| name | Imipenem |
| classification | Carbapenem antibiotic |
| pharmacokinetics | Imipenem is a parenteral antibiotic that is administered intravenously or intramuscularly. It is rapidly hydrolyzed in the presence of renal enzymes, so it must be administered with cilastatin, which inhibits renal dehydropeptidase I. This combination allows for systemic availability. The combination of imipenem and cilastatin has a short half-life. Imipenem exhibits good penetration into many tissues and fluids in the body. Renal function has a significant impact on the half-life and dosage of this drug; reduced renal function needs dose adjustment. |
| suggested dosage | Dosage for imipenem-cilastatin varies greatly depending on the infection being treated, and the patient's renal function. A starting dose range for adults with normal renal function is typically 500mg/500mg every 6-8 hours. Consult with a physician to determine the appropriate dose and schedule. **Always use the dose recommended by the prescribing physician.** Dosage should be adjusted in patients with renal impairment. |
| indications | Imipenem-cilastatin is indicated for the treatment of serious bacterial infections caused by susceptible organisms. These infections can include: pneumonia, skin infections, intra-abdominal infections, urinary tract infections, and bone infections. Its broad-spectrum activity allows for treatment of diverse bacterial infections. |
| safety in pregnancy | Use during pregnancy is only considered when the potential benefit outweighs the potential risk to the fetus. Consult with a physician to carefully weigh the pros and cons. Limited data exists. In preclinical studies, adverse effects were noted. Caution is advised. |
| safety in breastfeeding | The drug is likely to be excreted in breast milk, although the extent is not fully known. The decision to continue breastfeeding should be carefully discussed with a physician to balance potential benefits and risks for both the mother and the baby. In preclinical studies, adverse effects were noted. |
| side effects | | 1 | Nausea | | 2 | Vomiting | | 3 | Diarrhea | | 4 | Headache | | 5 | Rash | | 6 | Allergic reactions (rare) | | 7 | Seizures (more common with higher doses and in patients with a predisposition to seizures) | | 8 | Inflammatory conditions (such as pseudomembranous colitis) | | 9 | Elevated liver enzymes (transaminases) |
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| alternatives | |
| contraindications | | 1 | Known hypersensitivity to imipenem or cilastatin. | | 2 | Severe renal impairment (this is crucial and requires close monitoring by a physician). |
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| interactions | Imipenem may interact with other drugs. Consult a physician regarding any other medications the patient is taking. Some examples include other nephrotoxic drugs and potentially some aminoglycosides. |
| warnings and precautions | Patients with a history of seizures or neurological disorders should be monitored closely. Careful monitoring of renal function is critical. The drug should be administered cautiously to patients with pre-existing liver dysfunction. The potential for Clostridium difficile-associated diarrhea should be considered and treated appropriately if it arises. |
| additional informations | Dosage adjustment is necessary in patients with renal impairment. Appropriate monitoring of kidney function, liver function, and complete blood count (CBC) is necessary during treatment. The dosage information provided is for general guidance and should not replace the instructions of a physician. |
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