Trade Names:Primaxin IV- Powder for Injection 250 mg imipenem equivalent and 250 mg cilastatin equivalent. Contains 0.8 mEq sodium.- Powder for Injection 500 mg imipenem equivalent and 500 mg cilastatin equivalent. Contains 1.6 mEq sodium.
Trade Names:Primaxin IM- Powder for Injection 500 mg imipenem equivalent and 500 mg cilastatin equivalent. Contains 1.4 mEq sodium.
Imipenem inhibits bacterial cell wall synthesis. Cilastatin prevents metabolism of imipenem, resulting in increased urinary recovery and decreased renal toxicity.
Treatment of serious infections of lower respiratory tract and urinary tract, intra-abdominal and gynecologic infections, bacterial septicemia, bone and joint infections, skin and skin structure infections, endocarditis, and polymicrobic infections due to susceptible microorganisms.
IM use with hypersensitivity to local anesthetics of amide type or with severe shock or heart block.
IV use with patients with meningitis (safety and efficacy have not been established).
IV 125, 250, or 500 mg dose over 20 to 30 min. Infuse a 750 mg or 1 g dose over 40 to 60 min. If nausea develops, slow the infusion rate. Max: 50 mg/kg/day or 4 g/day, whichever is lower.Adults
IM 500 to 750 mg every 12 h. Max: 1,500 mg/day.Children less than 40 kg
IM 60 mg/kg/day.Children at least 40 kg
IM Adult dose.Premature Infants (at least 36 wk Gestational Age)
IM 20 mg/kg every 12 h.
Store unreconstituted powder at or below 77°F.
CNS side effects (eg, myoclonia, seizures) may be increased.Ganciclovir
Generalized seizures may occur; avoid use.Probenecid
Minimal increases in imipenem levels and half-life; do not give probenecid concurrently.
Do not physically mix imipenem-cilastatin with other antibiotics.
May cause positive Coombs test results.
Hypotension; palpitations; tachycardia; phlebitis; thrombophlebitis.
Nausea; diarrhea; vomiting; pseudomembranous colitis; hemorrhagic colitis; hepatitis.
Presence of RBCs, WBCs, casts, and bacteria in urine; increased BUN and creatinine.
Decreased Hgb and Hct; eosinophilia; increased or decreased WBCs and platelets; decreased erythrocytes.
Increased AST, ALT, alkaline phosphatase, and bilirubin.
Pain at injection site.
Category C .
Safety and efficacy in children younger than 12 yr of age are not established with IM use. IV use in newborns to 16 yr of age (with non-CNS infections) is supported by evidence from adequate and well-controlled studies. IV use is not recommended in pediatric patients with CNS infections because of the risk of seizures, or in pediatric patients less than 30 kg with impaired renal function as no data are available.
Administer drug with caution to penicillin-sensitive patients due to possible cross-activity.
Dosage reduction or alteration of dosage interval is required.
May result in bacterial or fungal overgrowth of nonsusceptible organisms.
Benzyl alcohol as a preservative has been associated with toxicity in newborns, especially those younger than 3 mo. Do not use diluents containing benzyl alcohol when IV is constituted for administration to pediatric patients.
IV administration may result in myoclonic activity confusional states or seizures.
Consider possibility in patients with diarrhea.
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