Imipenem + Cilastatin Sodium

What is imipenem + cilastatin sodium?

Imipenem + cilastatin sodium is a carbapenem antibiotic used to treat serious multidrug resistant bacterial infections in cats, dogs, and other animals. This medication should only be used in bacterial infections susceptible to the drug and when other classes of antibiotic have proven ineffective.

It is used off label (extra label) in veterinary medicine. Many drugs are commonly prescribed for off-label use in veterinary medicine. 

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet imipenem + cilastatin sodium?

• Imipenem + cilastatin sodium comes in an injectable form.
• Injections are given intravenously (into the vein) by your veterinarian.
• Give this medication exactly as prescribed and directed by your veterinarian.

This medication should start to take effect within a few hours; however, outward effects may not be immediately noticeable.

What if I miss giving my pet the medication?

Follow your veterinarian’s directions. Do not give the pet two doses at once.

Are there any potential side effects?

Imipenem + cilastatin sodium may cause the following side effects:

• Diarrhea, upset stomach, decreased appetite
• Pain at injection site

Serious adverse reactions may occur. If any of the following signs develop, stop giving imipenem + cilastatin sodium and contact your veterinarian immediately:

• An allergic reaction such as irregular breathing, rash, fever, puffiness and swelling around the face
• Signs of central nervous system (CNS) toxicity (e.g., tremors, seizures)

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses, but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, though effects may last longer in pets with kidney and/or liver disease.

Are there any risk factors for this medication?

DO NOT USE imipenem + cilastatin sodium in:

• Pets that are allergic to any component of the medication or allergic to similar drugs (e.g., meropenem)

USE WITH CAUTION in:

• Pets with kidney disease
• Pets with a history of seizures

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with imipenem + cilastatin sodium:

• Aminoglycosides (e.g., amikacin, gentamicin)
• Beta-lactam antibiotics
• Chloramphenicol
• Cyclosporine
• Ganciclovir
• Probenecid
• Theophylline
• Trimethoprim/sulfa

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• At home, monitor for any abnormal changes. If any occur, discontinue the medication and contact your veterinarian.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.

How do I store imipenem + cilastatin sodium?

• Store sterile powders for injection at room temperature less than 77°F (25°C).
• After reconstitution, the solution is stable for 4 hours at room temperature and 24 hours when refrigerated.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.