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Primaxin IM Side Effects

Generic name: cilastatin / imipenem

Medically reviewed by Drugs.com. Last updated on Jan 5, 2024.

Note: This document contains side effect information about cilastatin / imipenem. Some dosage forms listed on this page may not apply to the brand name Primaxin IM.

Applies to cilastatin / imipenem: powder for solution.

Serious side effects of Primaxin IM

Along with its needed effects, cilastatin / imipenem may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking cilastatin / imipenem:

More common

Less common

Rare

Other side effects of Primaxin IM

Some side effects of cilastatin / imipenem may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

For Healthcare Professionals

Applies to cilastatin / imipenem: injectable powder for injection, intramuscular powder for injection, intravenous powder for injection.

Local

Common (1% to 10%): Phlebitis/thrombophlebitis at the injection site

Uncommon (0.1% to 1%): Pain at the injection site, erythema at the injection site, vein induration, local pain and induration at the injection site

Frequency not reported: Infused vein infection, injection site irritation, injection site reaction[Ref]

Gastrointestinal

Drug-related nausea and/or vomiting appeared to occur more often in granulocytopenic patients than in nongranulocytopenic patients.[Ref]

Common (1% to 10%): Nausea, vomiting, diarrhea

Rare (0.01% to 0.1%): Pseudomembranous colitis

Very rare (less than 0.01%): Hemorrhagic colitis, gastroenteritis, abdominal pain, glossitis, tongue papillar hypertrophy, heartburn, increased salivation

Frequency not reported: Clostridium difficile-associated diarrhea, oral candidiasis, constipation

Postmarketing reports: Staining of the teeth and/or tongue[Ref]

Dermatologic

Common (1% to 10%): Rash (e.g., exanthematous)

Uncommon (0.1% to 1%): Pruritus, urticaria

Rare (0.01% to 0.1%): Erythema multiforme, angioedema/angioneurotic edema, exfoliative dermatitis

Very rare (less than 0.01%): Hyperhidrosis, skin texture changes, candidiasis

Postmarketing reports: Stevens-Johnson syndrome, toxic epidermal necrolysis

Beta-lactams:

-Frequency not reported: Severe cutaneous adverse reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms [DRESS], acute generalized exanthematous pustulosis)[Ref]

Hematologic

Common (1% to 10%): Eosinophilia

Uncommon (0.1% to 1%): Thrombocytosis, positive Coombs test, prolonged prothrombin time, decreased hemoglobin

Frequency not reported: Increased eosinophils, increased WBC, increased platelets, decreased hemoglobin and hematocrit, increased monocytes, abnormal prothrombin time, increased lymphocytes, increased basophils, decreased neutrophils, increased/decreased platelet count, increased/decreased hematocrit, anemia

Postmarketing reports: Pancytopenia, bone marrow depression, neutropenia, thrombocytopenia, leukopenia, hemolytic anemia, agranulocytosis[Ref]

Hepatic

Common (1% to 10%): Increased serum transaminases

Uncommon (0.1% to 1%): Increased bilirubin

Frequency not reported: Elevated ALT, elevated AST, increased/decreased bilirubin

Postmarketing reports: Hepatitis (including fulminant hepatitis), jaundice, hepatic failure[Ref]

Other

Common (1% to 10%): Increased alkaline phosphatase

Uncommon (0.1% to 1%): Fever

Very rare (less than 0.01%): Flushing, asthenia/weakness

Frequency not reported: Increased LDH, decreased serum sodium, increased potassium, increased chloride, facial edema, pain, superinfection

Postmarketing reports: Drug fever[Ref]

Nervous system

Uncommon (0.1% to 1%): Seizures, myoclonic activity, dizziness, somnolence

Rare (0.01% to 0.1%): Encephalopathy, paresthesia, focal tremor, hearing loss

Very rare (less than 0.01%): Exacerbation of myasthenia gravis, headache, vertigo, tinnitus

Frequency not reported: Myoclonus

Postmarketing reports: Tremor, dyskinesia, taste perversion[Ref]

Cardiovascular

Uncommon (0.1% to 1%): Hypotension

Very rare (less than 0.01%): Palpitations, tachycardia, cyanosis[Ref]

Psychiatric

Uncommon (0.1% to 1%): Confusion

Postmarketing reports: Psychic disturbances (including hallucinations), agitation

Renal

Uncommon (0.1% to 1%): Increased BUN, increased creatinine

Rare (0.01% to 0.1%): Oliguria/anuria

Postmarketing reports: Acute renal failure[Ref]

Genitourinary

Rare (0.01% to 0.1%): Polyuria

Very rare (less than 0.01%): Pruritus vulvae

Frequency not reported: Presence of urine protein, presence of urine red blood cells, presence of urine white blood cells, presence of urine casts, presence of urine bilirubin, presence of urine urobilinogen, increased urine protein, presence of urine bacteria

Postmarketing reports: Urine discoloration[Ref]

Hypersensitivity

Rare (0.01% to 0.1%): Anaphylactic reactions

Beta-lactams:

-Frequency not reported: Hypersensitivity (anaphylactic) reactions[Ref]

Respiratory

Very rare (less than 0.01%): Chest discomfort, dyspnea, hyperventilation, pharyngeal pain[Ref]

Musculoskeletal

Very rare (less than 0.01%): Polyarthralgia, thoracic spine pain[Ref]

References

1. Product Information. Primaxin (imipenem). Merck & Co., Inc. 2002;PROD.

2. Embil JM, Soto NE, Melnick DA. A post hoc subgroup analysis of meropenem versus imipenem/cilastatin in a multicenter, double-blind, randomized study of complicated skin and skin-structure infections in patients with diabetes mellitus. Clin Ther. 2006;28:1164-74.

3. Zhanel GG, Wiebe R, Dilay L, et al. Comparative Review of the Carbapenems. Drugs. 2007;67:1027-1052.

4. Calandra GB, Hesney M, Grad C. A multiclinic randomized study of the comparative efficacy, safety and tolerance of imipenem/cilastatin and moxalactam. Eur J Clin Microbiol. 1984;3:478-87.

5. Wang C, Calandra GB, Aziz MA, Brown KR. Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience. Rev Infect Dis. 1985;7:s528-36.

6. Lyon JA. Imipenem/cilastatin: the first carbapenem antibiotic. Drug Intell Clin Pharm. 1985;19:894-8.

7. Calandra GB, Brown KR, Grad LC, et al. Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin. Am J Med. 1985;78:73-8.

8. Young K. Imipenem/cilastatin. Pharm Ther Forum. 1986;34:1-3.

9. Clissold SP, Todd PA, Campoli-Richards DM. Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. Drugs. 1987;33:185-241.

10. Patel SA, Braun HL, Fine MS, et al. Imipenem-associated elevation of amylase and lipase. Am J Gastroenterol. 1989;84:80-1.

11. Schmitt DV, Leitner E, Welte T, Lode H. Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia-a Double Blind Prospective Multicentre Study. Infection. 2006;34:127-34.

12. Rivera M, Crespo M, Teruel JL, Marcen R, Ortuno J. Neurotoxicity due to imipenem/cilastatin in patients on continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant. 1999;14:258-9.

13. Chastre J, Wunderink R, Prokocimer P, Lee M, Kaniga K, Friedland I. Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized study. Crit Care Med. 2008;36:1089-96.

14. Larsen JW, Gabel-Hughes K, Kreter B. Efficacy and tolerability of imipenem-cilastatin versus clindamycin + gentamicin for serious pelvic infections. Clin Ther. 1992;14:90-6.

15. Semel JD, Allen N. Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole. South Med J. 1991;84:465-8.

16. Zazgornik J, Schein W, Heimberger K, et al. Potentiation of neurotoxic side effects by coadministration of imipenem to cyclosporine therapy in a kidney transplant recipient: synergism of side effects or drug. Clin Nephrol. 1986;26:265-6.

17. Eng RH, Munsif AN, Yangco BG, et al. Seizure propensity with imipenem. Arch Intern Med. 1989;149:1881-3.

18. Job ML, Dretler RH. Seizure activity with imipenem therapy: incidence and risk factors. DICP. 1990;24:467-9.

19. Duque A, Altimiras J, Garcia-Cases C, Vidal P. Vertigo caused by intravenous imipenem/cilastatin. DICP. 1991;25:1009.

20. Leo RJ, Ballow CH. Seizure activity associated with imipenem use: clinical case reports and review of the literature. DICP. 1991;25:351-4.

21. Oriordan J, Javed M, Doherty C, Hutchinson M. Worsening of myasthenia gravis on treatment with imipenem/cilastatin. J Neurol Neurosurg Psychiatry. 1994;57:383.

22. Lane M, Kania D, Rapp RP. Seizures related to use of imipenem-cilastatin. Am J Health Syst Pharm. 1996;53:1605-6.

23. Guglielmo BJ, Jacobs RA. Impact of dosage-monitoring system on frequency of seizures associated with imipenem-cilastatin. Am J Health Syst Pharm. 1996;53:2097-8.

24. Guglielmo BJ, Jacobs RA. Impact of dosage-monitoring system on frequency of seizures associated with imipenem-cilastatin. Am J Health Syst Pharm. 1996;53:1097-8.

25. Frucht S, Eidelberg D. Imipenem-induced myoclonus. Mov Disord. 1997;12:621-2.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.