Primaxin, Tienam
Generic Name
Imipenem
Manufacturer
MSD (Original), Various Generics
Country
USA (Original), Global
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Description
Overview of the medicine
Imipenem is a broad-spectrum carbapenem antibiotic often co-administered with cilastatin, a dehydropeptidase inhibitor. It is used to treat severe bacterial infections resistant to other antibiotics.
Uses & Indications
Dosage
Adults
500 mg Imipenem/Cilastatin IV every 6-8 hours, or 1 g every 6-8 hours for severe infections. Maximum 4 g/day.
Elderly
Dosage adjustment may be necessary based on renal function and severity of infection.
Renal_impairment
Significant dose reduction and/or increased dosing interval required based on creatinine clearance.
How to Take
Administered by intravenous infusion, typically over 20 to 60 minutes. Not for intramuscular use.
Mechanism of Action
Imipenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bactericidal activity. Cilastatin prevents its renal metabolism.
Pharmacokinetics
Onset
Rapid
Excretion
Primarily renal, with about 70% of unchanged Imipenem excreted in urine.
Half life
Approximately 1 hour for both Imipenem and Cilastatin.
Absorption
Rapidly and completely absorbed after intravenous administration. Bioavailability is 100%.
Metabolism
Imipenem is metabolized in the kidney by dehydropeptidase-1 (DHP-1), which is inhibited by Cilastatin.
Side Effects
Contraindications
- Hypersensitivity to Imipenem, Cilastatin, other carbapenems, or any component of the formulation
- Previous severe hypersensitivity reaction to any beta-lactam antibiotic.
Drug Interactions
Ganciclovir
Concurrent use with imipenem/cilastatin has been associated with an increased risk of generalized seizures.
Valproic acid
Carbapenems, including imipenem, may decrease valproic acid plasma concentrations, leading to loss of seizure control.
Oral Anticoagulants
May enhance the anticoagulant effect of warfarin and other oral anticoagulants.
Storage
Store dry powder vials at controlled room temperature (20-25°C), protected from light. Reconstituted solutions should be used promptly or stored as per specific instructions.
Overdose
In case of overdose, discontinue the drug, treat symptomatically, and institute supportive measures. Hemodialysis can remove imipenem.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Imipenem is excreted in breast milk; caution advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to Imipenem, Cilastatin, other carbapenems, or any component of the formulation
- Previous severe hypersensitivity reaction to any beta-lactam antibiotic.
Drug Interactions
Ganciclovir
Concurrent use with imipenem/cilastatin has been associated with an increased risk of generalized seizures.
Valproic acid
Carbapenems, including imipenem, may decrease valproic acid plasma concentrations, leading to loss of seizure control.
Oral Anticoagulants
May enhance the anticoagulant effect of warfarin and other oral anticoagulants.
Storage
Store dry powder vials at controlled room temperature (20-25°C), protected from light. Reconstituted solutions should be used promptly or stored as per specific instructions.
Overdose
In case of overdose, discontinue the drug, treat symptomatically, and institute supportive measures. Hemodialysis can remove imipenem.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Imipenem is excreted in breast milk; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years for dry powder from manufacturing date. Reconstituted solution has limited shelf life.
Availability
Hospitals, Pharmacies
Approval Status
FDA Approved
Patent Status
Patent Expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of Imipenem/Cilastatin in various severe bacterial infections.
Lab Monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (ALT, AST)
- Complete blood count (CBC)
- Monitoring for C. difficile infection if diarrhea occurs.
Doctor Notes
- Crucial to adjust dosage in patients with renal impairment to minimize the risk of CNS side effects, including seizures.
- Monitor for signs of superinfection, especially with prolonged use.
- Carefully consider drug interactions, particularly with valproic acid and ganciclovir.
Patient Guidelines
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any signs of allergic reactions, such as rash or difficulty breathing.
- Inform your doctor if you experience severe diarrhea, especially if bloody or watery.
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; patients should be advised to exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain good hydration during treatment.
- Avoid alcohol consumption as it may worsen some side effects.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.