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Imipenem, cilastatin, and relebactam (Intravenous)

Generic Name: cilastatin/imipenem/relebactam (im-i-PEN-em, sye-la-STAT-in, rel-e-BAK-tam)

Medically reviewed by Drugs.com. Last updated on Aug 23, 2020.

Commonly used brand name(s)

In the U.S.

  • Recarbrio

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Antibiotic

Pharmacologic Class: Beta-Lactam

Chemical Class: Carbapenem

Uses for imipenem, cilastatin, and relebactam

Imipenem, cilastatin, and relebactam combination injection is used to treat complicated bacterial infections in many different parts of the body (eg, kidneys, stomach). Imipenem, cilastatin, and relebactam is also used to treat hospital-acquired and ventilator-associated bacterial pneumonia.

Imipenem, cilastatin, and relebactam is an antibiotic that works by killing bacteria or preventing their growth. It will not work for colds, flu, or other virus infections.

Imipenem, cilastatin, and relebactam is to be given only by or under the direct supervision of your doctor.

Before using imipenem, cilastatin, and relebactam

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For imipenem, cilastatin, and relebactam, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to imipenem, cilastatin, and relebactam or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of imipenem, cilastatin, and relebactam combination injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of imipenem, cilastatin, and relebactam combination injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving imipenem, cilastatin, and relebactam.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving imipenem, cilastatin, and relebactam, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using imipenem, cilastatin, and relebactam with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cholera Vaccine, Live
  • Ganciclovir
  • Theophylline
  • Valganciclovir
  • Valproic Acid

Using imipenem, cilastatin, and relebactam with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cyclosporine

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of imipenem, cilastatin, and relebactam. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to carbapenems, cephalosporins, beta-lactams, penicillins, or other allergens, history of or
  • Diarrhea—Use with caution. May make these conditions worse.
  • Brain disease (eg, lesions) or
  • Seizures, history of or
  • Stroke, history of—May increase risk of developing seizures.
  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of imipenem, cilastatin, and relebactam

A nurse or other trained health professional will give you imipenem, cilastatin, and relebactam in a medical facility. It is given through a needle placed into one of your veins. It must be given slowly, so the needle will have to stay in place for at least 30 minutes every 6 hours.

Precautions while using imipenem, cilastatin, and relebactam

It is very important that your doctor check your progress closely while you are receiving imipenem, cilastatin, and relebactam. This is to make sure that the medicine is working properly and that the infection is cleared up completely. Blood and urine tests may be needed to check for unwanted effects.

Imipenem, cilastatin, and relebactam may cause serious types of allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you have itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive imipenem, cilastatin, and relebactam.

Some patients may develop seizures while receiving imipenem, cilastatin, and relebactam. If you already have had stroke or a history of seizures and you are taking anticonvulsants, you should continue to take them unless otherwise directed by your doctor. Tell your doctor if you are also using divalproex sodium (Depakote®) or valproic acid (Depakene®).

Imipenem, cilastatin, and relebactam may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving imipenem, cilastatin, and relebactam. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Do not take other medicines unless thy have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Imipenem, cilastatin, and relebactam side effects

Along with its needed effects, a medicine 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 or nurse immediately if any of the following side effects occur:

More common

  • Confusion
  • decreased urine output
  • diarrhea
  • dizziness
  • dry mouth
  • fast or irregular heartbeat
  • headache
  • increased thirst
  • loss of appetite
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • numbness or tingling in the hands, feet, or lips
  • pale skin
  • seizures
  • swelling of the face, ankles, or hands
  • troubled breathing
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Less common

  • Agitation
  • black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • fever
  • hallucinations
  • lack of feeling or emotion
  • nervousness
  • pain, redness, or swelling at the injection site
  • pinpoint red spots on the skin
  • pounding in the ears
  • sleepiness or unusual drowsiness
  • slow heartbeat
  • slow speech
  • unusual excitement, nervousness, or restlessness

Incidence not known

  • Back or leg pains
  • chest pain or tightness
  • chills
  • clay-colored stools
  • cough or hoarseness
  • dark urine
  • difficulty swallowing
  • general body swelling
  • hives, itching, or skin rash
  • light-colored stools
  • lower back or side pain
  • nosebleeds
  • painful or difficult urination
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • reddening of the skin, especially around the ears
  • sores, ulcers, or white spots on the lips or in the mouth
  • sore throat
  • stomach cramps, pain, and tenderness
  • swollen glands
  • unpleasant breath odor
  • vomiting of blood
  • watery and severe diarrhea, which may also be bloody
  • yellow eyes or skin

Some side effects 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:

Less common

  • Constipation

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

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