Ertapenem

Ertapenem is a prescription medication used to treat the symptoms of Community-Acquired Pneumonia, Complicated urinary Tract Infections (including Pyelonephritis), Acute Pelvic Infections, Complicated Intra-abdominal Infections, and Complicated Skin or Skin Structure Infections.

• Ertapenem is available under the following different brand names: Invanz

Adult and Pediatric dosage

Powder for injection

• 1g/vial

Community-Acquired Pneumonia

Adult dosage: 

• 1 g/day IV/IM up to 14 days; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically

Pediatric dosage

• Children younger than 3 months of age: safety and efficacy not established
• Children 3 months-12 years: 15 mg/kg IV/IM every 12 hours up to 14 days; not to exceed 1g every 12 hours; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically
• Children older than 12 years of age: 1 g/day IV/IM up to 14 days; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically 

Complicated Urinary Tract Infections (Including Pyelonephritis)

Adult dosage

• 1 g/day IV/IM up to 14 days; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically

Pediatric dosage

• Children younger than 3 months of age: safety and efficacy not established
• Children 3 months-12 years: 15 mg/kg IV/IM every 12 hours up to 14 days; not to exceed 1g every 12 hours; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically
• Children older than 12 years of age: 1 g/day IV/IM up to 14 days; after 3 or more days of parenteral therapy, may be switched to appropriate oral regimen if patient improves clinically 

Acute Pelvic Infections

Adult dosage

• 1 g/day IV/IM for 3-10 days

Pediatric dosage

• Children younger than 3 months of age: safety and efficacy not established
• Children 3 months-12 years: 15 mg/kg IV/IM every 12 hours for 3-10 days
• Children older than 12 years of age: 1 g/day IV/IM for 3-10 days 

Complicated Intra-abdominal Infections

Adult dosage

• 1 g/day IV/IM for 5-14 days

Pediatric dosage

• Children younger than 3 months of age: safety and efficacy not established
• Children 3 months-12 years: 15 mg/kg IV/IM every 12 hours for 5-14 days
• Children older than 12 years of age: 1 g/day IV/IM for 5-14 days 

Complicated Skin/Skin Structure Infections

Adult dosage

• 1 g/day IV/IM for 7-14 days; may be continued up to 4 weeks for diabetic foot infections, depending on severity of infection and response to therapy and response to therapy (treatment excludes diabetic foot infections with osteomyelitis)

Pediatric dosage

• Children younger than 3 months of age: safety and efficacy not established
• Children 3 months-12 years: 15 mg/kg IV/IM every 12 hours for 7-14 days; may be continued up to 4 weeks for diabetic foot infections, depending on severity of infection and response to therapy (treatment excludes diabetic foot infection with osteomyelitis) 
• Children older than 12 years of age: 1 g/day IV/IM up to 7-14 days; may be continued up to 4 weeks for diabetic foot infections, depending on severity of infection and response to therapy (treatment excludes diabetic foot infections with osteomyelitis) 

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Ertapenem include:

• nausea, 
• vomiting, 
• diarrhea, 
• headache, and
• pain, redness, or mild swelling at the injection site

Serious side effects of Ertapenem include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• severe stomach pain, 
• diarrhea that is watery or bloody, 
• tremors, twitching, or rigid (very stiff) muscles, 
• seizure, and
• unusual changes in mood or behavior 

Rare side effects of Ertapenem include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first

• Ertapenem has severe interactions with no other drugs.
• Ertapenem has serious interactions with the following drugs: 
  • BCG vaccine live
  • cholera vaccine
  • typhoid vaccine live
  • valproic acid
• Ertapenem has moderate interactions with the following drugs:
  • bazedoxifene/conjugated estrogens
  • conjugated estrogens
  • dichlorphenamide
  • dienogest/estradiol valerate
  • digoxin
  • estradiol
  • estrogens conjugated synthetic 
  • estropipate
  • mestranol
  • sodium picosulfate/magnesium oxide/anhydrous citric acid 
• Ertapenem has minor interactions with the following drugs: 
  • balsalazide
  • biotin
  • pantothenic acid
  • probenecid
  • pyridoxine
  • pyridoxine (antidote)
  • thiamine

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use.  Keep a list of all your medications with you, and share this information with your doctor and pharmacist.  Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to ertapenem, beta-lactams, or other drugs in the class
• IM administration: Hypersensitivity to amide local anesthetics (eg, lidocaine)

Effects of drug abuse

• None

Short-Term Effects

• See “What are Side Effects Associated with Using Ertapenem?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Ertapenem?”

Cautions

• Use with caution in CNS disorders (eg., history of seizures); adjust dose in renal impairment to avoid risk of seizures; carbapenem use has been associated with seizures
• Do not co-infuse with other medications or use dextrose diluent
• Prolonged use increases risk of superinfections
• Use caution in renal impairment; adjust dose in moderate to severe renal dysfunction
• Carbapenem use may decrease serum levels of divalproex sodium or valproic acid

Pregnancy and Lactation

• Available data from a small number of post-marketing cases with use in pregnancy are insufficient to inform any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes. 
• Ertapenem is present in human milk; there are no data on effects on breastfed infant or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition.