Blood levels with monthly aerosol delivery are below detectable limits. Other reactions include laryngitis, chest pain, and dyspnea. The role of aerosolized pentamidine in promoting extrapulmonary P. carinii infection and pneumothorax is unclear. The most common causes of drug discontinuation were nephrotoxicity and hypoglycemia. It is usually characterized by a gradual increase in creatinine in the second week of treatment, but may cause acute renal failure.
Risk is increased with dehydration and concurrent use of nephrotoxic drugs.
Suspected or confirmed TB should be treated prior to aerosol treatments. Adequate air exchanges with exhaust to outside and appropriate use of particulate air filters are required. Some suggest pregnant HCWs should avoid environmental exposure to pentamidine until risks to fetus are better defined. Avoid concurrent use of parenteral pentamidine with nephrotoxic drugs - aminoglycosides, amphotericin B, and foscarnet. The Johns Hopkins University on behalf of its Division of Infectious Diseases and AIDS Service.