Imipenem-Cilastatin Sodium
Also known as: Primaxin, Imipem, Klonam, Tenacid, Tienam, Tracix, Zienam
**What you need to know about Imipenem-Cilastatin:** * **Hospital Setting:** This is a highly specialized, potent antibiotic typically reserved for severe or highly resistant infections. It is almost exclusively administered in a veterinary hospital setting where your pet can be closely monitored. * **Administration:** It must be given by injection (usually through an IV catheter or into the muscle). If given into the muscle, it may cause some pain, so the veterinarian may mix it with a local anesthetic to make your pet more comfortable. * **Side Effects:** While generally safe when monitored, it can cause stomach upset (vomiting, loss of appetite, diarrhea). Rarely, it can cause neurological signs like tremors or seizures. **If you are visiting your pet and notice any twitching or unusual movements, notify the veterinary staff immediately.** * **Cost:** Because this is an advanced, human-grade hospital antibiotic, treatment can be quite expensive. Your veterinarian will discuss the estimated costs with you.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Susceptible infections
- Susceptible infections
- Tissue infections
- Sepsis, more resistant organisms
- Treatment of Nocardiosis
- Susceptible infections (Adult horses)
- Susceptible infections (Foals)
- Susceptible infections (Foals)
- Susceptible infections
- Susceptible infections
- Tissue infections
- Sepsis, more resistant organisms
- Treatment of Nocardiosis
How it is given
Possible side effects
- Gastrointestinal upset (vomiting, anorexia, diarrhea)
- CNS toxicity (seizures, tremors)
- Hypersensitivity reactions (pruritus, fever, anaphylaxis)
- Infusion reactions (thrombophlebitis)
- Severe pain and potential neurovascular damage at IM injection sites
- Transient increases in BUN, serum creatinine, AST, ALT, and Alkaline Phosphatase
- Hypotension or tachycardia (rare)
Cautions & contraindications
- Patients with known hypersensitivity to imipenem, cilastatin, or other beta-lactam antibiotics (due to partial cross-reactivity)
- Caution in patients with renal impairment (dosage adjustment required)
- Caution in patients with underlying CNS disorders (e.g., seizures, head trauma) due to increased risk of neurotoxicity
- **CRITICAL WARNINGS:** * **Do NOT administer via rapid IV infusion.** Rapid infusion significantly increases the risk of CNS toxicity and seizures. Doses ≤ 500 mg should be given over 20-30 minutes; doses > 500 mg should be given over 40-60 minutes. * **Formulation Specificity:** The IV and IM dosage forms are **NOT interchangeable**. If giving IM or SC, the specific IM product must be used. * **Renal Impairment:** Animals with reduced renal function (including neonates and geriatrics) are at a higher risk for seizures. Dosages may need to be reduced or dosing intervals extended. * **IM Administration:** Can cause severe pain. It is recommended to dilute the IM form in 1% lidocaine (without epinephrine) to relieve associated pain.
Drug interactions
- Aminoglycosides: Additive effects or synergy may result, particularly against Enterococcus, Staph. aureus, and Listeria monocytogenes. No synergy or antagonism noted against Enterobacteriaceae or Pseudomonas aeruginosa.
- Beta-Lactam Antibiotics: Antagonism may occur against several Enterobacteriaceae (including Pseudomonas aeruginosa, Klebsiella, Enterobacter, Serratia). Concurrent use is not recommended.
- Chloramphenicol: May antagonize the antibacterial effects of imipenem (based on in vitro evidence).
- Probenecid: May increase concentrations and elimination half-life of cilastatin, but not imipenem; concurrent use is not recommended.
- Trimethoprim/Sulfa: Synergy may occur against Nocardia asteroides when used in combination.
Frequently asked questions
What is Imipenem-Cilastatin Sodium used for in pets?
**What you need to know about Imipenem-Cilastatin:** * **Hospital Setting:** This is a highly specialized, potent antibiotic typically reserved for severe or highly resistant infections. It is almost exclusively administered in a veterinary hospital setting where your pet can be closely monitored. * **Administration:** It must be given by injection (usually through an IV catheter or into the muscle). If given into the muscle, it may cause some pain, so the veterinarian may mix it with a local anesthetic to make your pet more comfortable. * **Side Effects:** While generally safe when monitored, it can cause stomach upset (vomiting, loss of appetite, diarrhea). Rarely, it can cause neurological signs like tremors or seizures. **If you are visiting your pet and notice any twitching or unusual movements, notify the veterinary staff immediately.** * **Cost:** Because this is an advanced, human-grade hospital antibiotic, treatment can be quite expensive. Your veterinarian will discuss the estimated costs with you.
Is Imipenem-Cilastatin Sodium safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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