Medicine Information

Inpen

Name: Inpen
Brand: Inpen
Rating: 4.5 (117 reviews)

Powder for Solution for Injection (IV)1 gm Imipenem and 1 gm CilastatinAntibiotics, CarbapenemsATC: J01DH51

Generic Name

Imipenem and Cilastatin

Manufacturer

Example Pharmaceutical Co. Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
inpen 1 gm injection	৳ 1,300.00	N/A

Description

Overview of the medicine

Inpen is a broad-spectrum antibiotic containing Imipenem and Cilastatin. Imipenem is a carbapenem antibiotic effective against a wide range of bacteria, and Cilastatin prevents its breakdown in the kidneys, enhancing its effectiveness and reducing potential renal toxicity.

Uses & Indications

Lower respiratory tract infections

Urinary tract infections

Intra-abdominal infections

Gynecological infections

Skin and soft tissue infections

Bacterial septicemia

Bone and joint infections

Endocarditis

Polymicrobic infections

Febrile neutropenia

Dosage

Adults

Usually 250 mg to 1000 mg (Imipenem/Cilastatin) every 6 to 8 hours by IV infusion, depending on the severity and type of infection. Maximum daily dose is 4 gm.

Elderly

Dosage should be adjusted based on renal function, similar to adult patients with renal impairment.

Renal_impairment

Significant dosage reduction is required based on creatinine clearance (CrCl). Consult a dosing chart specific to CrCl levels.

How to Take

For intravenous infusion only. Reconstitute the powder with an appropriate diluent (e.g., 0.9% sodium chloride, 5% dextrose in water) and administer slowly over the recommended period.

Mechanism of Action

Imipenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bacterial cell lysis and death. Cilastatin inhibits dehydropeptidase-I, an enzyme found in the renal tubules that metabolizes imipenem, thereby increasing the urinary concentrations of imipenem.

Pharmacokinetics

Onset

Rapid, with peak plasma concentrations occurring within 20 minutes after a 30-minute IV infusion.

Excretion

Primarily renal; approximately 70% of both imipenem and cilastatin are recovered in the urine within 10 hours after a 30-minute IV infusion.

Half life

Imipenem: approximately 1 hour; Cilastatin: approximately 1 hour.

Absorption

Administered intravenously, providing 100% bioavailability.

Metabolism

Imipenem is partially metabolized by renal dehydropeptidase-I (inhibited by cilastatin). Cilastatin is partially metabolized.

Side Effects

Contraindications

Patients with known hypersensitivity to Imipenem, Cilastatin, or any component of the formulation.
Patients with a history of severe hypersensitivity reactions to other beta-lactam antibiotics (e.g., penicillins, cephalosporins).

Drug Interactions

Probenecid

Increases plasma levels and prolongs the half-life of both Imipenem and Cilastatin.

Ganciclovir

Concomitant use with Imipenem/Cilastatin has been associated with generalized seizures.

Cyclosporine

Possible increased cyclosporine levels with concomitant use.

Valproic acid

Carbapenems, including Imipenem/Cilastatin, may decrease valproic acid plasma concentrations, leading to loss of seizure control.

Storage

Store dry powder vials below 25°C (77°F) in original packaging, protected from light and moisture. Do not freeze. Reconstituted solutions should be used immediately or refrigerated and used within specific timeframes.

Overdose

In case of overdose, discontinue the drug and provide supportive care. Imipenem/Cilastatin can be removed by hemodialysis.

Pregnancy & Lactation

Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Excreted in breast milk; use with caution in nursing mothers, considering the potential risks to the infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

1 gm Imipenem/1 gm Cilastatin vial

Shelf Life

Typically 24-36 months from manufacturing date for dry powder. Reconstituted solution shelf life is limited (e.g., 4 hours at room temperature, 24 hours refrigerated).

Availability

Available in hospitals and pharmacies

Approval Status

Approved by regulatory authorities (e.g., FDA, DGDA)

Patent Status

Generic available, original patent expired

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have established the efficacy and safety of Imipenem/Cilastatin across various severe bacterial infections.

Lab Monitoring

Renal function tests (creatinine, BUN) for patients with renal impairment or prolonged therapy.
Liver function tests (ALT, AST) periodically.
Complete blood count (CBC) with prolonged therapy.

Doctor Notes

Administer slowly by IV infusion to minimize local irritation and systemic side effects.
Careful dosage adjustment is crucial in patients with renal impairment to prevent accumulation and reduce the risk of CNS toxicity (e.g., seizures).
Monitor patients for hypersensitivity reactions (including cross-reactivity with other beta-lactams) and signs of superinfection.

Patient Guidelines

Complete the full course of antibiotic treatment as prescribed, even if symptoms improve.
Report any severe diarrhea, skin rash, or signs of an allergic reaction immediately.
Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.

Missed Dose Advice

If a dose is missed, administer it as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and resume your 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 until they know how the medication affects them.