Drugs for Treatment of PCP

COMMON ADVERSE
REGIMEN DOSAGE EFFECTS COST*

Trimethoprim- 5 mg per kg of Maculopapular rash, $137,

sulfamethoxazole trimethoprim fever, bone marrow generic
(Bactrim, Septra) component every 8 suppression, hepatitis,
hours, IV or orally nausea, vomiting, 8, brand
(for most patients, hyperkalemia
oral dosage is 2
double-strength
tablets three times
daily)

Pentamidine 4 mg per kg IV once Hypo- or 99, brand

daily, infused over hyperglycemia and
60 minutes subsequent diabetes
mellitus, arrhythmias,
QT interval
prolongation,
leukopenia,
pancreatitis, bone
marrow suppression,
hepatitis, fever

Trimetrexate Trimetrexate: for Neutropenia, 264, brand

(Neutrexin) and patients < 50 kg thrombocytopenia
leucovorin 1.5 mg per kg per
day IV; for patients
50 to 80 kg1.2 mg
per kg per day IV; for
patients > 80 kg
1.0 mg per kg per
day IV

Leucovorin: for 20 to 70,

patients < 50 kg generic98 to
0.8 mg per kg IV or 163, generic
orally every 6 hours;
 COMMON ADVERSE
REGIMEN DOSAGE EFFECTS COST*

for patients 50 kg
0.5 mg per kg IV or
orally every 6 hours
(round off to next
highest dosage
when using
leucovorin orally);
continue leucovorin
for 72 hours after
last trimetrexate
dose.

May add dapsone, 0.20 to 0.30,

100 mg per day generic
orally.

Trimethoprim Trimethoprim, 5 mg Nausea, vomiting, 7, brand (2 to

(Proloprim) and per kg orally every 8 fever, rash, bone 3, generic)
dapsone hours and dapsone, marrow suppression,
100 mg orally once hepatitis, hemolysis, 0.20 to 0.30,
daily methemoglobinemia generic

Clindamycin Clindamycin, 600 to Rash, anemia, 42, brand (2

(Cleocin) and 900 mg IV or 300 to neutropenia, to 3,
primaquine 400 mg orally every methemoglobinemia, generic)10,
6 to 8 hemolysis brand (3 to
hoursPrimaquine 7,
base, 15 to 30 mg generic)0.75,
orally once daily brand

Atovaquone 750 mg of Nausea, vomiting, rash 42, brand

(Mepron) suspension orally
three times daily with
fatty foods (do not
use in patients with
diarrhea or
 COMMON ADVERSE
REGIMEN DOSAGE EFFECTS COST*

malabsorption)

PCP = Pneumocystis carinii pneumonia; IV = intravenously.

*Estimated cost to the pharmacist based on average wholesale prices (rounded to

the nearest dollar for prices above $1) for one day of treatment based on a patient
weighing 70 kg (154 lb) in Red book. Montvale, N.J.: Medical Economics Data,
1999. Cost to the patient may be greater, depending on prescription filling fee.

IV.

Oral.

Updated basis for dosing.

One tablet (26.3 mg) is the equivalent of 15 mg base

Drugs for Prophylaxis of PCP
DRUG DOSAGE COST*

TMP-SMZ 1 double-strength tablet (160 mg TMP/800 mg $ 38, brand

(Bactrim, SMZ) orally once daily 11 to 14,
Septra) generic

or

1 tablet (80 mg TMP/400 mg SMZ) orally once 23, brand 7

daily to 10,
generic

or

1 double-strength tablet orally three times 15, brand 5

every week to 6, generic

Dapsone 100 mg orally once daily for PCP. 5 to 10,

generic 3 to
5, generic 3,
brand

In toxoplasma IgGpositive-patients: use 50- 96 to 108,

mg dapsone orally once daily, plus generic
pyrimethamine (Daraprim), 50 mg orally every
week and leucovorin, 25 mg orally every week

or

dapsone, 200 mg orally every week, plus 1 to 3,

pyrimethamine, 75 mg orally every week, and generic 5,
leucovorin, 25 mg orally every week generic 96 to
108, generic

Aerosolized 300 mg aerosolized by Respirgard II jet nebulizer 99, brand

pentamidine every month; administer in negative-airflow room
(NebuPent) to patients screened for active TB; pretreat with
inhaled bronchodilator in patients who experience
DRUG DOSAGE COST*

cough or bronchospasm

Atovaquone 750 mg orally twice daily (1,500 mg per day) 833, brand
(Mepron)

TMP = trimethoprim; SMZ = sulfamethoxazole; TB = tuberculosis.

*Estimated cost to the pharmacist based on average wholesale prices (rounded to

the nearest dollar) for one month of treatment in Red book. Montvale,N.J.: Medical
Economics Data, 1999. Cost to the patient may be greater, depending on
prescription filling fee.