Cilanem
Generic Name
Imipenem + Cilastatin
Manufacturer
Varies by manufacturer (e.g., Square Pharmaceuticals Ltd.)
Country
Varies by manufacturer (e.g., Bangladesh, India, USA)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| cilanem 500 mg injection | ৳ 1,195.00 | N/A |
Description
Overview of the medicine
Cilanem 500 mg Injection is a broad-spectrum carbapenem antibiotic used to treat a wide range of severe bacterial infections. It contains Imipenem, an antibiotic that kills bacteria, and Cilastatin, which prevents the breakdown of Imipenem in the kidneys, allowing it to remain active for longer.
Uses & Indications
Dosage
Adults
Usual dose 250-1000 mg (Imipenem equivalent) every 6-8 hours by IV infusion, not exceeding 4g/day.
Elderly
Dosage adjusted based on renal function.
Renal_impairment
Dosage must be significantly reduced based on creatinine clearance.
How to Take
Administer by intravenous infusion over 20 to 60 minutes. Reconstitute the powder with an appropriate diluent (e.g., 0.9% Sodium Chloride) according to manufacturer's instructions.
Mechanism of Action
Imipenem binds to penicillin-binding proteins (PBPs) in the bacterial cell wall, inhibiting cell wall synthesis and leading to bacterial cell death. Cilastatin inhibits the renal enzyme dehydropeptidase-I, which metabolizes imipenem, thereby increasing the urinary concentrations of imipenem and reducing its nephrotoxic potential.
Pharmacokinetics
Onset
Rapid onset, usually within minutes of IV infusion.
Excretion
Primarily renal, 70% of imipenem and 70-75% of cilastatin are excreted unchanged in urine within 10 hours.
Half life
Approximately 1 hour for both imipenem and cilastatin.
Absorption
Rapid and complete absorption after intravenous administration.
Metabolism
Imipenem is extensively metabolized in the kidneys by dehydropeptidase-I (inhibited by cilastatin). Cilastatin is also metabolized in the kidney.
Side Effects
Contraindications
- Hypersensitivity to imipenem, cilastatin, or other carbapenems or beta-lactam antibiotics.
- Severe hypersensitivity (e.g., anaphylactic reaction) to any other type of beta-lactam antibacterial agent.
Drug Interactions
Probenecid
Inhibits renal excretion of imipenem and cilastatin, increasing their plasma levels.
Ganciclovir
Concurrent use may increase the risk of generalized seizures.
Cyclosporine
Increased risk of CNS side effects.
Valproic acid/Sodium valproate
May decrease valproic acid levels, leading to loss of seizure control.
Storage
Store below 25°C in a dry place, protected from light. Keep out of reach of children. Reconstituted solutions should be used immediately or stored as per manufacturer guidelines.
Overdose
Management is symptomatic and supportive. Hemodialysis can remove imipenem-cilastatin from the body.
Pregnancy & Lactation
Use in pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Excreted in breast milk; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date when stored correctly. Reconstituted solution shelf life varies.
Availability
Hospitals, pharmacies, clinics
Approval Status
Approved by major regulatory bodies globally (e.g., FDA, EMA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of imipenem-cilastatin in treating various severe bacterial infections, including those resistant to other antibiotics.
Lab Monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (AST, ALT, bilirubin)
- Complete blood count (CBC) with differential
Doctor Notes
- Important for severe hospital-acquired infections or infections resistant to other antibiotics.
- Close monitoring of renal function is essential, especially in elderly or renally impaired patients.
- Be aware of potential CNS side effects, particularly seizures, especially in patients with pre-existing CNS disorders.
Patient Guidelines
- Inform your doctor about any allergies, especially to penicillin or other antibiotics.
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any severe side effects like seizures, rash, or severe diarrhea immediately.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or seizures; caution advised when driving or operating machinery.
Lifestyle Advice
- Maintain good hygiene to prevent further infections.
- Stay hydrated during treatment.
- Avoid alcohol consumption if feeling unwell or if it exacerbates side effects.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.