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Pentamidine (systemic): Drug information

Pentamidine (systemic): Drug information
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For additional information see "Pentamidine (systemic): Patient drug information" and "Pentamidine (systemic): Pediatric drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Pentam
Pharmacologic Category
  • Antifungal Agent;
  • Antiprotozoal
Dosing: Adult
Leishmaniasis, visceral, secondary prophylaxis

Leishmaniasis, visceral, secondary prophylaxis (off-label use): Note: For patients with HIV and CD4 count <200 cells/mm3 (Ref).

IV: 4 mg/kg (maximum: 300 mg) once every 2 to 4 weeks until CD4 count >350 cells/mm3, HIV viral load undetectable ≥6 months, and no evidence of visceral leishmaniasis relapse (Ref).

Pneumocystis pneumonia

Pneumocystis pneumonia (alternative agent):

Prophylaxis (primary and secondary), patients with HIV (off-label use): IV: 300 mg every 28 days. Continue prophylaxis following initiation of antiretroviral therapy (ART) until CD4 count ≥200 cells/mm3 for ≥3 months; may consider discontinuation of prophylaxis in patients with a CD4 count between 100 to 200 cells/mm3 who are receiving ART and have had an undetectable viral load for ≥3 to 6 months (Ref).

Treatment: IV: 4 mg/kg/dose once daily (Ref) for 21 days (Ref); may reduce to 2 to 3 mg/kg/dose once daily if toxicity occurs (Ref).

West African trypanosomiasis, first-stage disease

West African trypanosomiasis (Trypanosoma brucei gambiense infection; sleeping sickness), first-stage disease (off-label use): IM, IV: 4 mg/kg once daily for 7 days (Ref).

Dosing: Kidney Impairment: Adult

IV: The FDA-approved labeling recommends that caution should be used in patients with renal impairment; however, no specific dosage adjustment guidelines are available. The following guidelines have been used by some clinicians (Ref):

CrCl ≥10 mL/minute: No dosage adjustment necessary.

CrCl <10 mL/minute: Administer 4 mg/kg every 24 to 36 hours.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied). Use with caution.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Pentamidine (systemic): Pediatric drug information")

Pneumocystis jirovecii pneumonia, prophylaxis in oncology patients and solid organ transplant recipients

Pneumocystis jirovecii pneumonia (PCP), prophylaxis (primary and secondary) in oncology patients (including hematopoietic stem cell transplant recipients) and solid organ transplant recipients (alternative agent): Limited data available:

Infants, Children, and Adolescents: IV: 4 mg/kg/dose every 3 to 4 weeks; maximum dose: 300 mg/dose (Ref); administration as frequently as every 2 weeks has also been described (Ref).

Pneumocystis jirovecii pneumonia, treatment

Pneumocystis jirovecii pneumonia (PCP), treatment (alternative agent):

Non-HIV-exposed/-infected: Infants, Children, and Adolescents: IM, IV: 4 mg/kg/dose once daily for 21 days (Ref).

HIV-exposed/-infected:

Infants and Children: IV: 4 mg/kg/dose once daily; if clinical improvement after 7 to 10 days of therapy, may change to an oral regimen to complete a 21-day course (Ref).

Adolescents: IV: 4 mg/kg/dose once daily for 21 days; may reduce to 3 mg/kg/dose once daily if toxicity occurs (Ref).

African trypanosomiasis, first-stage disease, treatment

African trypanosomiasis (sleeping sickness; T. brucei gambiense infection), first-stage disease (without CNS involvement), treatment:

Infants, Children, and Adolescents: IM, IV: 4 mg/kg/dose once daily for 7 days (Ref).

Dosing: Kidney Impairment: Pediatric

There are no specific dose adjustments provided in the manufacturer's labeling, has not been studied; use with caution. The following guidelines have been used by some clinicians based on usual pediatric dose of 4 mg/kg every 24 hours (Ref):

Infants, Children, and Adolescents: IV:

GFR >30 mL/minute/1.73 m2: No adjustment required.

GFR 10 to 30 mL/minute/1.73 m2: Administer 4 mg/kg/dose every 36 hours.

GFR <10 mL/minute/1.73 m2 and peritoneal dialysis: Administer 4 mg/kg/dose every 48 hours.

Hemodialysis: Administer 4 mg/kg/dose every 48 hours, after dialysis on dialysis days.

Peritoneal dialysis: 4 mg/kg/dose every 48 hours.

Continuous renal replacement therapy: No dosage adjustment required.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustment provided in the manufacturer's labeling; has not been studied. Use with caution.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Local: Injection site reaction (intramuscular: 11%; includes sterile abscess, necrosis, pain, induration)

Renal: Renal insufficiency (29%), increased serum creatinine (24%)

1% to 10%:

Cardiovascular: Hypotension (5%)

Central nervous system: Confusion (≤2%), hallucinations (≤2%)

Dermatologic: Skin rash (3%)

Endocrine & metabolic: Hypoglycemia (6%)

Gastrointestinal: Anorexia (≤6%), nausea (≤6%), dysgeusia (2%)

Hematologic & oncologic: Leukopenia (10%), thrombocytopenia (3%), anemia (1%)

Hepatic: Increased liver enzymes (9%)

Renal: Azotemia (9%), increased blood urea nitrogen (7%)

<1%, postmarketing, and/or case reports: Abdominal pain, acute pancreatitis, acute rhinitis, ageusia, amnesia, anaphylaxis, anosmia, anxiety, arthralgia, asthma, blepharitis, blurred vision, bronchitis, bronchospasm, cardiac arrhythmia, cerebrovascular accident, chest congestion, chest tightness, chills, confusion, conjunctivitis, contact lens intolerance, cough, cyanosis, depression, dermatitis, desquamation, diabetes mellitus, diabetic ketoacidosis, diarrhea, disseminated intravascular coagulation, dizziness, drowsiness, dry hair, dyspepsia, dyspnea, emotional lability, eosinophilia, eosinophilic pneumonitis, erythema, extravasation (tissue ulceration, necrosis, and/or sloughing), eye pain, flank pain, gag reflex, hair breakage, headache, hearing loss, hematochezia, hematuria, hemoptysis, hepatic insufficiency, hepatitis, hepatomegaly, hyperglycemia, hyperkalemia, hypersensitivity reaction, hypertension, hyperventilation, hypocalcemia, hypoesthesia, hypomagnesemia, insomnia, interstitial pneumonitis, laryngitis, laryngospasm, melena, nasal congestion, nephritis, nervousness, neuralgia, neuropathy, neutropenia, night sweats, palpitations, pancreatitis, pancytopenia, paranoia, paresthesia, peripheral neuropathy, phlebitis, pleurisy, pneumothorax, prolonged prothrombin time, pruritus, pulmonary disease, rales, renal failure, renal insufficiency, rhinitis, seizure, serious infection (extrapulmonary pneumocystosis), sialorrhea, splenomegaly, Stevens-Johnson syndrome, ST segment changes on ECG, syncope, tachycardia, tachypnea, torsades de pointes, tremor, unsteady gait, urinary incontinence, urticaria, vasodilation, vasculitis, ventricular tachycardia, vertigo, vomiting, xeroderma, xerostomia

Contraindications

Hypersensitivity to pentamidine isethionate or any component of the formulation

Warnings/Precautions

Concerns related to adverse effects:

• Hypotension: Severe hypotension (some fatalities) has been observed, even after a single dose. May occur with either IV or IM administration, although more common with rapid IV administration. Monitor blood pressure during (and after) infusion.

• QT prolongation: May cause QT prolongation and subsequent torsade de pointes; avoid use in patients with diagnosed or suspected congenital long QT syndrome.

• Stevens-Johnson syndrome: Has been reported with use.

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with preexisting cardiovascular disease; hyper-/hypotension and arrhythmia, including ventricular tachycardia (eg, torsade de pointes) have been reported.

• Diabetes: Use with caution in patients with diabetes mellitus; hyper-/hypoglycemia and pancreatic islet cell necrosis with hyperinsulinemia has been reported. Symptoms may occur months after therapy; monitor blood glucose daily on therapy and periodically thereafter.

• Extravasation: Intravenous pentamidine is an irritant with vesicant-like properties. Ensure proper needle or catheter placement prior to and during infusion; avoid extravasation. Ulceration, tissue necrosis, and/or sloughing have been reported with extravasation.

• Hematologic disorders: Use with caution in patients with current evidence and/or prior history of hematologic disorders; anemia, leukopenia and/or thrombocytopenia have been reported. Concurrent use with other bone marrow suppressants may increase the risk for myelotoxicity.

• Hepatic impairment: Use with caution in patients with hepatic impairment.

• Hypocalcemia: Use with caution in patients with hypocalcemia.

• Pancreatitis: Use with caution in patients with a history of pancreatic disease or elevated amylase/lipase levels; acute pancreatitis (with fatality) has been reported. Discontinue pentamidine if signs/symptoms of acute pancreatitis occur.

• Renal impairment: Use with caution in patients with renal impairment.

Concurrent drug therapy issues:

• Drugs with QT prolongation potential: Avoid concurrent use with other drugs known to prolong QTc interval.

• Nephrotoxic drugs: Concurrent use with other nephrotoxic drugs may increase the risk for nephrotoxicity.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Injection, as isethionate [preservative free]:

Pentam: 300 mg (1 ea)

Generic: 300 mg (1 ea)

Generic Equivalent Available: US

Yes

Pricing: US

Solution (reconstituted) (Pentam Injection)

300 mg (per each): $200.27

Solution (reconstituted) (Pentamidine Isethionate Injection)

300 mg (per each): $112.50 - $180.50

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Injection:

Generic: 200 mg (1 ea)

Solution Reconstituted, Injection, as isethionate:

Generic: 300 mg (1 ea)

Administration: Adult

IM: Administer deep IM.

IV: Infuse slowly over 60 to 120 minutes; rapid IV administration can cause severe hypotension.

Irritant with vesicant-like properties; ensure proper needle or catheter placement prior to and during infusion. Avoid extravasation.

Extravasation management: If extravasation occurs, stop infusion immediately; leave cannula/needle in place temporarily but do NOT flush the line; gently aspirate extravasated solution, then remove needle/cannula; elevate extremity; apply dry warm compresses (Ref).

Administration: Pediatric

Parenteral:

IM: Administer deep IM.

IV: Administer by slow IV infusion over a period of at least 60 to 120 minutes; rapid IV administration can cause severe hypotension.

Irritant with vesicant-like properties; ensure proper needle or catheter placement prior to and during infusion. Avoid extravasation. If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); remove needle/cannula; elevate extremity. Apply dry warm compresses (Ref).

Use: Labeled Indications

Pneumocystis pneumonia, treatment: Treatment of pneumonia caused by Pneumocystis jirovecii.

Use: Off-Label: Adult

Leishmaniasis, visceral, secondary prophylaxis; Pneumocystis pneumonia, prophylaxis; West African trypanosomiasis (Trypanosoma brucei gambiense infection; sleeping sickness), first stage

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Amisulpride (Oral): May increase QTc-prolonging effects of Pentamidine (Systemic). Risk C: Monitor

Androgens: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Antidiabetic Agents: Hyperglycemia-Associated Agents may decrease therapeutic effects of Antidiabetic Agents. Risk C: Monitor

Antidiabetic Agents: May increase hypoglycemic effects of Hypoglycemia-Associated Agents. Risk C: Monitor

Bacillus clausii: Antibiotics may decrease therapeutic effects of Bacillus clausii. Management: Bacillus clausii should be taken in between antibiotic doses during concomitant therapy. Risk D: Consider Therapy Modification

BCG (Intravesical): Antibiotics may decrease therapeutic effects of BCG (Intravesical). Risk X: Avoid

BCG Vaccine (Immunization): Antibiotics may decrease therapeutic effects of BCG Vaccine (Immunization). Risk C: Monitor

Cholera Vaccine: Antibiotics may decrease therapeutic effects of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics. Risk X: Avoid

Dabrafenib: Pentamidine (Systemic) may increase QTc-prolonging effects of Dabrafenib. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

Domperidone: May increase QTc-prolonging effects of Pentamidine (Systemic). Risk X: Avoid

Fecal Microbiota (Live) (Oral): May decrease therapeutic effects of Antibiotics. Risk X: Avoid

Fecal Microbiota (Live) (Rectal): Antibiotics may decrease therapeutic effects of Fecal Microbiota (Live) (Rectal). Risk X: Avoid

Fluorouracil Products: Pentamidine (Systemic) may increase QTc-prolonging effects of Fluorouracil Products. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

Foscarnet: Pentamidine (Systemic) may increase adverse/toxic effects of Foscarnet. The specific toxicities may include hypocalcemia, renal failure, and QT-prolongation. Management: Consider alternatives to this combination when possible. If this combination must be used, monitor patients more closely for hypocalcemia, renal dysfunction, and QT interval prolongation. Risk D: Consider Therapy Modification

Haloperidol: May increase QTc-prolonging effects of Pentamidine (Systemic). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

Herbal Products with Glucose Lowering Effects: May increase hypoglycemic effects of Hypoglycemia-Associated Agents. Risk C: Monitor

Hypoglycemia-Associated Agents: May increase hypoglycemic effects of Hypoglycemia-Associated Agents. Risk C: Monitor

Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies): Antibiotics may decrease therapeutic effects of Immune Checkpoint Inhibitors (Anti-PD-1, -PD-L1, and -CTLA4 Therapies). Risk C: Monitor

Lactobacillus and Estriol: Antibiotics may decrease therapeutic effects of Lactobacillus and Estriol. Risk C: Monitor

Levoketoconazole: Pentamidine (Systemic) may increase QTc-prolonging effects of Levoketoconazole. Risk X: Avoid

Maitake: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Monoamine Oxidase Inhibitors: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Mycophenolate: Antibiotics may decrease active metabolite exposure of Mycophenolate. Specifically, concentrations of mycophenolic acid (MPA) may be reduced. Risk C: Monitor

Ondansetron: Pentamidine (Systemic) may increase QTc-prolonging effects of Ondansetron. Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

Pegvisomant: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Pimozide: May increase QTc-prolonging effects of Pentamidine (Systemic). Risk X: Avoid

Piperaquine: Pentamidine (Systemic) may increase QTc-prolonging effects of Piperaquine. Risk X: Avoid

Prothionamide: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

QT-prolonging Agents (Highest Risk): May increase QTc-prolonging effects of Pentamidine (Systemic). Management: Consider alternatives to this combination. If combined, monitor for QTc interval prolongation and ventricular arrhythmias. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk D: Consider Therapy Modification

QT-prolonging Antidepressants (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Antidepressants (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Antipsychotics (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Antipsychotics (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Class IC Antiarrhythmics (Moderate Risk): May increase QTc-prolonging effects of Pentamidine (Systemic). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-Prolonging Inhalational Anesthetics (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-Prolonging Inhalational Anesthetics (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias, including torsades de pointes when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Kinase Inhibitors (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Kinase Inhibitors (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Miscellaneous Agents (Moderate Risk): May increase QTc-prolonging effects of Pentamidine (Systemic). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Moderate CYP3A4 Inhibitors (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Moderate CYP3A4 Inhibitors (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Quinolone Antibiotics (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Quinolone Antibiotics (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QT-prolonging Strong CYP3A4 Inhibitors (Moderate Risk): Pentamidine (Systemic) may increase QTc-prolonging effects of QT-prolonging Strong CYP3A4 Inhibitors (Moderate Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

Quinolones: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Quinolones may decrease therapeutic effects of Agents with Blood Glucose Lowering Effects. Specifically, if an agent is being used to treat diabetes, loss of blood sugar control may occur with quinolone use. Risk C: Monitor

Salicylates: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Saquinavir: Pentamidine (Systemic) may increase QTc-prolonging effects of Saquinavir. Risk X: Avoid

Selective Serotonin Reuptake Inhibitor: May increase hypoglycemic effects of Agents with Blood Glucose Lowering Effects. Risk C: Monitor

Sertindole: Pentamidine (Systemic) may increase QTc-prolonging effects of Sertindole. Risk X: Avoid

Sodium Picosulfate: Antibiotics may decrease therapeutic effects of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk D: Consider Therapy Modification

Thioridazine: Pentamidine (Systemic) may increase QTc-prolonging effects of Thioridazine. Risk X: Avoid

Typhoid Vaccine: Antibiotics may decrease therapeutic effects of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Avoid use of live attenuated typhoid vaccine (Ty21a) in patients being treated with systemic antibacterial agents. Postpone vaccination until 3 days after cessation of antibiotics and avoid starting antibiotics within 3 days of last vaccine dose. Risk D: Consider Therapy Modification

Vasopressin: Drugs Suspected of Causing SIADH may increase therapeutic effects of Vasopressin. Specifically, the pressor and antidiuretic effects of vasopressin may be increased. Risk C: Monitor

Pregnancy Considerations

Pentamidine crosses the human placenta (Fortunato 1989; Schwebke 1995).

Intravenous pentamidine can be used as an alternative treatment in pregnant patients with HIV infection for mild to moderate Pneumocystis pneumonia (HHS [OI adult 2024]). Pentamidine may be used to treat stage one trypanosomiasis caused by T. brucei gambiense (CDC 2020); data related to treatment of pregnant patients for this indication are limited (Pohlig 2016).

Breastfeeding Considerations

It is not known if pentamidine is present in breast milk.

Due to the potential for serious adverse reactions in the breastfeeding infant, the manufacturer recommends a decision be made whether to discontinue breastfeeding or to discontinue the drug, considering the importance of treatment to the mother.

Monitoring Parameters

LFTs, renal function tests, blood glucose, serum potassium and calcium, CBC and platelets; ECG; BP (during and after infusion).

Mechanism of Action

Interferes with microbial RNA/DNA, phospholipids and protein synthesis, through inhibition of oxidative phosphorylation and/or interference with incorporation of nucleotides and nucleic acids into RNA and DNA

Pharmacokinetics (Adult Data Unless Noted)

Absorption: IM: Well absorbed.

Distribution: Vdss: Binds to tissues and plasma protein; high concentrations are found in the liver, kidney, adrenals, spleen, lungs, and pancreas; poor penetration into CNS; IV: 821 ± 535 L; IM: 2724 ± 1066 L.

Half-life elimination: IV: 6.4 ± 1.3 hours; IM: 9.4 ± 2 hours; may be prolonged with severe renal impairment.

Excretion: Urine (IV: ≤12% as unchanged drug).

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Pentamidine may accumulate in renal failure.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Pentamidina luar;
  • (ES) Spain: Pentamidina combino;
  • (FI) Finland: Pentacarinat;
  • (KR) Korea, Republic of: Pentamidine isethi;
  • (MY) Malaysia: Pentamidine;
  • (QA) Qatar: Pentacarinat
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