Imipenem + Cylastatyna Ranbaxy (Cilastatin, Imipenem)

Imipenem/cilastatin is indicated for a range of serious bacterial infections that require broad‑spectrum intravenous therapy.

• Complicated intra‑abdominal infections: eradicates mixed aerobic and anaerobic pathogens to resolve infection.
• Complicated urinary tract infections: provides rapid bacterial clearance in resistant Gram‑negative infections.
• Nosocomial pneumonia: treats hospital‑acquired lung infections caused by multidrug‑resistant organisms.
• Skin and soft tissue infections: covers a wide spectrum of Gram‑positive and Gram‑negative bacteria.
• Septicemia: delivers bactericidal activity in bloodstream infections requiring immediate therapy.

• Imipenem binds to penicillin‑binding proteins, inhibiting the final stages of bacterial cell‑wall peptidoglycan synthesis, which leads to cell lysis. Cilastatin co‑administered intravenously inhibits renal dehydropeptidase I, preventing enzymatic degradation of imipenem and thereby maintaining therapeutic plasma concentrations.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Diarrhea: often self‑limiting, may be watery.
• Injection site pain: localized discomfort during infusion.
• Elevated liver enzymes: transient increase in transaminases.
• Rash: non‑specific skin eruption.
• Headache: mild, transient.

Serious or Rare Side Effects

• Seizures: especially in patients with renal impairment or high doses.
• Anaphylaxis: acute, potentially life‑threatening hypersensitivity.
• Clostridioides difficile colitis: severe diarrhea due to gut flora disruption.
• Neutropenia: marked reduction in white blood cells.
• Thrombocytopenia: low platelet count leading to bleeding risk.
• Renal dysfunction: worsening kidney function in susceptible individuals.

Use of imipenem/cilastatin requires careful clinical assessment and monitoring.

• Renal function: adjust dose in patients with impaired kidney function.
• Seizure risk: avoid high doses in patients with a history of seizures.
• Hypersensitivity: discontinue immediately if an allergic reaction occurs.
• Antibiotic stewardship: limit use to confirmed bacterial infections to reduce resistance.
• Pregnancy and lactation: assess risk‑benefit; limited data available.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Imipenem/cilastatin may interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Valproic acid: may reduce valproate levels, risking seizure breakthrough.
• Probenecid: can increase imipenem concentrations, heightening neurotoxicity.

Moderate Interactions (Monitor Closely)

• Diuretics (e.g., furosemide): may enhance nephrotoxic potential.
• Anticoagulants (e.g., warfarin): monitor INR as antibiotic may affect metabolism.
• Other nephrotoxic agents (e.g., aminoglycosides): assess renal function frequently.
• CNS depressants: observe for additive central nervous system effects.