| name | Imipenem-Cilastatin |
| classification | Antibiotic, carbapenem class |
| pharmacokinetics | | absorption | Imipenem is poorly absorbed orally. Administered intravenously or as an IM injection. Cilastatin enhances renal excretion of imipenem, leading to higher systemic levels. | | distribution | Distributes well throughout tissues and fluids, including the cerebrospinal fluid (CSF) with adequate CSF penetration | | metabolism | Metabolized to various inactive metabolites primarily in the liver. | | excretion | Renal excretion is the primary route, significantly enhanced by cilastatin, which inhibits the enzymatic degradation of imipenem. |
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| suggested dosage | | adult | Dosage depends on the severity and type of infection. Consult a physician for appropriate dosage. Typical dosage for IM injection/IV infusion may range from 0.5-4 grams every 6 hours. Adjust doses for renal insufficiency. This is an example and not a prescription. It is crucial to follow a healthcare professional's recommendation. | | notes | Dosage should be adjusted based on patient's renal function. |
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| indications | | 1 | Treatment of serious infections caused by susceptible bacteria, including infections of the respiratory tract, urinary tract, skin and soft tissues, bone and joint, and intra-abdominal infections. Often used in combination with other antibiotics or drugs. |
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| safety in pregnancy | Use only when clearly needed. Potential risks and benefits should be carefully weighed with the physician. There are some limited data. Potential for fetal harm, particularly in later stages of pregnancy. Discuss with your healthcare provider. |
| safety in breastfeeding | Imipenem and cilastatin are excreted into breast milk. The levels are likely to be too low to pose a significant risk to infants, however, it is crucial to consult a healthcare provider. The potential benefits to the mother should be weighed against potential risks to the infant. |
| side effects | | 1 | Nausea, vomiting, diarrhea, abdominal pain, headache, dizziness, seizures (particularly in patients with renal impairment or a history of seizures), allergic reactions (rash, hives, anaphylaxis), thrombocytopenia, neutropenia, and elevated liver enzymes. |
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| contraindications | | 1 | Known hypersensitivity or allergy to Imipenem-cilastatin or any component of the formulation | | 2 | Severe renal impairment (significant reduction in creatinine clearance) | | 3 | Known history of seizures or other neurological conditions that might be exacerbated by imipenem | | 4 | Caution with patients who have hepatic impairment |
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| interactions | | 1 | May interact with other medications, especially those affecting renal function, such as aminoglycosides, or those affecting the nervous system. | | 2 | Increased risk of seizures with concomitant use of drugs that lower the seizure threshold (e.g., certain antipsychotics, antidepressants, or other drugs). |
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| warnings and precautions | | 1 | Careful monitoring of renal function is essential during and after treatment. | | 2 | Regular monitoring of blood counts and liver function tests should be performed. | | 3 | Caution in patients with a history of seizures or those with conditions that may lower the seizure threshold. |
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| alternatives | | 1 | Other carbapenem antibiotics (e.g., meropenem, doripenem) | | 2 | Other antibiotics active against the causative organism (depending on the infection type) |
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| additional information | | 1 | Imipenem is given with cilastatin to prevent its rapid breakdown by the kidneys. This combination allows for better drug effectiveness. | | 2 | Always use the medication as prescribed by a healthcare professional, and consult with a doctor regarding dosage and any potential side effects. Always disclose your complete medical history to your doctor |
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