Dosing Guidlines for Adults

Drug Detail for Adult Drugs


Imipenem

Antimicrobial Agents

Antibacterial Antibiotics

Miscellaneous Antibacterial Antibiotics


General Toxicity Notes
Excreted Unchanged %
20-70
Half-Life (NormalESRD) hours
1/4
Plasma Protein Binding %
13-21
Volume of Distribution L/kg
0.17-0.3
Dose for Normal Renal Function
0.25-1 g q6h
Second Dose
Adjustment for Renal Failure Method
D
Adjustment for Renal Failure GFR, mL/min >50 [Recommended Level]
100%[A]
Adjustment for Renal Failure GFR, mL/min 10-50 [Recommended Level]
50%[A]
Adjustment for Renal Failure GFR, mL/min <10 [Recommended Level]
25%[A]
Supplement for Dialysis [Recommendation Level]: IHD
IHD: Dose after dialysis
Supplement for Dialysis [Recommendation Level]: PD
PD: Dose for GFR <10
Supplement for Dialysis [Recommendation Level]: CRRT
CRRT: 500 mg q6h, [A]
References
Gibson TP, Demetriades JL, Bland JA. Imipenem/cilastatin: pharmacokinetic profile in renal insufficiency. Am J Med. 1985; 78: 54-61. [PMID: 3859216] / Golper TA, Gleason JR, Vincent HH, et al. Drug removal during high efficiency and high flux hemodialysis. Contemp Iss Nephrol. 1993; 27: 175-208. [PMID unavailable] / Keane WF, Everett ED, Golper TA, Gokal R, Halstenson C, Kawaguchi Y, et al. Peritoneal dialysis-related peritonitis treatment recommendations. 1993 update. The Ad Hoc Advisory Committee on Peritonitis Management. International Society for Peritoneal Dialysis. Perit Dial Int. 1993; 13: 14-28. [PMID: 8443273] / Konishi K, Suzuki H, Saruta T, Hayashi M, Deguchi N, Tazaki H, et al. Removal of imipenem and cilastatin by hemodialysis in patients with end-stage renal failure. Antimicrob Agents Chemother. 1991; 35: 1616-20. [PMID: 1929334] / Mueller BA, Scarim SK, Macias WL. Comparison of imipenem pharmacokinetics in patients with acute or chronic renal failure treated with continuous hemofiltration. Am J Kidney Dis. 1993; 21: 172-9. [PMID: 8430678] / St Peter WL, Redic-Kill KA, Halstenson CE. Clinical pharmacokinetics of antibiotics in patients with impaired renal function. Clin Pharmacokinet. 1992; 22: 169-210. [PMID: 1559311] / Tegeder I, Bremer F, Oelkers R, Schobel H, Sch&#252; ttler J, Brune K, et al. Pharmacokinetics of imipenem-cilastatin in critically ill patients undergoing continuous venovenous hemofiltration. Antimicrob Agents Chemother. 1997; 41: 2640-5. [PMID: 9420033] / Verbist L, Verpooten GA, Giuliano RA, Debroe ME, Buntinx AP, Entwistle LA, et al. Pharmacokinetics and tolerance after repeated doses of imipenem/cilastatin in patients with severe renal failure. J Antimicrob Chemother. 1986; 18 Suppl E: 115-20. [PMID: 3469184]
Toxicity Notes
Seizures in ESRD. Nonrenal clearance in acute renal failure is less than in chronic renal failure. Administered with cilastin to prevent nephrotoxicity of renal metabolite.