Formulary
Imipenem with cilastatin: Indications, Dosing, Side Effects and Interactions
Imipenem with cilastatin clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Imipenem with cilastatin: Indications, Dosing, Side Effects and Interactions
Imipenem with cilastatin clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Aerobic and anaerobic Gram-positive and Gram-negative infections (not indicated**
- **Adult** (By Intravenous Infusion): for CNS infections), Hospital-acquired septicaemia 500 mg every 6 hours, alternatively 1 g every 8 hours.
**Infection caused byPseudomonasor other less sensitive organisms,Empirical treatment of infection in febrile patients with neutropenia,Life-threatening infection**
- **Adult** (By Intravenous Infusion): Infection caused by Pseudomonas or other less sensitive organisms, Empirical treatment of infection in febrile patients with neutropenia, Life-threatening infection 1 g every 6 hours.
**Aerobic and anaerobic Gram-positive and Gram-negative infections (not indicated for CNS infections), Hospital-acquired septicaemia for imipenem with cilastatin**
- **Neonate up to 7 days** (By intravenous infusion): 20 mg/kg every 12 hours.
- **Neonate 7 days to 20 days** (By intravenous infusion): 20 mg/kg every 8 hours.
- **Neonate 21 days to 28 days** (By intravenous infusion): 20 mg/kg every 6 hours.
- **Child 1-2 months** (By intravenous infusion): 20 mg/kg every 6 hours.
- **Child 3 months-17 years** (By intravenous infusion): 15 mg/kg every 6 hours (max. per dose 500 mg).
**Infection caused by Pseudomonas or other less sensitive organisms, Empirical treatment of infection in febrile patients with neutropenia, Life-threatening infection for imipenem with cilastatin**
- **Child 3 months-17 years** (By intravenous infusion): 25 mg/kg every 6 hours (max. per dose 1 g).
**Cystic fibrosis for imipenem with cilastatin**
- **Child** (By intravenous infusion): 25 mg/kg every 6 hours (max. per dose 1 g).
Cautions
For imipenem with cilastatin CNS disorders; epilepsy
Side effects
For imipenem with cilastatin Common or very common Diarrhoea; eosinophilia; nausea; skin reactions; thrombophlebitis; vomiting Uncommon Bone marrow disorders; confusion; dizziness; drowsiness; hallucination; hypotension; leucopenia; movement disorders; psychiatric disorder; seizure; thrombocytopenia; thrombocytosis Rare or very rare Agranulocytosis; anaphylactic reaction; angioedema; chest discomfort; colitis haemorrhagic; cyanosis; dyspnoea; encephalopathy; flushing; focal tremor; gastrointestinal discomfort; haemolytic anaemia; headache; hearing loss; hepatic disorders; hyperhidrosis; hyperventilation; increased risk of infection; myasthenia gravis aggravated; oral disorders; palpitations; paraesthesia; polyarthralgia; polyuria; pseudomembranous enterocolitis; renal impairment; severe cutaneous adverse reactions (SCARs); spinal pain; tachycardia; taste altered; tinnitus; tongue discolouration; tooth discolouration; urine discolouration; vertigo Frequency not known Agitation; antibiotic associated colitis
Pregnancy
For imipenem with cilastatin Manufacturer advises avoid unless potential benefit outweighs risk (toxicity in animal studies).
Breast feeding
For imipenem with cilastatin Specialist sources indicate suitable for use in breast-feeding. D
Renal impairment
For imipenem with cilastatin Manufacturer advises caution if creatinine clearance less than 90 mL/minute. Dose adjustments Manufacturer advises reduce dose if creatinine clearance less than 90 mL/minute (risk of CNS side-effects)-consult product literature. See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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