Imipenem E Cilastatina Sun Pharma Italia Srl (Cilastatin, Imipenem)

Imipenem and Cilastatin is a broad‑spectrum carbapenem antibiotic used for serious bacterial infections.

• Complicated intra‑abdominal infections: provides bacterial eradication and clinical cure in patients with intra‑abdominal sepsis.
• Complicated urinary tract infections: eliminates resistant uropathogens and resolves infection signs.
• Skin and soft tissue infections: treats severe cellulitis and wound infections caused by susceptible organisms.
• Febrile neutropenia: offers empiric coverage against Gram‑negative and Gram‑positive pathogens in neutropenic patients.

• Imipenem binds to multiple penicillin‑binding proteins, inhibiting the final stages of peptidoglycan cross‑linking and causing bacterial cell wall rupture. Cilastatin is co‑administered to inhibit renal dehydropeptidase‑I, preventing rapid hydrolysis of imipenem and thereby increasing its plasma concentration and urinary excretion. The combined effect results in potent, time‑dependent bactericidal activity against a wide range of Gram‑negative, Gram‑positive and anaerobic organisms.

Imipenem and Cilastatin may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea: mild gastrointestinal upset.
• Diarrhea: watery or loose stools.
• Injection site pain: local discomfort at the infusion site.
• Rash: mild skin erythema.

Serious or Rare Side Effects

• Seizures: risk increases with high doses or renal impairment.
• Anaphylaxis: severe allergic reaction requiring immediate treatment.
• Clostridioides difficile colitis: antibiotic‑associated diarrhea.
• Neutropenia: marked reduction in white blood cells.

When using Imipenem and Cilastatin, clinicians should observe several precautionary measures to minimise risk.

• Renal function: adjust dose in patients with impaired kidney function.
• CNS effects: monitor for seizures, especially in patients with a history of epilepsy or high‑dose therapy.
• Hypersensitivity: avoid in individuals with known β‑lactam allergy.
• Electrolytes: correct hypokalemia and hypomagnesemia before infusion to reduce neurotoxicity.
• Concomitant antibiotics: use with caution when combined with other nephrotoxic or neurotoxic agents.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Imipenem and Cilastatin can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Valproic acid: concomitant use may reduce valproate levels and precipitate seizures.
• Monoamine oxidase inhibitors: carbapenems may increase risk of hypertensive crisis.

Moderate Interactions (Monitor Closely)

• Diuretics (e.g., furosemide): may increase risk of electrolyte disturbances and neurotoxicity.
• CNS depressants (e.g., phenobarbital): may lower seizure threshold.
• Other nephrotoxic drugs (e.g., aminoglycosides): heightened risk of renal impairment.
• Oral contraceptives: carbapenems may reduce hormonal efficacy, consider backup contraception.