Reports of fatalities due to severe hypotension, hypoglycaemia, acute pancreatitis & cardiac arrhythmias in patients treated by both IM & IV routes. Establish baseline BP & patients should receive pentamidine lying down. Closely monitor BP during administration & at regular intervals until treatment is concluded. Patients receiving pentamidine by inhalation should be closely monitored for the development of severe adverse reactions. Reports of bronchospasm following use of nebuliser, particularly in patients w/ history of smoking or asthma. May prolong QT interval. Use w/ care in patients w/ conditions known to increase proarrhythmic risk, including patients w/ long QT syndrome, cardiac disease (eg, CHD, heart failure), history of ventricular arrhythmias, uncorrected hypokalaemia &/or hypomagnesaemia, bradycardia (<50 bpm), or during concomitant administration w/ QT-prolonging agents. Consider continuous cardiac monitoring if QTc >500 msec while receiving therapy. Consider alternative regimen if QTc interval >550 msec. Carry out the following tests before, during & after therapy by parenteral route: blood urea, nitrogen & serum creatinine daily during therapy; complete blood & platelet counts daily during therapy; fasting blood glucose measurements daily during therapy, & at regular intervals after completion of therapy; LFTs including bilirubin, alkaline phosphatase, AST, & ALT; serum Ca wkly; serum Mg twice wkly; ECG at regular intervals; urine analysis & serum electrolytes daily during therapy. The benefit of aerosolised therapy in patients at high risk of pneumothorax should be weighed against the clinical consequences of such manifestation. Use w/ caution in patients w/ hepatic &/or renal dysfunction, HTN or hypotension, hyperglycaemia or hypoglycaemia, leucopenia, thrombocytopenia or anaemia. Should not be administered to pregnant patients unless considered essential. Use is contraindicated in breastfeeding mothers unless considered essential.
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