Imipenem and Cilastatin Injection

Imipenem and cilastatin injection is used to treat certain serious infections that are caused by bacteria. 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.

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 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, 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.

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.

Before using imipenem and cilastatin injection,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.  
• you should know that some medications should not be taken with imipenem and cilastatin injection. Other medications may cause dosing changes or extra monitoring when taken with imipenem and cilastatin injection. Make sure you have discussed any medications you are currently taking or plan to take before starting imipenem and cilastatin injection with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking imipenem and cilastatin injection, please get the advice of your doctor or pharmacist.
• 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.

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

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 (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed and out of reach of children. Store vials at room temperature and away from excess heat and moisture (not in the bathroom). Store prepared solution in the refrigerator for up to 24 hours or at room temperature for up to 4 hours.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information

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

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.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the imipenem and cilastatin injection, call your doctor.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Primaxin^® (containing Cilastatin, Imipenem)