Pentamidine
Pentamidine isethionate
Also known as: Pentacarinat · Pentamidine isethionate · Pentamidini isetionas
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Leishmaniosis (resistant cases) | 4 mg/kg | IM | q48-72h | Seek expert advice on treatment duration | 🌍 EU |
- Leishmaniosis (resistant cases): Use only when resistance to pentavalent antimony drugs has occurred. Highly toxic.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Pentamidine is an antiprotozoal agent primarily used in veterinary medicine as a second-line or salvage treatment for leishmaniosis in dogs, particularly when resistance to pentavalent antimony drugs (e.g., meglumine antimonate and sodium stibogluconate) has occurred.
Warning: Pentamidine is a highly toxic drug with a narrow therapeutic index. The potential to cause severe toxic damage, particularly to the kidneys and liver, must be carefully weighed against the benefits.
Clinical Pearl: Due to its significant toxicity profile and the availability of safer alternatives (like allopurinol and miltefosine), pentamidine is rarely used as a first-line agent. Expert advice should always be sought prior to initiating therapy.
Mechanism of action
Pentamidine kills protozoans by interacting with parasite DNA. It is rapidly taken up by the parasites via a high-affinity energy-dependent carrier → disrupts DNA, RNA, and protein synthesis → leads to protozoal death.
Safety & warnings
Contraindications
- Impaired liver function
- Impaired kidney function
- Rapid intravenous (IV) injection (due to severe cardiovascular effects)
Adverse effects
- Pain at the injection site
- Necrosis at the injection site
- Hypotension
- Nausea
- Salivation
- Vomiting
- Diarrhoea
- Hypoglycaemia
- Blood dyscrasias
Precautions
Handling Warning: Pentamidine is a highly toxic agent. Veterinary staff handling this drug should take precautions similar to those recommended for cytotoxic agents used in cancer chemotherapy (e.g., wearing gloves, masks, and using closed-system transfer devices).
Administration Warning: NEVER administer by rapid IV injection due to the risk of severe, potentially fatal hypotension.
Organ Toxicity: High potential for nephrotoxicity and hepatotoxicity. Baseline and ongoing monitoring of renal and hepatic parameters is mandatory.
Drug interactions
Increased risk of severe nephrotoxicity
Monitoring
- Renal function (BUN, Creatinine, Urinalysis)
- Liver enzymes (ALT, AST, ALP) and Bilirubin
- Blood glucose concentrations
- Blood pressure (especially around the time of administration)
- Complete Blood Count (CBC) for dyscrasias
- Injection site for signs of necrosis
Pharmacokinetics
Half-life
Absorption
Well absorbed following intramuscular injection.
Distribution
Extensively distributed and bound to tissues; accumulates heavily in the liver, kidneys, and spleen.
Metabolism
Undergoes minimal hepatic metabolism.
Elimination
Excreted primarily unchanged in the urine over a prolonged period.
Overdose
Overdosage significantly increases the risk of severe hypotension, hypoglycaemia, acute renal failure, and hepatotoxicity. Treatment is largely supportive and symptomatic, including IV fluid therapy to support blood pressure and renal perfusion, and dextrose supplementation for hypoglycaemia.
Available products
Formulations
- Injectable: 300 mg vials of powder for reconstitution
Human-labeled
- Pentacarinat 300 mg powder for solution for injection/infusion
Regulatory status
Human authorized product (POM) used under the cascade. Requires special handling precautions.
Human authorized product (POM) used under the cascade. Requires special handling precautions.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store intact vials at room temperature. Reconstituted solutions should be used promptly or stored according to the manufacturer's specific guidelines.
Client information
Pentamidine is a potent medication used to treat severe parasitic infections like Leishmaniasis, usually only when other standard treatments have failed.
Because this drug can have serious side effects, your veterinarian will need to closely monitor your pet's kidney function, liver function, and blood sugar levels during treatment.
Important: Report any signs of extreme lethargy, vomiting, weakness (which could indicate low blood sugar), or severe pain/sores at the injection site to your veterinarian immediately.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.