31–70 500 mg every 6–8 hours21–30 500 mg every 8–12 hours<20 250–500 mg (or 3.5 mg/kg whichever is lower) every 12 hours
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Dialysed. Dose as in GFR<20 mL/min
HD                     :Dialysed. Dose as in GFR<20 mL/min
HDF/high flux   :Dialysed. Dose as in GFR<20 mL/minCAV/VVhDialysed. 250 mg every 6 hours or 500 mg every 8 hours1CVVhd/HDFDialysed. 250 mg every 6 hours or 500 mg every 6–8 hours1
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Ciclosporin: variable reports of increase/ no change in ciclosporin levels, and of neurotoxicityConvulsions reported with concomitant administration of ganciclovir
ADMINISTRATION
Reconstition
250 mg with 50 mL, 500 mg with 100 mL sodium chloride 0.9% (in some units 500 mg with 50 mL)IM: 2 mL lidocaine 1%
Route
IM, IV peripherally or centrally (500 mg/50 mL – given centrally)
Rate of Administration
250 or 500 mg dose over 20–30 minutes 1 g over 40–60 minutes
Comments
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OTHER INFORMATION
Risk of adverse neurological effects, e.g. convulsions. Extreme caution required in patients with history of CNS diseaseCilastatin can accumulate in patients with impaired renal functionSodium content 1.72 mmol/500 mg vial Imipenem is administered with cilastatin to prevent metabolism of imipenem within the kidneyNon-renal clearance in acute renal failure is less than in chronic renal failurePatients with GFR<5 mL/min should not receive drug unless HD is started within 48 hours. Metabolised to inactive, nephrotoxic metabolites