Imipenem-cilastatin

Imipenem / Cilastatin Brands

Brand Name Manufacturer Name Distributor Drug Strength Packaging Formulation Formulation Strength Price
Bacqure Sun Pharmaceuticals Ltd Sunpar Pharmaceuticals Ltd. 500mg/500mg 1 Injection per vial KES 1,620.00
Imbac Popular Pharmaceuticals Ltd Omaera Pharmaceuticals Ltd 500mg 1 Injection per vial KES 1,971.00
Imicil Synermed Pharmaceuticals Ltd Saicare Enterprises Ltd. 500mg/500mg 1 Injection per vial KES 1,300.00
Inno-Cila Innocia Life Sciences PVT. Ltd Pharma Specialities Ltd. 500mg/500mg 1 Injection per vial KES 1,350.00
Kinem Akorn India PVT Ltd. Medox Pharmaceuticals Ltd. 500mg/500mg 1 Injection per vial KES 1,585.00
Lastinem Venus Remedies Limited Surgipharm Ltd 500mg 1 Injection per vial KES 1,800.00
Pantin Biopharm Group Maxim Pharmaceuticals Ltd 500mg/500mg 1 Injection per vial KES 1,800.00
Pelastin PT Sanbe Pharma Sai Pharmaceuticals Ltd. 500mg 1 Injection per vial KES 1,500.00
Imipenem / Cilastatin more info
Mode Of Action

Imipenem is a carbapenem, a beta lactam antibiotic, with aerobic and anaerobic activity against both gram positive and gram negative bacteria. Since it is inactivated in the kidney, it is co-administered with cilastatin, which blocks a specific enzyme that is involved in its metabolism.

Drug Indication Aerobic and anaerobic gram +ve and -ve bacterial infections. Septicaemia, endocarditis, gynaecological infections, mixed infections, bone, joints, skin and soft tissue infections
Precautions Should not be given to patients known to be hypersensitive to it, and should be given with caution to patients known to be hypersensitive to penicillins, cephalosporins, or other beta lactams because of the possibility of cross-sensitivity. It should be given with caution to patients with renal impairment, and the dose reduced appropriately. Particular care is necessary in patients with CNS disorders such as epilepsy.
Contra-Indications Carbapenem / beta-lactam sensitivity.
Side Effects Allergic reactions, GI distubances, pseudomembranous colitis, blood dyscrasia, red urine, liver impairment, seizure, confusional states, super-infections, psychological disturbances.
Dosage By intravenous infusion, in terms of imipenem, 12g daily (in 3-4 divided doses); less sensitive organisms, up to 50mg/kg daily (max. 4g daily) in 3-4 divided doses; child 3 months and older, 60mg/kg (up to max. of 2g) daily in 4 divided doses; over 40kg, adult dose Surgical prophylaxis, 1g at induction repeated after 3 hours, supplemented in high risk (e.g. colorectal) surgery by doses of 500mg 8 and 16 hours after induction.Children: < 1 week old; >1.5g BW: 5mg/kg IV 12hourly for non-CNS infections, 1- 4 weeks old; >1.5 g BW: 25mg/kg IV 8hourly for non-CNS infections. 4 weeks old-3 months old; >1.5 g BW: 25mg/kg IV 6hourly for non-CNS infections. >3 months old: 15-25 mg/kg/dose IV 6hourly for non-CNS infections; not to exceed 2g/day for fully susceptible organisms or 4g/day for moderately susceptible organisms. >12 years old: 10-15 mg/kg IM 6hourly for mild to moderate infections. Cystic fibrosis patients, up to 90 mg/kg/day IV used in older children.
Drug Category DRUGS ACTING ON INFECTIONS
Drug Sub-Category Penicillins

Dosing: Adult

Doses based on imipenem content. Note: I.M. administration is not intended for severe or life-threatening infections (eg, septicemia, endocarditis, shock), UTI, bone/joint or polymicrobic infections. For adults weighing <70 kg, refer to Dosing Adjustment in Renal Impairment

Burkholderia mallei (melioidosis) (unlabeled use): 25 mg/kg (up to 1 g) every 6 hours for at least 10 days (Currie, 2003)

Intra-abdominal infections:

I.V.:

Mild infection: 250-500 mg every 6 hours

Severe infection: 500 mg every 6 hours or 1 g every 8 hours for 4-7 days (provided source controlled). Note: Not recommended for mild-to-moderate, community-acquired intra-abdominal infections due to risk of toxicity and the development of resistant organisms (Solomkin, 2010)

I.M.: Mild-to-moderate infection: 750 mg every 12 hours

Liver abscess (unlabeled use): I.V.: 500 mg every 6 hours for 4-6 weeks (Ulug, 2010)

Lower respiratory tract, skin/skin structure, gynecologic infections: I.M.: Mild/moderate: 500-750 mg every 12 hours

Moderate infections:

I.M.: 750 mg every 12 hours

I.V.:

Fully-susceptible organisms: 500 mg every 6-8 hours

Moderately-susceptible organisms: 500 mg every 6 hours or 1 g every 8 hours

Neutropenic fever (unlabeled use): I.V.: 500 mg every 6 hours (Paul, 2006)

Pseudomonas infections: I.V.: 500 mg every 6 hours; Note: Higher doses may be required based on organism sensitivity.

Severe infections: I.V.: Note: I.M. administration is not intended for severe or life-threatening infections (eg, septicemia, endocarditis, shock):

Fully-susceptible organisms: 500 mg every 6 hours

Moderately-susceptible organisms: 1 g every 6-8 hours

Maximum daily dose should not exceed 50 mg/kg or 4 g/day, whichever is lower

Urinary tract infection, uncomplicated: I.V.: 250 mg every 6 hours

Urinary tract infection, complicated: I.V.: 500 mg every 6 hours

Mild infections: Note: Rarely a suitable option in mild infections; normally reserved for moderate-severe cases:

I.M.: 500 mg every 12 hours

I.V.:

Fully-susceptible organisms: 250 mg every 6 hours

Moderately-susceptible organisms: 500 mg every 6 hours

Dosing: Pediatric

(For additional information see "Imipenem and cilastatin: Pediatric drug information")

Dosage based on imipenem content:

Non-CNS infections: I.V.:

Neonates ≤3 months and weight ≥1500 g:

<1 week: 25 mg/kg every 12 hours

1-4 weeks: 25 mg/kg every 8 hours

4 weeks to 3 months: 25 mg/kg every 6 hours

Children: >3 months: 15-25 mg/kg every 6 hours

Maximum dosage: Susceptible infections: 2 g/day; moderately-susceptible organisms: 4 g/day

Burkholderia mallei (melioidosis) (unlabeled use): 20 mg/kg every 8 hours for 10 days

Cystic fibrosis: Doses up to 90 mg/kg/day have been used

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

I.V.: Note: Adjustments have not been established for I.M. dosing:

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