Ertapenem

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

1 g daily

PHARMACOKINETICS

  • Molecular weight                           :497.5 (as sodium)
  • %Protein binding                           :85–95
  • %Excreted unchanged in urine     : 38
  • Volume of distribution (L/kg)       :0.1
  • half-life – normal/ESRD (hrs)      :4/14

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–50 Dose as in normal renal function10–30 Use 50–100% of dose

  • <10           : Use 50% of dose, or 1 g 3 times a week. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Dialysed. Dose as in GFR
  • <10           : mL/min
  • HD                     :Dialysed. Dose as in GFR
  • <10           : mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR
  • <10           : mL/min
  • CAV/VVHD      :Dialysed. Dose as in GFR=10–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    10 mL water for injection or sodium chloride 0.9%

    Route

    IV, (IM – not licensed)

    Rate of Administration

    IV Infusion: 30 minutes

    Comments

    Dilute in sodium chloride 0.9% only Incompatible with glucose Dilute solutions are stable for 6 hours at room temperature or 24 hours in a refrigerator. Use within 4 hours of removal from refrigerator

    OTHER INFORMATION

    Approximately 30% of dose is dialysed after a 4 hour haemodialysis sessionAnother on-line reference source says that 100% of the dose can be used in people with a GFR of 10–50 mL/minAnecdotally ertapenem has been used at a dose of 1 g 3 times a weekGive at least 6 hours before haemodialysis session if unable to give post dialysis.

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