Imipenem/Cilastatin

Imipenem/Cilastatin is a prescription medication used to treat the symptoms of Lower Respiratory Tract, Skin/Skin Structure, Gynecologic Infections, Intra-abdominal Infections, Pseudomonas Infections, and Urinary Tract Infections.

• Imipenem/Cilastatin is available under the following different brand names: Primaxin

Dosages of Imipenem/Cilastatin:

Adult and Pediatric dosage

Powder for injection

• 250mg/250mg
• 500mg/500mg

Lower Respiratory Tract, Skin/Skin Structure, and Gynecologic Infections

Adults

• Mild to moderate: 500-750 mg IV every 12 hours

Intra-abdominal Infections

Adults

• Mild to moderate: 250-500 mg IV every 6 hours
• Severe: 500 mg IV every 6 hours or 1 g every 8 hours for 4-7 days, provided that infection is brought under control

Pseudomonas Infections

Adults

• 500 mg IV every 6 hours; higher dosages may be administered, depending on organism sensitivity 

Urinary Tract Infections

Adults 

• Uncomplicated: 250 mg IV every 6 hours
• Complicated: 500 mg IV every 6 hours

Pediatric dosages based on Imipenem component

• Infants younger than 1 week, weighing over 1.5 kg: 25 mg/kg IV every 12 hours for non-CNS infections  
• Infants 1-4 weeks of age, weighing over 1.5 kg: 25 mg/kg IV every 8 hours for non-CNS infections
• Children 4 weeks-3 months of age, weighing over 1.5 kg: 25 mg/kg IV every 6 hours for non-CNS infections
• Children older than 3 months: 15-25 mg/kg IV every 6 hours for non-CNS infections; not to exceed 2 g/day for fully susceptible organisms or 4 g/day for moderately susceptible organisms
• Children older than 12 years: 10-15 mg/kg IV every 6 hours for mild-to-moderate infections
• Cystic fibrosis patients: Up to 100 mg/kg/day IV divided every 6 hours; not to exceed 4 g/day (in older children)

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Imipenem/Cilastatin include:

• pain, swelling, redness, bruising, or hardening at the injection site, 
• dizziness, 
• drowsiness, 
• nausea, 
• vomiting, 
• diarrhea, 
• itching, and 
• rash

Serious side effects of Imipenem/Cilastatin include:

• hives, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• severe stomach pain, 
• diarrhea that is watery or bloody, 
• upper stomach pain, 
• loss of appetite, 
• yellowing of the skin or eyes (jaundice), 
• seizure, 
• fever, and 
• lightheadedness

Rare side effects of Imipenem/Cilastatin include:

• none 

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

• Imipenem/Cilastatin has severe interactions with no other drugs.
• Imipenem/Cilastatin has serious interactions with the following drugs:
  • BCG intravesical live
  • cholera vaccine
  • divalproex sodium
  • ganciclovir
  • probenecid
  • valacyclovir
  • valproic acid 
• Imipenem/Cilastatin has moderate interactions with the following drugs:
  • BCG vaccine live
  • cyclosporine
  • sodium picosulfate
  • sodium picosulfate/magnesium oxide/anhydrous citric acid
  • typhoid vaccine live
• Imipenem/Cilastatin has minor interactions with no other drugs. 

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 Imipenem or Cilastatin

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Imipenem/Cilastatin?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Imipenem/Cilastatin?”

Cautions

• History of hypersensitivity to penicillins
• Use with caution in CNS disorders (eg., history of seizures); adjust dosage in renal impairment to avoid the risk of seizures; carbapenem use has been associated with seizures
• Prolonged use increases the risk of superinfections
• Use with caution in renal impairment; adjust dosage in moderate to severe renal dysfunction
• Carbapenem use may decrease serum levels of divalproex sodium or valproic acid
• Combination with aminoglycosides may thwart resistant P aeruginosa
• Not for use in children with CNS problems

Pregnancy and Lactation

• Available data from a small number of postmarketing cases in pregnancy are not sufficient to identify any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes
• There are insufficient data on the presence of Imipenem/Cilastatin in human milk, and no data on effects on the breastfed child, or milk production; developmental and health benefits of breastfeeding shoulder be considered along with mother’s clinical need for therapy and any potential adverse effects on the breastfed child from therapy or the underlying maternal condition