Imipenem + Cilastatin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Susceptible infections As imipenem: 1-2 g/day in divided doses 6-8 hrly. Surgical prophylaxis As imipenem: 1 g on induction of anesth, followed by 1 g 3 hr later. Additional doses of 500 mg may be given at 8 and 16 hr after induction if needed. IM Susceptible infections As imipenem: 500 or 750 mg 12 hrly. Uncomplicated gonorrhoea As imipenem: 500 mg as single dose.
Dosage Details
Intramuscular
Uncomplicated gonorrhoea
Adult: In terms of imipenem: A single 500 mg dose may be used.

Intramuscular
Mild to moderate susceptible infections
Adult: In terms of imipenem, 500 mg or 750 mg every 12 hr.

Intravenous
Prophylaxis of surgical infections
Adult: In terms of imipenem, 1 g given on induction of anaesthesia, followed by 1 g 3 hr later, with additional doses of 500 mg at 8 and 16 hr after induction if necessary.

Intravenous
Susceptible infections
Adult: In terms of imipenem, 1-2 g daily in divided doses every 6-8 hr, given via IV infusion. Doses 250 or 500 mg are infused over 20-30 minutes, and doses of 750 mg or 1 g over 40-60 minutes.
Child: >40 kg: same as adult dose. >3 mth and <40 kg: 15-25 mg/kg every 6 hr by IV infusion. Up to 90 mg/kg may be given to older children with cystic fibrosis. Neonates and infants <3 mth: 4 wk-3 mth, 25 mg/kg every 6 hr; 1-4 wk, 25 mg/kg every 8 hr; up to 1 wk, 25 mg/kg every 12 hr.
Renal Impairment
Intravenous:
Susceptible infections:
CrClDosage
≤5Only give if haemodialysis started within 48 hr
21-30500 mg every 8-12 hr
31-70500 mg every 6-8 hr
6-20250 mg or 3.5 mg/kg (whichever is lower) every 12 hr
Contraindications
Hypersensitivity.
Special Precautions
Caution when used in patients with known hypersensitivity to other β-lactams due to possibility of cross-sensitivity. CNS disorders such as epilepsy; renal, hepatic impairment; pregnancy, lactation.
Adverse Reactions
Skin rashes, urticaria, eosinophilia, fever, nausea, vomiting, diarrhoea, tooth or tongue discoloration and altered taste. Erythema multiforme, exfoliative dermatitis. Pain and thrombophlebitis may occur at the inj site.
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.
Drug Interactions
Concurrent admin with probenecid may increase the half-life of cilastatin. Increased risk of generalised seizures when used concurrently with ganciclovir.
Action
Description: Imipenem is a potent inhibitor of bacterial cell wall synthesis and is bactericidal against a broad spectrum of pathogens. It is resistant to degradation by bacterial β-lactamases. Cilastatin is an inhibitor of dehydropeptidase I, an enzyme found in the brush border of the renal tubules. It is given as the sodium salt with imipenem to prevent its renal metabolism and protect against nephrotoxic effects.
Pharmacokinetics:
Absorption: IM admin: 60-75% (imipenem); 95-100% (cilastatin).
Distribution: Rapidly and widely distributed to most tissues and fluids. Protein binding: 20% (imipenem) and 40% (cilastatin).
Metabolism: Imipenem: Metabolised renally by dehydropeptidase I; cilastatin: Partly metabolised renally.
Excretion: Via urine (about 70% as unchanged drug). Half-life: 2-3 hr (imipenem after IM admin).
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Imipenem + Cilastatin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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