Imipenem and Cilastatin Injection

WHY is this medicine prescribed?

Imipenem and cilastatin injection is used to treat certain serious infections that are caused by bacteria, including endocarditis (infection of the heart lining and valves) and respiratory tract (including pneumonia), urinary tract, abdominal (stomach area), gynecological, blood, skin, bone, and joint infections. Imipenem is in a class of medications called carbapenem antibiotics. It works by killing bacteria. Cilastatin is in a class of medications called dehydropeptidase inhibitors. It works by helping imipenem stay active in your body for a longer period of time.

Antibiotics such as imipenem and cilastatin injection will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Are there OTHER USES for this medicine?

Imipenem and cilastatin injection is also sometimes used to treat patients who have fever and are at high risk for infection because they have a low number of white blood cells. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Imipenem and cilastatin injection comes as a powder to be mixed with liquid to be injected intravenously (into a vein) or intramuscularly (into a muscle). When imipenem and cilastatin is injected intravenously, it is usually infused (injected slowly) over a period of 20 minutes to 1 hour every 6 or 8 hours. When imipenem and cilastatin is given intramuscularly, it is injected into the muscles of the buttocks or thigh once every 12 hours. The length of treatment depends on the type of infection being treated. Your doctor will tell you how long to use imipenem and cilastatin injection. After your condition improves, your doctor may switch you to another antibiotic that you can take by mouth to complete your treatment.

You may receive imipenem and cilastatin injection in a hospital, or you may administer the medication at home. If you are using imipenem and cilastatin injection at home, use it at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or other healthcare provider to explain any part you do not understand. Use imipenem and cilastatin injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

If you will be using imipenem and cilastatin injection at home, your healthcare provider will show you how to use the medication. Be sure that you understand these directions, and ask your healthcare provider if you have any questions. Ask your healthcare provider what to do if you have any problems injecting imipenem and cilastatin injection.

You should begin to feel better during the first few days of treatment with imipenem and cilastatin injection. If your symptoms do not improve or if they get worse, call your doctor.

Use imipenem and cilastatin injection until you finish the prescription, even if you feel better. If you stop using imipenem and cilastatin injection too soon or if you skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

What SPECIAL PRECAUTIONS should I follow?

Before using imipenem and cilastatin injection,

• tell your doctor and pharmacist if you are allergic to imipenem or cilastatin; other carbapenem antibiotics such as doripenem (Doribax), ertapenem (Invanz), or meropenem (Merrem); local anesthetics such as bupivacaine (Exparel, Marcaine, Sensorcaine), etidocaine (Duranest), lidocaine, mepivacaine (Carbocaine, Prolocaine), or prilocaine (Citanest); cephalosporins such as cefaclor (Ceclor), cefadroxil (Duricef), or cephalexin (Keflex); other beta-lactam antibiotics such as penicillin or amoxicillin (Amoxil, Trimox, Wymox); any other medications; or any of the ingredients in imipenem and cilastatin injection. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: ganciclovir, probenecid (Probalan), or valproic acid (Depakene, Depakote). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever brain lesions, seizures, or kidney disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using imipenem and cilastatin injection, call your doctor.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Imipenem and cilastatin injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• diarrhea
• headache
• redness, pain, or swelling at the injection site

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment)
• hives
• itching
• rash
• difficulty breathing or swallowing
• blisters on the skin, mouth, nose, and eyes
• sloughing (shedding) of skin
• confusion
• seizures

Imipenem and cilastatin injection may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• confusion
• drooping eyelids
• seizures

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to imipenem and cilastatin injection.f

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.