Cilastatin / Imipenem Side Effects

Medically reviewed by Drugs.com. Last updated on Jun 2, 2024.

Applies to cilastatin / imipenem: powder for solution.

Precautions

Some patients may develop tremors or seizures while receiving this medicine. If you already have a history of seizures and you are taking anticonvulsants, you should continue to take them unless otherwise directed by your doctor.

In some patients, imipenem and cilastatin combination may cause diarrhea.

• Severe diarrhea may be a sign of a serious side effect. Do not take any diarrhea medicine without first checking with your doctor . Diarrhea medicines may make your diarrhea worse or make it last longer.
• For mild diarrhea, diarrhea medicine containing kaolin (e.g., Kaopectate liquid) or attapulgite (e.g., Kaopectate tablets, Diasorb) may be taken. However, other kinds of diarrhea medicine should not be taken. They may make your 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 health care professional.

Serious side effects

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:

Other side effects

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:

For healthcare professionals

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

Local adverse events

• 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

• 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]

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

See also:

Further information

Cilastatin/imipenem side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer