PRIMAXIN IV 500 Rx
Generic Name and Formulations:
Imipenem 500mg, cilastatin sodium 500mg; IV inj; sodium content 3.2mEq/g imipenem.
Merck & Co., Inc.
Indications for PRIMAXIN IV 500:
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.
Carbapenem (thienamycin) + dehydropeptidase I inhibitor.
Concomitant ganciclovir (increased seizure risk), probenecid: not recommended. May antagonize valproic acid; monitor (consider alternative therapy).
Local reactions, GI upset, confusion, myoclonia, seizures, changes in serum electrolytes, dizziness, somnolence, anaphylaxis, blood dyscrasias, elevated liver enzymes, fever, rash, hypotension.
Clinical Pain Advisor Articles
- History of Migraine May Be Associated With Higher Risk for Cochlear Disorders
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Symptom Severity, Sensory Sensitivity May Indicate Pain Centralization in Chronic Overlapping Pain Conditions
- Prescribed Opioids Difficulties Scale Effective for Assessing Concerns of Patients With Chronic Pain
- Predictors of Opioid Overdose in High-Risk Users
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Methadone Improves Short-Term Outcomes Better Than Morphine in Neonatal Abstinence Syndrome
- Addressing Rare Headache Disorders: Acute Confusional Migraine
- Hospital-Owned Practices Associated With Positive Workplace Perceptions Among Staff
- Optimal Strategies for Opioid Weaning After Ambulatory Surgery
- Chinese Traditional Medicine Showed Effectiveness on Pain, Quality of Life in Advanced Cancer