Imipenem + Cilastatin

Indications

Bacterial Infection Respiratory Tract Infection Skin and Soft Tissue Infection Sepsis

Imipenem + Cilastatin is a combination of Imipenem, a penem antibacterial, and Cilastatin, a renal dehydropeptidase inhibitor. Doctors use it to treat serious infections caused by designated susceptible bacteria. These are the infections it is indicated for: lower respiratory tract infections, urinary tract infections, intra-abdominal infections, gynecologic infections, bacterial septicemia, bone and joint infections, skin and skin structure infections, and endocarditis.

⚠️ Always consult a registered physician before taking any medicine.

Pharmacology

Imipenem + Cilastatin is a combined preparation. Imipenem is a penem antibacterial. Cilastatin sodium is a renal dehydropeptidase inhibitor, and it limits the breakdown of imipenem in the kidneys.

Imipenem kills bacteria by blocking the synthesis of their cell wall. It binds most strongly to penicillin binding proteins (PBPs) 1A, 1B, 2, 4, 5 and 6 of Escherichia coli, and to PBPs 1A, 1B, 2, 4 and 5 of Pseudomonas aeruginosa. The lethal effect is linked to binding to PBP 2 and PBP 1B.

Imipenem stays highly stable in the presence of beta-lactamases, both penicillinases and cephalosporinases, whether they are produced by Gram-negative or Gram-positive bacteria. It is also a potent inhibitor of betalactamases from certain Gram-negative bacteria that are naturally resistant to most beta-lactam antibacterials, for example Pseudomonas aeruginosa, Serratia spp. and Enterobacter spp.

Pregnancy & Breastfeeding

Imipenem + Cilastatin is Pregnancy Category C. There are no adequate and well-controlled studies of this combination in pregnant women, so it should be used during pregnancy only if the potential benefit justifies the potential risk to the mother and fetus.

It is not known whether Imipenem-Cilastatin sodium passes into human milk. Many drugs do pass into breast milk, so caution should be exercised when this combination is given to a nursing woman.

⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.

Dosage Reference

⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.

Adults: The adult dosage of Imipenem + Cilastatin should be based on suspected or confirmed pathogen susceptibility. For adult patients with normal renal function (creatinine clearance of greater than or equal to 90 mL/min), the recommended dosage regimens are 500 mg every 6 hours OR 1000 mg every 8 hours OR 1000 mg every 6 hours. The dose must be reduced for a patient with a creatinine clearance of less than 90 mL/min. Patients with creatinine clearances of less than 15 mL/min should not receive this combination unless hemodialysis is instituted within 48 hours. Reconstitute the vial with an appropriate diluent, then dilute the reconstituted suspension with an appropriate infusion solution before giving it by intravenous infusion. The recommended pediatric dosage for non-CNS infections depends on age. For children greater than or equal to 3 months of age, it is 15 to 25 mg/kg every 6 hours. For those less than or equal to 3 months of age (greater than or equal to 1,500 g body weight), the dosage is 25 mg/kg every 6 hours at 4 weeks to 3 months of age, 25 mg/kg every 8 hours at 1 to 4 weeks of age, and 25 mg/kg every 12 hours at less than 1 week of age. Give doses of less than or equal to 500 mg by intravenous infusion over 20 to 30 minutes. Doses greater than 500 mg should be given by intravenous infusion over 40 to 60 minutes. The maximum total daily dosage should not exceed 4g/day.

Side Effects & Interactions

Side Effects

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Key Interactions

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