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.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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