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藥碼
IMI03
藥名
Imipenem 針 500 mg
英文商品名
Imipenem 針 500 mg
中文商品名
疫必寧靜脈乾粉注射劑
螢幕名
Imipenem 針 500 mg
劑型
Inj
規格
Imipenem 500mg, Cilastatin 500mg
成分
藥理分類
Misc. beta-lactams
健保碼
BC26741277
ATC碼
J01DH51
J01DH
V03AX
藥品圖片
外觀圖片
適應症
Blood stream infection, bone and joint infections, gynecologic infections,intra-abdominal infection, health care-associated or high-risk community-acquired infection, intra-abdominal infections, pneumonia, skin and soft tissue infection, urinary tract infection (complicated and uncomplicated)
藥理
Antibiotic, Carbapenem
藥動學
Protein binding: Imipenem: ~20%; cilastatin: ~40%
Metabolism: Imipenem is metabolized in the kidney by dehydropeptidase I; cilastatin prevents imipenem metabolism by this enzyme.
Half-life elimination: IV: Both drugs: Prolonged with renal impairment:
Neonates: Imipenem: 1.7 to 2.4 hours; Cilastatin: 3.9 to 6.3 hours (Freij 1985)
Infants and Children: Imipenem: 1.2 hours (Blumer 1996)
Adults: ~60 minutes
Excretion: Both drugs: Urine (~70% as unchanged drug)
禁忌症
Hypersensitivity to imipenem/cilastatin or any component of the formulation
Documentation of allergenic cross-reactivity for carbapenems, penicillins, and cephalosporins is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.
懷孕分類
Imipenem and cilastatin cross the placenta .
哺乳分類
Imipenem is present in breast milk.
副作用
Decreased hematocrit, decreased hemoglobin, eosinophilia, thrombocythemia, increased serum AST, increased serum ALT
劑量和給藥方法
  • Traditional intermittent infusion method: IV 500 mg every 6 hours infused over 30 minutes or 1 g every 6 to 8 hours infused over 40 to 60 minutes.
  • Extended infusion method (off label): IV 500 mg to 1 g every 6 hours infused over 3 hours. May give a loading dose of 500 mg to 1 g over 30 minutes, especially when rapid attainment of therapeutic drug concentrations is desired (eg, sepsis).
    • 小兒調整劑量
  • General dosing, susceptible infection; severe infections: IV 60-100 mg/kg/day divided every 6 hours; maximum 4,000 mg/day
  • Burkholderia pseudomallei (melioidosis): IV Initial 60 to 100 mg/kg/day divided every 6 to 8 hours for at least 10 days; maximum 4,000 mg/day; continue parenteral therapy until clinical improvement, then switch to oral therapy if tolerated and/or appropriate
  • Intra-abdominal infection, complicated: IV 60 to 100 mg/kg/day divided every 6 hours; maximum 500 mg
  • Non-tuberculosis mycobacterium, cystic fibrosis: IV 15 to 20 mg/kg/dose every 12 hours; maximum 1,000 mg/dose
  • Peritonitis (peritoneal dialysis): Intraperitoneal Loading 250 mg/L; maintenance 50 mg/L
  • Pulmonary exacerbation, cystic fibrosis: IV 100 mg/kg/day divided every 6 hours; maximum 4,000 mg/day; efficacy may be limited due to rapid development of resistance
    • 腎功能調整劑量
    Usual dosing regimen of 500 mg Q6H:
  • CrCl >90 mL/minute: No dosage adjustment necessary.
  • CrCl 60-90 mL/minute: 400 mg Q6H
  • CrCl 30-60 mL/minute: 300 mg Q6H
  • CrCl 15-30 mL/minute: 200 mg Q6H
  • CrCl <15 mL/minute: Do not administer unless hemodialysis is instituted within 48 hours.

    Usual dosing regimen of 1,000 mg Q8H:
  • CrCl >90 mL/minute: No dosage adjustment necessary.
  • CrCl 60-90 mL/minute: 500 mg Q6H
  • CrCl 30-60 mL/minute: 500 mg Q8H
  • CrCl 15-30 mL/minute: 500 mg Q12H
  • CrCl <15 mL/minute: Do not administer unless hemodialysis is instituted within 48 hours.

    Usual dosing regimen of 1,000 mg Q6H:
  • CrCl>90 mL/minute: No dosage adjustment necessary.
  • CrCl 60-90 mL/minute: 750 mg Q8H
  • CrCl 30-60 mL/minute: 500 mg Q6H
  • CrCl 15-30 mL/minute: 500 mg Q12H
  • CrCl <15 mL/minute: Do not administer imipenem/cilastatin unless hemodialysis is instituted within 48 hours.

    End-stage renal disease (ESRD) on intermittent hemodialysis (IHD):
    Use the dosing recommendation for patients with a CrCl 15-30 mL/minute; administer dose after dialysis session and at intervals timed from the end of that dialysis session or 250 to 500 mg Q12H.

    Continuous renal replacement therapy (CRRT):
  • CVVH: Loading dose of 1 g followed by either 250 mg Q6H or 500 mgQ8H
  • CVVHD: Loading dose of 1 g followed by either 250 mg Q6H or 500 mg Q6-8H
  • CVVHDF: Loading dose of 1 g followed by either 250 mgQ6Hor 500 mg Q6H
    • 肝功能調整劑量
    There are no dosage adjustments provided in the manufacturer's labeling.
    安定性
    仿單:
    必須存放於 25°C 以下
    請將小瓶存放於外盒中以避光保存
    未開封保存期限 : 3 年
    溶解或稀釋後之溶液須立即使用，由溶解開始至完成輸注時間間隔不得超逾 2 小時。
    注射給藥指引
    給藥途徑
    IVD (靜脈滴注)
    靜脈輸注液
    再生溶液：NS、D5W (仿單)。稀釋溶液：NS、D5W (仿單)。
    每瓶稀釋液體積
    再生溶液：10mL；稀釋液添加至最終 100mL、濃度 5mg/mL (仿單)
    注射濃度
    給藥速率
    劑量<500mg：滴注時間需大於20-30分鐘；劑量>500mg：大於40-60分鐘 (仿單)
    安定性
    仿單:
    必須存放於 25°C 以下
    請將小瓶存放於外盒中以避光保存
    未開封保存期限 : 3 年
    溶解或稀釋後之溶液須立即使用，由溶解開始至完成輸注時間間隔不得超逾 2 小時。
    注意事項
    * NS：0.9%生理食鹽水； D5W：5%葡萄糖水； LR：乳酸林格氏液； 1/2NS：0.45%生理食鹽水； SWFI：注射用水
    藥袋資訊
    臨床用途
    抗生素
    主要副作用
    肝功能異常、骨髓功能異常(如貧血、血小板低下)等
    泡製方法
    儲存方式
    請置於 15-30℃ 乾燥處儲存，配置後室溫存放至多4小時、冷藏24小時。
    注意事項
    其他說明
    急首 b4 | 藥庫 注D11
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    健保藥價
    214
    自費價
    284.62
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