Indications for Imipenem and Cilastatin Sodium 250mg:
Serious susceptible infections including bacterial septicemia, lower respiratory tract, urinary tract, skin and skin structure, bone and joint, intraabdominal, gynecologic, endocarditis.
Base dose on imipenem component. Give by IV infusion only. Infuse over 20–30mins (500mg) or 40–60mins (1000mg); slower rate if nausea/vomiting occurs. Susceptible bacteria: 500mg every 6hrs or 1000mg every 8hrs. Intermediate susceptibility: 1000mg every 6hrs. Max 4g/day. Renal impairment (CrCl <90mL/min): reduce dose; see full labeling. CrCl <15mL/min: not recommended unless hemodialysis starts within 48hrs. Hemodialysis: give after session (see full labeling).
<30kg with renal impairment or CNS infections (seizure risk): not recommended. Base dose on imipenem component. Give by IV infusion only. Infuse over 20–30mins (if ≤500mg) or 40–60mins (if >500mg); slower rate if nausea/vomiting occurs. Non-CNS infections (if ≥1.5kg): <1wk of age: 25mg/kg every 12hrs; 1–4wks: 25mg/kg every 8hrs; 4wks–3mos: 25mg/kg every 6hrs; ≥3mos: 15–25mg/kg every 6hrs. Max 4g/day.
Not for the treatment of meningitis. Penicillin, cephalosporin, β-lactam, or other allergy. CNS disorders (esp. brain lesions or history of seizures). Monitor renal, hepatic, hematologic function periodically with prolonged use. Renal impairment. Pregnancy. Nursing mothers.
Carbapenem (thienamycin) + dehydropeptidase I inhibitor.
Concomitant ganciclovir (increased seizure risk), probenecid: not recommended. May antagonize valproic acid; consider alternative; if co-administration needed, consider supplemental anticonvulsant.
Phlebitis, nausea, diarrhea, vomiting, rash, inj site reactions, fever, hypotension, seizures, dizziness, pruritus, vein induration, urticaria, somnolence; C. difficile-associated diarrhea, hypersensitivity reactions (discontinue if occur). Children: also gastroenteritis, discolored urine, oliguria/anuria, oral candidiasis, tachycardia.
Single-dose vials 250mg—contact supplier; 500mg—25