Bacterial infections:

Indications for Imipenem and Cilastatin Sodium 250mg:

Serious susceptible infections including bacterial septicemia, lower respiratory tract, urinary tract, skin and skin structure, bone and joint, intraabdominal, gynecologic, endocarditis.

Adult:

Base dose on imipenem component. Give by IV infusion only. Infuse over 20–30mins (500mg) or 40–60mins (1000mg); slower rate if nausea/vomiting occurs. Susceptible bacteria: 500mg every 6hrs or 1000mg every 8hrs. Intermediate susceptibility: 1000mg every 6hrs. Max 4g/day. Renal impairment (CrCl <90mL/min): reduce dose; see full labeling. CrCl <15mL/min: not recommended unless hemodialysis starts within 48hrs. Hemodialysis: give after session (see full labeling).

Children:

<30kg with renal impairment or CNS infections (seizure risk): not recommended. Base dose on imipenem component. Give by IV infusion only. Infuse over 20–30mins (if ≤500mg) or 40–60mins (if >500mg); slower rate if nausea/vomiting occurs. Non-CNS infections (if ≥1.5kg): <1wk of age: 25mg/kg every 12hrs; 1–4wks: 25mg/kg every 8hrs; 4wks–3mos: 25mg/kg every 6hrs; ≥3mos: 15–25mg/kg every 6hrs. Max 4g/day.

Warnings/Precautions:

Not for the treatment of meningitis. Penicillin, cephalosporin, β-lactam, or other allergy. CNS disorders (esp. brain lesions or history of seizures). Monitor renal, hepatic, hematologic function periodically with prolonged use. Renal impairment. Pregnancy. Nursing mothers.

See Also:

Pharmacologic Class:

Carbapenem (thienamycin) + dehydropeptidase I inhibitor.

Interactions:

Concomitant ganciclovir (increased seizure risk), probenecid: not recommended. May antagonize valproic acid; consider alternative; if co-administration needed, consider supplemental anticonvulsant.

Adverse Reactions:

Phlebitis, nausea, diarrhea, vomiting, rash, inj site reactions, fever, hypotension, seizures, dizziness, pruritus, vein induration, urticaria, somnolence; C. difficile-associated diarrhea, hypersensitivity reactions (discontinue if occur). Children: also gastroenteritis, discolored urine, oliguria/anuria, oral candidiasis, tachycardia.

How Supplied:

Single-dose vials 250mg—contact supplier; 500mg—25