to properly prepare and use inhaled pentamidine and the nebulizer. If you have any questions, talk to your health care provider.

Do not mix the dissolved pentamidine inhalation solution with any other medicines. The nebulizer you use to administer inhaled pentamidine should not be used to administer a bronchodilator medicine. If you have any questions about the different inhaled medicines you use, talk to your health care provider.

This medicine helps in preventing Pneumocystis jirovecii pneumonia, but you may still get pneumocystis pneumonia (PCP). Call your health care provider right away if you get new or worsening breathing problems, cough, or fever. You may need another medicine.

What should I tell my health care provider before using inhaled pentamidine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if inhaled pentamidine is right for you.

In particular, make sure that you discuss any of the following.

Smoking or Asthma. Tell your health care provider if you smoke or have asthma before using inhaled pentamidine. This medicine can cause breathing problems (see the Side Effects section for more details).

Lung Infection. Tell your health care provider if you currently have symptoms of a lung infection, such as breathing problems, coughs, and fever. Your health care provider may check your symptoms to make sure inhaled pentamidine is the right medicine for you.

Other Medicines and Supplements. Inhaled pentamidine may interact with other medicines and supplements. Before using inhaled pentamidine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how inhaled pentamidine could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if inhaled pentamidine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop inhaled pentamidine.

Interactions

Does inhaled pentamidine interact with foods or drinks?

There are no known interactions between inhaled pentamidine and foods or drinks.

It is unknown if drinking alcohol will affect inhaled pentamidine, but heavy drinking can slow your immune response and make you more likely to get an infection.

Does inhaled pentamidine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using inhaled pentamidine.

Cisplatin, which is a medicine used to treat certain cancers
Amphotericin B (Abelcet, AmBisome), which is a medicine used to treat fungal infections
An aminoglycoside antibiotic, such as amikacin or gentamicin, which is a medicine given by injection to treat infections
Vancomycin (Firvanq, Vancocin), which is an antibiotic used to treat certain infections
Foscarnet (Foscavir), which is a medicine used to treat certain viral infections

This may not be a complete list of medicines that can interact with inhaled pentamidine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much inhaled pentamidine?

If you or someone else has used too much inhaled pentamidine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.