|  | |  |  | Pentamidine isethionate Basic information | 
 | Product Name: | Pentamidine isethionate |  | Synonyms: | 1,5-BIS(P-AMIDINOPHENOXY)PENTANE BIS(2-HYDROXYETHANESULFONATE SALT);1,5-BIS[P-AMIDINOPHENOXY]PENTANE BIS[2-HYDROXYETHANESULFONATE SALT] ISETHIONATE SALT;PENTAMIDINE ISETHIONATE NMDA ANTAGONIST,  NEUR;Pentamide Isethionate;PENTAMINE ISETHIONATE;p,p'-[Pentamethylenedioxy] dibenzamidine bis[β-hydroxyethanesulfonate];4,4'-(PENTAMETHYLENEDIOXY)DIBENZAMIDE BIS(2-HYDROXYETHANESULFONATE);4,4'-(PENTAMETHYLENEDIOXY)DIBENZAMIDINE, BIS-2-HYDROXYETHANESULFONATE |  | CAS: | 140-64-7 |  | MF: | C23H36N4O10S2 |  | MW: | 592.68 |  | EINECS: | 205-424-1 |  | Product Categories: | HIV/AIDS/Related Products;Amines;API;Aromatics;Intermediates & Fine Chemicals;Pharmaceuticals |  | Mol File: | 140-64-7.mol |  |  | 
|  |  | Pentamidine isethionate Chemical Properties | 
| Hazard Codes | Xi |  | Risk Statements | 36/37/38-43 |  | Safety Statements | 26-36/37 |  | RIDADR | 3249 |  | WGK Germany | 3 |  | RTECS | CV6500000 |  | HazardClass | 6.1(b) |  | PackingGroup | III |  | HS Code | 2925294500 |  | Toxicity | LD50 intraperitoneal in mouse: 63mg/kg | 
|  |  | Pentamidine isethionate Usage And Synthesis | 
 | Chemical Properties | White or almost white powder or colourless crystals, hygroscopic. |  | Originator | Nebupent,Fujisawa Healthcare Inc ,USA |  | Uses | Pentamidine isethionate salt has been used: 
 as a positive control for anti-leishmanial, anti-plasmodial and cytotoxic assaysas a prototypical compound to analyse the inhibitor effect on human ether-a-go-go-related gene (HERG) K+ channel traffickingas an anti-leishmanial agent in promastigotes
 
 |  | Uses | Has been widely used as a drug to treat protozoal diseases, such as malaria, amoebic dysentery and trypanosomiasis. It has also been shown to be effective for both prophylaxis of pneumocystic carinii pneumonia (PCC). |  | Uses | Antiparasitic |  | Definition | ChEBI: An organosulfonate salt obtained by reaction of pentamidine with two equivalents of 2-hydroxyethylsulfonic acid. |  | Manufacturing Process | 2.5 g of p,p'-dicyano-1,5-diphenoxy-pentane (obtained by the interaction of phydroxybenzonitrile and pentamethylene-dibromide in aqueous alkaline solution, melting point 114°C) are dissolved in 15 cc of nitrobenzene and 2.5 cc of absolute ethyl alcohol added. The solution is saturated with dry hydrochloric acid gas at 0°C and allowed to stand for 48 h. It is then diluted with dry ether and the precipitated 1,5-diphenoxypentane, 4,4'di(ethoxycarbonimidoyl) dihydrochlorid is filtered and washed with ether. 4 g of 1,5-diphenoxypentane, 4,4'-di(ethoxycarbonimidoyl) dihydrochloride are mixed with 30 cc. of 6 % ethyl alcoholic ammonia and heated in a closed vessel at 50°C for 5 h. The alcohol is removed and the residual 1,5diphenoxypentane, 4,4'-diamidino dihydrochloride is twice recrystallised fromdilute hydrochloric acid and finally purifled by dissolving in water and precipitating with acetone. Its melts at 236°C, dec.
 Pentamidine isetionate salt may be produced by the reaction pentamidine base with isethionic acid.
 |  | Therapeutic Function | Antiprotozoal |  | General Description | Odorless white or almost white crystals or powder. Odor also reported as a slight butyric odor. Very bitter taste. pH (5% aqueous solution) 4.5-6.5. |  | Air & Water Reactions | Hygroscopic. May be sensitive to prolonged exposure to air. Aqueous solutions deteriorate on storage. Water soluble. |  | Reactivity Profile | Can decompose on prolonged exposure to light. |  | Fire Hazard | Flash point data for Pentamidine isethionate are not available; however, Pentamidine isethionate is probably combustible. |  | Biological Activity | Antimicrobial. Neuroprotective; inhibits constitutive nitric oxide synthase in the brain and acts as a NMDA glutamate receptor antagonist. |  | Biochem/physiol Actions | Neuroprotective; inhibits constitutive nitric oxide synthase in the brain; NMDA glutamate receptor antagonist. |  | Clinical Use | 4,4’-(Pentamethylenedioxy)dibenzamidine diisethionate(NebuPent, Pentam 300) is a water-soluble crystalline saltthat is stable to light and air. The principal use of pentamidineis for the treatment of pneumonia caused by the opportunisticpathogenic protozoan P. carinii, a frequent secondaryinvader associated with AIDS. The drug may beadministered by slow intravenous infusion or by deep intramuscularinjection for PCP. An aerosol form of pentamidineis used by inhalation for the prevention of PCP inhigh-risk patients infected with HIV who have a previoushistory of PCP infection or a low peripheral CD4+ lymphocytecount. Pentamidine has been used for the prophylaxis and treatmentof African trypanosomiasis. It also has some value fortreating visceral leishmaniasis. Pentamidine rapidly disappearsfrom the plasma after intravenous injection and is distributedto the tissues, where it is stored for a long period.This property probably contributes to the usefulness of thedrug as a prophylactic agent.
 |  | Drug interactions | Potentially hazardous interactions with other drugs Anti-arrhythmics: increased risk of ventricular 
arrhythmias with amiodarone - avoid; possible 
increased risk of ventricular arrhythmias with 
disopyramide.
 Antibacterials: increased risk of ventricular 
arrhythmias with delamanid, moxifloxacin and 
parenteral erythromycin - avoid with moxifloxacin; 
increased risk of ventricular arrhythmias with 
parenteral pentamidine and telithromycin.
 Antidepressants: increased risk of ventricular 
arrhythmias with tricyclics; increased risk of 
ventricular arrhythmias with citalopram and 
escitalopram - avoid.
 Antimalarials: increased risk of ventricular 
arrhythmias with piperaquine with artenimol - 
avoid.
 Antipsychotics: increased risk of ventricular 
arrhythmias with amisulpride, droperidol and 
phenothiazines - avoid with amisulpride and 
droperidol.
 Antivirals: increased risk of hypocalcaemia with 
parenteral pentamidine and foscarnet; increased risk 
of ventricular arrhythmias with saquinavir - avoid.
 Cytotoxics: increased risk of ventricular arrhythmias 
with vandetanib - avoid.
 Ivabradine: increased risk of ventricular arrhythmias.
 |  | Metabolism | Extensively hepatically metabolised. Renal clearance accounts for <5% of the plasma clearance 
of pentamidine.
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|  |  | Pentamidine isethionate Preparation Products And Raw materials | 
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