PRIMAXIN IV 250 Rx
Generic Name and Formulations:
Imipenem 250mg, cilastatin sodium 250mg; IV inj; sodium content 3.2mEq/g imipenem.
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.
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.
<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.
IM: Allergy to amide-type local anesthetics. Heart block. Severe shock.
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.
Concomitant ganciclovir (increased seizure risk), probenecid: not recommended. May antagonize valproic acid; monitor (consider alternative therapy).
Carbapenem (thienamycin) + dehydropeptidase I inhibitor.
Local reactions, GI upset, confusion, myoclonia, seizures, changes in serum electrolytes, dizziness, somnolence, anaphylaxis, blood dyscrasias, elevated liver enzymes, fever, rash, hypotension.