Monday, 6 August 2012

imipenem and cilastatin


Generic Name: imipenem and cilastatin (IM i PEN em and SYE la STAT in)

Brand names: Primaxin IM, Primaxin IV, Primaxin IV ADD-Vantage


What is imipenem and cilastatin?

Imipenem is an antibiotic that fights serious infections caused by bacteria.


Cilastatin helps imipenem work more effectively by preventing the breakdown of the antibiotic in the kidneys.


Imipenem and cilastatin is used to treat severe infections of the lower respiratory tract, skin, stomach, female reproductive organs, and other body systems.


Imipenem and cilastatin may also be used for other purposes not listed here.


What is the most important information I should know about imipenem and cilastatin?


Do not use imipenem and cilastatin if you are allergic to it, if you have heart block, or if you are allergic to lidocaine or other local anesthetics (numbing medicine).

Before using imipenem and cilastatin, tell your doctor if you have kidney disease (or if you are on dialysis), or a seizure disorder.


Also tell your doctor if you are either allergic to or are currently taking a penicillin or cephalosporin antibiotic such as Amoxil, Augmentin, Bactocill, Beepen-VK, Ceclor, Ceftin, Duricef, Dycill, Dynapen, Keflex, Ledercillin VK, Omnipen, Pen-V, Pfizerpen, Principen, Veetids, and others.

Primaxin IM (for the muscle) and Primaxin IV (for the vein) are different forms of this medicine and should be used only for their specific type of injection. Do not inject Primaxin IM into a vein and do not inject Primaxin IV into a muscle.


Call your doctor at once if you have serious side effects such as pounding heartbeats, confusion, hallucinations, seizure (convulsions), feeling light-headed, fainting, flu symptoms, nausea, stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), or a severe blistering, peeling, and red skin rash.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.


What should I discuss with my healthcare provider before use imipenem and cilastatin?


Do not use imipenem and cilastatin if you are allergic to it, if you have heart block, or if you are allergic to lidocaine or other local anesthetics (numbing medicine).

If you have any of these other conditions, you may need a dose adjustment or special tests:


  • kidney disease (or if you are on dialysis);


  • epilepsy or other seizure disorder;




  • a history of allergy to penicillin antibiotics such as Amoxil, Augmentin, Omnipen, Principen, Dycill, Dynapen, Bactocill, Beepen-VK, Ledercillin VK, Pen-V, Pfizerpen, Veetids, and others; or




  • a history of allergy to cephalosporin antibiotics such as Ceclor, Ceftin, Duricef, Keflex, and others.




FDA pregnancy category C. It is not known whether imipenem and cilastatin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.. It is not known whether imipenem and cilastatin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use imipenem and cilastatin?


Imipenem and cilastatin is injected into a vein (IV) or into a muscle (IM).


Imipenem and cilastatin is usually given in a clinic or hospital setting. The IV medicine must be given as a slow infusion and can take up to an hour to complete. Tell your caregiver if you feel nauseated during the infusion. You may need to receive the medicine at a slower rate.


The IM form of imipenem and cilastatin is given as a rapid injection into a muscle. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.


Primaxin IM (for the muscle) and Primaxin IV (for the vein) are different forms of this medicine and should be used only for their specific type of injection. Do not inject Primaxin IM into a vein and do not inject Primaxin IV into a muscle.


Imipenem and cilastatin is usually given as long as needed until your infection has cleared or you have been symptom-free for at least 48 hours.


Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Imipenem and cilastatin will not treat a viral infection such as the common cold or flu.


Do not give this medication to another person, even if they have the same symptoms you do.


Imipenem and cilastatin is a powder that must be mixed with a liquid (diluent). Primaxin IM and Primaxin IV are each mixed with different types of diluent.


Prepare your dose in a syringe only when you are ready to give yourself an injection.


After mixing Primaxin IV, you may keep it in a refrigerator and use it within 24 hours. You may also store the mixed IV medicine at room temperature if you use it within 4 hours. Store unmixed imipenem and cilastatin powder at room temperature away from moisture and heat.

What happens if I miss a dose?


If imipenem and cilastatin is given in a hospital setting, it is not likely that you will miss a dose. If you are using the medication at home and you miss a dose, give the injection as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.


What happens if I overdose?


Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include weakness, drooping eyelid, tremors, trouble breathing, or seizure (black-out or convulsions).


What should I avoid while using imipenem and cilastatin?


Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.


Imipenem and cilastatin side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

  • fast or pounding heartbeats;




  • diarrhea that is watery or bloody;




  • confusion, tremors, hallucinations, seizure (convulsions);




  • feeling light-headed, fainting;




  • fever, chills, body aches, flu symptoms;




  • nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or




  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.



Less serious side effects may include:



  • pain, swelling, or redness where the medicine was injected;




  • mild nausea, vomiting, heartburn, or stomach pain;




  • sore throat;




  • vaginal itching or discharge;




  • mild skin rash or itching;




  • dizziness or tired feeling;




  • numbness or tingling; or




  • ringing in your ears.



This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.


Imipenem and cilastatin Dosing Information


Usual Adult Dose for Aspiration Pneumonia:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: Parenteral therapy should be continued until the patient's clinical condition stabilizes and fever subsides. Oral antibiotic therapy may then be initiated according to microbiologic sensitivity data. Therapy of documented anaerobic pleuropulmonary infections should be continued until the infiltrate is cleared or a residual scar forms, sometimes requiring 2 to 4 months.

Usual Adult Dose for Bacteremia:

500 mg IV every 6 hours or 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Septicemia:

500 mg IV every 6 hours or 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Bronchitis:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Pelvic Infections:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Endometritis:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Deep Neck Infection:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 3 to 4 weeks, depending on the nature and severity of the infection

Usual Adult Dose for Endocarditis:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Febrile Neutropenia:

500 mg IV every 6 hours if suspected causative organism is fully susceptible, 1 g IV every 8 hours if other suspected causative organisms are moderately susceptible, or 1 g IV every 6 hours if Pseudomonas aeruginosa is suspected causative organism (based on imipenem content)
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: Once the patient is stable and afebrile for at least 24 hours, and the absolute neutrophil count is at least 500 cells/mm3, oral antimicrobial therapy, based on susceptibility patterns, may be initiated. Then duration of therapy is dependent on the clinical situation.

Usual Adult Dose for Intraabdominal Infection:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 7 to 14 days, depending on the nature and severity of the infection

IM:
Mild to moderate infections: 750 mg IM every 12 hours
Maximum dose: 1500 mg/day

Usual Adult Dose for Joint Infection:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 3 to 4 weeks, depending on the nature and severity of the infection
Longer therapy, 6 weeks or more, may be required for prosthetic joint infections.

Usual Adult Dose for Meningitis:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 14 days, depending on the nature and severity of the infection
Treatment of meningitis due to Listeria species should be continued for 3 to 6 weeks.

Usual Adult Dose for Nosocomial Pneumonia:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: If the causative organism is not Pseudomonas aeruginosa, the duration of treatment should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Usual Adult Dose for Osteomyelitis:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 4 to 6 weeks, depending on the nature and severity of the infection
Chronic osteomyelitis may require additional oral antimicrobial therapy, possibly for up to 6 months. Surgical debridement of devitalized bone is also critical.

Usual Adult Dose for Peritonitis:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 10 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Pneumonia:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 7 days if pneumococcal pneumonia is suspected and up to 21 days for other infecting organisms, depending on the nature and severity of the infection

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Pyelonephritis:

250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Skin or Soft Tissue Infection:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 7 to 10 days, or for 3 days after acute inflammation resolves, depending on the nature and severity of the infection
For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Skin and Structure Infection:

IV: 250 mg IV every 6 hours or 500 mg to 1 g IV every 6 to 8 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 7 to 10 days, or for 3 days after acute inflammation resolves, depending on the nature and severity of the infection
For more severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required.

IM:
Mild to moderate infections: 500 to 750 mg IM every 12 hours (based on imipenem content), depending on the nature and severity of the infection
Maximum dose: 1500 mg/day

Usual Adult Dose for Urinary Tract Infection:

Uncomplicated: 250 mg IV every 6 hours (based on imipenem content)
Complicated: 500 mg IV every 6 hours (based on imipenem content)

Maximum dose: 50 mg/kg/day or 4 g/day, whichever is less
Duration: 3 to 7 days, depending on the nature and severity of the infection

Usual Pediatric Dose for Bacteremia:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Endocarditis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Intraabdominal Infection:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Joint Infection:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Osteomyelitis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Peritonitis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Pneumonia:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Pyelonephritis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Septicemia:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Bacterial Infection:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Urinary Tract Infection:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Skin and Structure Infection:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Bronchitis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Pelvic Infections:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Endometritis:

IV:
Non-CNS infections: (based on imipenem content)
Less than 7 days, less than 1500 g: 20 to 25 mg/kg IV every 12 hours
Less than 7 days, 1500 g or more: 25 mg/kg IV every 12 hours
1 to 4 weeks, less than 1200 g: 25 mg/kg IV every 12 hours
1 to 4 weeks, 1200 g or more: 25 mg/kg IV every 8 hours
4 weeks to 3 months: 25 mg/kg IV every 6 hours
3 months or older: 15 to 25 mg/kg IV every 6 hours

Maximum dose: 2 g/day for fully susceptible organisms and 4 g/day for moderately susceptible organisms

IM: Safety and efficacy of IM imipenem-cilastatin have not been established in pediatric patients below the age of 12 years.

Usual Pediatric Dose for Pneumonia with Cystic Fibrosis:

Greater than 12 years with normal renal function: Up to 90 mg/kg/day IV in divided doses (based on imipenem content)
Maximum dose: 4 g/day


What other drugs will affect imipenem and cilastatin?


Tell your doctor about all other medications you use, especially:



  • valproic acid (Depakene, Stavzor);




  • ganciclovir (Cytovene);




  • probenecid (Benemid);




  • a penicillin antibiotic such as amoxicillin (Amoxil, Augmentin), ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), or penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids, and others); or




  • a cephalosporin antibiotic such as cefaclor (Ceclor), cefuroxime (Ceftin), cefadroxil (Duricef), cephalexin (Keflex), and others.



This list is not complete and other drugs may interact with imipenem and cilastatin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More imipenem and cilastatin resources


  • Imipenem and cilastatin Use in Pregnancy & Breastfeeding
  • Imipenem and cilastatin Drug Interactions
  • Imipenem and cilastatin Support Group
  • 0 Reviews for Imipenem and cilastatin - Add your own review/rating


Compare imipenem and cilastatin with other medications


  • Aspiration Pneumonia
  • Bacteremia
  • Bacterial Infection
  • Bone infection
  • Bronchitis
  • Deep Neck Infection
  • Endocarditis
  • Endometritis
  • Febrile Neutropenia
  • Intraabdominal Infection
  • Joint Infection
  • Kidney Infections
  • Meningitis
  • Nosocomial Pneumonia
  • Pelvic Infections
  • Peritonitis
  • Pneumonia
  • Pneumonia with Cystic Fibrosis
  • Septicemia
  • Skin and Structure Infection
  • Skin Infection
  • Urinary Tract Infection


Where can I get more information?


  • Your doctor or pharmacist can provide more information about imipenem and cilastatin.


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