Imipenem with cilastatin

Indications & Dose:

Aerobic and anaerobic Gram-positive and Gramnegative infections (not indicated for CNS infections) Hospitalacquired septicaemia 

• BY INTRAVENOUS INFUSION 

Adult: 500 mg every 6 hours, alternatively 1 g every 8 hours Infection caused by Pseudomonas or other less sensitive organisms

Empirical treatment of infection in febrile patients with neutropenia

Life-threatening infection

• BY INTRAVENOUS INFUSION

  Adult: 1 g every 6 hoursr

Child

IV >40 kg, adult dose

IV <40 kg, 60 mg/kg/day in divided doses 

Contraindications:

IM: hypersensitivity to local anesthetics of the amide type (contains lidocaine) 

Side Effects:

Common or very common Diarrhoea . eosinophilia . nausea (may reduce rate of infusion) . rash . vomiting

Uncommon Confusion . dizziness . drowsiness . hallucinations . hypotension . leucopenia . myoclonic activity . seizures . thrombocytopenia . thrombocytosis

Rare Acute renal failure . anaphylactic reactions . antibiotic-associated colitis .encephalopathy . hearing loss . hepatitis . paraesthesia . polyuria .

Stevens-Johnson syndrome . taste disturbances . tooth, tongue or urine discoloration . toxic epidermal necrolysis . tremor 

Very rare Abdominal pain . aggravation of myasthenia gravis . asthenia . cyanosis . dyspnoea . flushing . glossitis . haemolytic anaemia . headache . heartburn . hyperhidrosis . hypersalivation . hyperventilation . palpitation . polyarthralgia . tachycardia . tinnitus

Frequency not known Neurotoxicity (at high dose, renal failure, CNS disease)

ALLERGY Use with caution in patients with sensitivity to betalactam antibacterials.

PREGNANCY Manufacturer advises avoid unless potential benefit outweighs risk (toxicity in animal studies).

 BREAST FEEDING Present in milk but unlikely to be absorbed.

 RENAL IMPAIRMENT Risk of CNS side-effects; reduce dose if eGFR less than 70 mL/minute/ 1.73m2—consult product literature.

Cautions:

Precautions:

Elderly, hypersensitivity to penicillins, seizure disorders, renal disease, children < 12 yr 

Interaction:

Drugs

Cyclosporine, tacrolimus: Risk of CNS toxicity

Theophylline: Increased seizure risk without elevated theophylline levels 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; unknown if excreted in breast milk

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: