Ertapenem Side Effects
Medically reviewed by Drugs.com. Last updated on Oct 21, 2023.
Applies to ertapenem: injection powder for solution.
Serious side effects of Ertapenem
Along with its needed effects, ertapenem 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 ertapenem:
- discoloration of skin
- feeling of pressure
- itching skin
- redness of skin
- skin rash
- unusually warm skin
- Bluish color changes in skin color
- dry, red, hot, or irritated skin
- fast, pounding, or irregular heartbeat or pulse
- pain, tenderness, or swelling of foot or leg
- Abdominal or stomach cramps
- abdominal tenderness
- diarrhea, watery and severe, which may also be bloody
- fainting or loss of consciousness
- fast or irregular breathing
- increased thirst
- loss of bladder control
- muscle spasm or jerking of all extremities
- sudden loss of consciousness
- swelling of eyes or eyelids
- tightness in chest
- trouble in breathing
- unusual tiredness or weakness
- unusual weight loss
Incidence not known
- difficulty swallowing
- itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
- seeing, hearing, or feeling things that are not there
- shortness of breath
Other side effects of Ertapenem
Some side effects of ertapenem 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:
- chest pain
- confusion about identity, place, and time
- mental depression
- Acid or sour stomach
- blurred vision
- body aches or pain
- difficult or labored breathing
- difficulty having a bowel movement (stool)
- dryness or soreness of throat
- faintness or lightheadedness when getting up from a lying or sitting position
- itching of the vagina or genital area
- lack or loss of strength
- leg pain
- pain during sexual intercourse
- pounding in the ears
- runny nose
- slow heartbeat
- sore mouth or tongue
- stomach discomfort, upset, or pain
- sudden sweating
- tender, swollen glands in neck
- thick, white vaginal discharge with no odor or with a mild odor
- tightness in chest
- trouble sleeping
- unable to sleep
- voice changes
- white patches in mouth and/or on tongue
For Healthcare Professionals
Applies to ertapenem: injectable powder for injection.
In general, most side effects were considered mild to moderate. The most common side effects were diarrhea, infused vein complication, nausea, headache, and vaginitis in females.[Ref]
Small intestinal obstruction, C difficile infection or colitis, dry mouth, and hematochezia were reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.[Ref]
Very common (10% or more): Diarrhea (up to 10.3%)
Common (1% to 10%): Nausea, abdominal pain, constipation, vomiting, small intestinal obstruction
Uncommon (0.1% to 1%): Clostridium difficile infection or colitis, dry mouth, hematochezia, gastrointestinal hemorrhage, acid regurgitation, dyspepsia, oral candidiasis, flatulence, C difficile-associated diarrhea, stomatitis, dysphagia, hemorrhoids, ileus, duodenitis, esophagitis, gastritis, mouth ulcer, pancreatitis, pyloric stenosis, pseudomembranous enterocolitis
Rare (0.01% to 0.1%): Fecal incontinence, pelvic peritonitis
Frequency not reported: Feces discolored, melena
Postmarketing reports: Teeth staining[Ref]
Common (1% to 10%): Increased ALT, increased AST, increased direct serum bilirubin, increased total serum bilirubin
Uncommon (0.1% to 1%): Increased indirect serum bilirubin, cholelithiasis, jaundice, increased direct and indirect serum bilirubin
Rare (0.01% to 0.1%): Cholecystitis, liver disorder, increased urobilinogen[Ref]
Common (1% to 10%): Infused vein complication, phlebitis/thrombophlebitis
Uncommon (0.1% to 1%): Injection site induration, injection site pain
Frequency not reported: Tenderness, ecchymosis, infusion site pain, infusion site burning, infusion site pruritus, infusion site erythema, injection site erythema, infusion site warmth, infusion site phlebitis, infusion site swelling[Ref]
Common (1% to 10%): Headache, dizziness
Uncommon (0.1% to 1%): Cerebrovascular accident, syncope, somnolence, seizure, tremor, hypesthesia, spasm, paresthesia, vertigo, taste perversion
Postmarketing reports: Coordination abnormal, depressed level of consciousness, dyskinesia, gait disturbance, myoclonus, tremor[Ref]
Cerebrovascular accident was reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.
In clinical trials, seizures were reported in 0.5% of patients, most often in patients with central nervous system disorders (e.g., brain lesions, seizure history) and/or renal dysfunction. A case report describes a patient on continuous ambulatory peritoneal dialysis who had multiple tonic-clonic seizures after receiving 2 doses of this drug.[Ref]
Common (1% to 10%): Wound infection, increased serum alkaline phosphatase, fever, edema/swelling, wound complication, death, postoperative infection
Uncommon (0.1% to 1%): Crepitations, abdominal abscess, fungal rash, pelvic abscess, incision site complication, incision site hemorrhage, intestinal stoma complication, anastomotic leak, seroma, wound dehiscence, wound secretion, abdominal distention, abdominal pain, chest pain, pain, chills, septicemia, septic shock, malaise, asthenia/fatigue, necrosis, candidiasis, fungal infection, positive Clostridium difficile toxin, increased urine bacteria, urine yeast present, weight loss, decreased serum potassium, decreased serum albumin, increased serum potassium, increased serum sodium, facial edema, extravasation, flank pain, flushing
Rare (0.01% to 0.1%): Decreased serum bicarbonate, postoperative wound infection, abortion, increased serum LDH, increased serum phosphorus
Frequency not reported: Hot flush[Ref]
Postoperative infection, wound infection, anastomotic leak, seroma, wound complication, wound dehiscence, wound secretion, crepitations, abdominal abscess, fungal rash, pelvic abscess, incision site complication, incision site hemorrhage, and intestinal stoma complication were reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.
In patients with complicated intraabdominal infections, death occurred in 4.7% (n=316) of patients receiving this drug and 2.6% of patients receiving comparator drug; however, these deaths were considered not drug-related.[Ref]
Anemia was reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.[Ref]
Common (1% to 10%): Increased platelet count, anemia, decreased hemoglobin, decreased hematocrit, increased eosinophils, decreased absolute neutrophil count, decreased platelet count
Uncommon (0.1% to 1%): Decreased segmented neutrophils, increased prothrombin time, increased activated partial thromboplastin time, decreased WBCs, increased segmented neutrophils, increased WBCs
Rare (0.01% to 0.1%): Increased monocytes, neutropenia, thrombocytopenia, decreased lymphocytes, increased band neutrophils, increased lymphocytes, increased metamyelocytes, increased myelocytes, atypical lymphocytes[Ref]
Common (1% to 10%): Altered mental status (includes agitation, confusion, disorientation, decreased mental acuity, changed mental status, somnolence, stupor), insomnia
Uncommon (0.1% to 1%): Anxiety, nervousness, depression, aggressive behavior, confusion
Rare (0.01% to 0.1%): Agitation
Postmarketing reports: Altered mental status (including agitation, aggression, delirium, disorientation, mental status changes), hallucinations
Common (1% to 10%): Urinary tract infection, vaginitis, increased urine RBCs, increased urine WBCs
Uncommon (0.1% to 1%): Dysuria, pollakiuria, vaginal pruritus, hematuria, urinary retention, bladder dysfunction, vaginal candidiasis, vulvovaginitis, increased urine epithelial cells
Rare (0.01% to 0.1%): Genital bleeding
Frequency not reported: Presence of urine protein[Ref]
Pneumonia, atelectasis, lung crackles, lung infiltration, pulmonary congestion, pulmonary embolism, and wheezing were reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.[Ref]
Common (1% to 10%): Atelectasis, dyspnea, pneumonia
Uncommon (0.1% to 1%): Lung crackles, lung infiltration, pulmonary congestion, pulmonary embolism, wheezing, cough, pharyngitis, rales/rhonchi, respiratory distress, pleural effusion, hypoxemia, bronchoconstriction, pharyngeal discomfort, epistaxis, pleuritic pain, asthma, hemoptysis, hiccups, voice disturbance
Rare (0.01% to 0.1%): Nasal congestion[Ref]
Common (1% to 10%): Rash, pruritus
Uncommon (0.1% to 1%): Cellulitis, erythema, sweating, dermatitis, desquamation, urticaria
Rare (0.01% to 0.1%): Dermatomycosis
Frequency not reported: Diaper dermatitis, petechiae
Postmarketing reports: Severe cutaneous adverse reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms [DRESS syndrome], acute generalized exanthematous pustulosis)[Ref]
Cellulitis was reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.[Ref]
Common (1% to 10%): Hypotension
Uncommon (0.1% to 1%): Heart failure, hematoma, chest pain, hypertension, tachycardia, cardiac arrest, bradycardia, arrhythmia, atrial fibrillation, heart murmur, ventricular tachycardia, asystole, subdural hemorrhage, sinus bradycardia
Rare (0.01% to 0.1%): Hemorrhage, increased blood pressure[Ref]
Common (1% to 10%): Increased serum creatinine
Uncommon (0.1% to 1%): Renal impairment, oliguria/anuria, increased BUN/serum urea
Rare (0.01% to 0.1%): Renal insufficiency, acute renal insufficiency, decreased serum creatinine[Ref]
Muscle spasms were reported in a study using 1 g of this drug for prophylaxis of surgical site infection after elective colorectal surgery.[Ref]
Uncommon (0.1% to 1%): Muscle spasms (greater than 0.5%), gout (greater than 0.1%), leg pain (greater than 0.1%)
Postmarketing reports: Muscular weakness[Ref]
Uncommon (0.1% to 1%): Dehydration, anorexia, increased serum glucose
Rare (0.01% to 0.1%): Hypoglycemia[Ref]
Uncommon (0.1% to 1%): Allergic reactions
Rare (0.01% to 0.1%): Allergy
Postmarketing reports: Anaphylaxis (including anaphylactoid reactions)[Ref]
Rare (0.01% to 0.1%): Scleral disorder
More about ertapenem
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Related treatment guides
1. Product Information. Invanz (ertapenem). Merck & Co., Inc. 2001.
2. Musson DG, Majumdar A, Holland S, et al. Pharmacokinetics of total and unbound ertapenem in healthy elderly subjects. Antimicrob Agents Chemother. 2004;48:521-4.
3. Pletz MW, Rau M, Bulitta J, et al. Ertapenem pharmacokinetics and impact on intestinal microflora, in comparison to those of ceftriaxone, after multiple dosing in male and female volunteers. Antimicrob Agents Chemother. 2004;48:3765-72.
4. Keating GM, Perry CM. Ertapenem: a review of its use in the treatment of bacterial infections. Drugs. 2005;65:2151-78.
5. Cerner Multum, Inc. UK Summary of Product Characteristics.
6. Mistry GC, Majumdar AK, Swan S, et al. Pharmacokinetics of ertapenem in patients with varying degrees of renal insufficiency and in patients on hemodialysis. J Clin Pharmacol. 2006;46:1128-38.
7. Zhanel GG, Wiebe R, Dilay L, et al. Comparative Review of the Carbapenems. Drugs. 2007;67:1027-1052.
8. Cerner Multum, Inc. Australian Product Information.
9. Itani KM, Wilson SE, Awad SS, Jensen EH, Finn TS, Abramson MA. Ertapenem versus cefotetan prophylaxis in elective colorectal surgery. N Engl J Med. 2006;355:2640-51.
10. Saidel-Odes L, Borer A, Riesenberg K, Smolyakov R, Schlaeffer F. History of cerebrovascular events: a relative contraindication to ertapenem treatment. Clin Infect Dis. 2006;43:262-3.
11. Kong V, Beckert L, Awunor-Renner C. A case of beta lactam-induced visual hallucination. N Z Med J. 2009;122:76-7.
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.