Generic Name and Formulations:

Imipenem 250mg, cilastatin sodium 250mg; IV inj; sodium content 3.2mEq/g imipenem.

Company:

Merck & Co., Inc.
Indications for PRIMAXIN IV 250:

Serious susceptible infections including bacterial septicemia, lower respiratory tract, urinary tract, skin and skin structure, bone and joint, intraabdominal, gynecologic, polymicrobial infections, endocarditis.

Adult:

See literature. Base dose on imipenem component. Give by IV infusion. Uncomplicated UTI: 250mg every 6 hours. Complicated UTI: 500mg every 6 hours. Other infections: Mild: 250–500mg every 6 hours; moderate: 500mg every 6–8 hours or 1g every 8 hours; severe: 500mg–1g every 6 hours or 1g every 8 hours; max 50mg/kg per day or 4g/day (whichever is less). Reduce dose if CrCl ≤70mL/min or body wt <70kg. CrCl ≤5mL/min: not recommended unless hemodialysis starts within 48 hours.

Children:

<30kg and renal dysfunction: not recommended. Give by IV infusion. CNS infections: not recommended (seizure risk). Non-CNS infections (if ≥1.5kg): <1week of age: 25mg/kg every 12hours; 1–4weeks: 25mg/kg every 8hours; 4weeks–3months: 25mg/kg every 6hours; ≥3months: 15–25mg/kg every 6hours. Max 2g/day if susceptible or 4g/day if moderately susceptible; doses up to 90mg/kg per day have been used in older children with cystic fibrosis.

Contraindications:

IM: Allergy to amide-type local anesthetics. Heart block. Severe shock.

Warnings/Precautions:

Penicillin, cephalosporin, or other allergy. CNS disorders (esp. brain lesions or seizures). Renal impairment: reduce dose. Hemodialysis: see literature. GI disease (esp. colitis). IM: prepare with lidocaine (see literature). Pregnancy (Cat.C). Nursing mothers.

Interactions:

Concomitant ganciclovir (increased seizure risk), probenecid: not recommended. May antagonize valproic acid; monitor (consider alternative therapy).

See Also:

PRIMAXIN IV 500

PRIMAXIN IM 500

Pharmacological Class:

Carbapenem (thienamycin) + dehydropeptidase I inhibitor.

Adverse Reactions:

Local reactions, GI upset, confusion, myoclonia, seizures, changes in serum electrolytes, dizziness, somnolence, anaphylaxis, blood dyscrasias, elevated liver enzymes, fever, rash, hypotension.

How Supplied:

Vials (IV)—25
Vials (IM)—10